73 research outputs found
Governing Antimicrobial Resistance (AMR) in a Changing Climate: A Participatory Scenario Planning Approach Applied to Sweden in 2050
Background: Antimicrobial resistance (AMR) is a growing global crisis with long-term and unpredictable health, social and economic impacts, with which climate change is likely to interact. Understanding how to govern AMR amidst evolving climatic changes is critical. Scenario planning offers a suitable approach. By envisioning alternative futures, stakeholders more effectively can identify consequences, anticipate problems, and better determine how to intervene. This study explored future worlds and actions that may successfully address AMR in a changing climate in a high-income country, using Sweden as the case.Methods: We conducted online scenario-building workshops and interviews with eight experts who explored: (1) how promising interventions (taxation of antimicrobials at point of sale, and infection prevention measures) could each combat AMR in 2050 in Sweden given our changing climate; and (2) actions to take starting in 2030 to ensure success in 2050. Transcripts were thematically analyzed to produce a narrative of participant validated alternative futures.Results: Recognizing AMR to be a global problem requiring global solutions, participants looked beyond Sweden to construct three alternative futures: (1) âTax Burn Outâ revealed taxation of antimicrobials as a low-impact intervention that creates inequities and thus would fail to address AMR without other interventions, such as infection prevention measures. (2) âAddressing the Basicsâ identified infection prevention measures as highly impactful at containing AMR in 2050 because they would contribute to achieving the Sustainable Development Goals (SDGs), which would be essential to tackling inequities underpinning AMR and climate change, and help to stabilize climate-induced mass migration and conflicts; and (3) âSiloed Nationsâ described a movement toward nationalism and protectionism that would derail the âAddressing the Basicsâ scenario, threatening health and wellbeing of all. Several urgent actions were identified to combat AMR long-term regardless which future un-folds, such as global collaboration, and a holistic approach where AMR and climate change are addressed as interlinked issues.Conclusion: Our participatory scenario planning approach enabled participants from different sectors to create shared future visions and identify urgent actions to take that hinge on global collaboration, addressing AMR and climate change together, and achieving the SDGs to combat AMR under a changing climate
Factors influencing antimicrobial resistance in the European food system and potential leverage points for intervention: A participatory, One Health study
Introduction Antimicrobial resistance (AMR) is a global crisis that evolves from a complex system of factors. Understanding what factors interact is key to finding solutions. Our objective was to identify the factors influencing AMR in the European food system and places to intervene. Materials and methods We conducted two workshops involving participants with diverse perspectives to identify the factors influencing AMR and leverage points (places) to target interventions. Transcripts were open coded for factors and connections, then transcribed into Vensim 8.0.4 to develop a causal loop diagram (CLD) and compute the number of feedback loops. Thematic analysis followed to describe AMR dynamics in Europeâs food system and places for intervention. The CLD and themes were confirmed via participant feedback. Results Seventeen participants representing human, animal and agricultural sectors identified 91 CLD factors and 331 connections. Seven themes (e.g., social and economic conditions) describing AMR dynamics in Europeâs food system, five âoverarching factorsâ that impact the entire CLD system (e.g., leadership) and fourteen places for intervention (e.g., consumer demand) emerged from workshop discussions. Most leverage points fell on highly networked feedback loops suggesting that intervening at these places may create unpredictable consequences. Conclusions Our study produced a CLD of factors influencing AMR in Europeâs food system that implicates sectors across the One Health spectrum. The high connectivity between the CLD factors described by participants and our finding that factors are connected with many feedback mechanisms underscores the complexity of the AMR problem and the challenge with finding long-term solutions. Identifying factors and feedbacks helped identify relevant leverage points in the system. Some actions, such as governmentâs setting AMU standards may be easier to implement. These actions in turn can support multi-pronged actions that can help redefine the vision, values and goals of the system to sustainably tackle AMR
A Call for Action: The Application of the International Health Regulations to the Global Threat of Antimicrobial Resistance
Stephen Harbarth and colleagues argue that the International Health Regulations
(IHR) should be applied to the global health threat of antimicrobial
resistance
Factors impacting antimicrobial resistance in the South East Asian food system and potential places to intervene: A participatory, one health study
BackgroundWith AMU projected to increase, South East Asia (SEA) is at high risk of experiencing disproportionate health, social, and economic burdens due to antimicrobial resistance (AMR). Our objective was to identify factors influencing AMR in SEAâs food system and places for intervention by integrating the perspectives of experts from the region to inform policy and management decisions.Materials and methodsWe conducted two 6.5âh workshops and two 90-min interviews involving 18 AMR and other disciplinary experts from human, animal, and environment sectors who brainstormed the factors influencing AMR and identified leverage points (places) for intervention. Transcripts and workshop materials were coded for factors and their connections and transcribed into a causal loop diagram (CLD). Thematic analysis described AMR dynamics in SEAâs food system and leverage points for intervention. The CLD and themes were confirmed via participant feedback.ResultsParticipants constructed a CLD of AMR in the SEA food system that contained 98 factors interlinked by 362 connections. CLD factors reflected eight sub-areas of the SEA food system (e.g., government). Seven themes [e.g., antimicrobial and pesticide use and AMR spread (n =â40 quotes)], six âoverarching factorsâ that impact the entire AMR system [e.g., the drive to survive (n =â12 quotes)], and 10 places for intervention that target CLD factors (n =â5) and overarching factors (n =â2) emerged from workshop discussions.ConclusionThe participant derived CLD of factors influencing AMR in the SEA food system demonstrates that AMR is a product of numerous interlinked actions taken across the One Health spectrum and that finding solutions is no simple task. Developing the model enabled the identification of potentially promising leverage points across human, animal, and environment sectors that, if comprehensively targeted using multi-pronged interventions, could evoke system wide changes that mitigate AMR. Even targeting some leverage points for intervention, such as increasing investments in research and capacity building, and setting and enforcing regulations to control antimicrobial supply, demand, and use could, in turn, shift mindsets that lead to changes in more difficult to alter leverage points, such as redefining the profit-driven intent that drives system behavior in ways that transform AMU and sustainably mitigate AMR
Precision global health : a roadmap for augmented action
With increased complexity in various global health challenges comes a need for increased
precision and the adoption of more tailored health interventions. Building on precision public health, we
propose precision global health (PGH), an approach that leverages life sciences, social sciences, and data
sciences, augmented with artificial intelligence (AI), in order to identify transnational problems and deliver
targeted and impactful interventions through integrated and participatory approaches. With more than four
billion Internet users across the globe and the accelerating power of AI, PGH taps on our current augmented
capacity to collect, integrate, analyse and visualise large volumes of data, both non-specific and specific to
health. With the support of governments and donors, and together with international and non-governmental
organisations, universities and research institutions can generate innovative solutions to improve health and
wellbeing of the most vulnerable populations around the world. In line with the Sustainable Development
Goals, we propose here a road map for the development and implementation of PGH.https://jphe.amegroups.compm2021Immunolog
Global governance of antimicrobial resistance: anatomy of a regime complex
Antimicrobial resistance has attracted growing attention as a global challenge that not only crosses national borders but also sectoral boundaries. Like many contemporary issues, antimicrobial resistance is governed globally by an array of norms, policies and institutions without central control. Drawing on an interdisciplinary approach from medicine and international relations/law, this doctoral dissertation aims to understand the nature and extent of the âregime complexâ on antimicrobial resistance based on the analysis of primary documents from international organizations. In addition to the main manuscript, this dissertation is constituted of three articles published in peer-reviewed journals and a report produced for the UN Interagency Coordination Group on Antimicrobial Resistance
Renforcer la rĂ©siliÂence des systĂšÂmes de santĂ© face aux maladies infectieuses
Le COVID-19 et la rĂ©sistance antimicrobienne sont des dĂ©fis sanitaires mondiaux trĂšs diffĂ©rents, mais les deux rĂ©vĂšlent les vulnĂ©rabilitĂ©s des systĂšmes de santĂ© et sont fortement connectĂ©s Ă dâautres aspects, tels que lâinnovation dans le domaine des technologies de la santĂ© et lâaccĂšs Ă ces derniĂšres. Afin de tirer certaines leçons de la pandĂ©mie de COVID-19, cet article identifie un cadre commun pour aborder ces dĂ©fis et il soutient quâil convient de saisir lâĂ©lan politique actuel Ă lâĂ©gard du COVID- 19 pour renforcer la rĂ©silience des systĂšmes de santĂ© face aux maladies infectieuses
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