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National action to combat AMR: a One-Health approach to assess policy priorities in action plans
  1. Anju Ogyu1,
  2. Olivia Chan1,
  3. Jasper Littmann2,
  4. Herbert H Pang1,
  5. Xia Lining3,
  6. Ping Liu1,
  7. Nobuaki Matsunaga4,
  8. Norio Ohmagari4,
  9. Keiji Fukuda1,
  10. Didier Wernli1,5
  1. 1 School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
  2. 2 Norwegian Institute of Public Health, Oslo, Norway
  3. 3 College of Veterinary Medicine, Xinjiang Agricultural University, Ulumuqi, China
  4. 4 AMR Clinical Reference Center, National Center for Global Health and Medicine, Shinjuku-ku, Japan
  5. 5 Global Studies Institute, University of Geneva, Geneva, Switzerland
  1. Correspondence to Anju Ogyu; anjuo{at}


Little is known about the overall trend and prioritisations of past and current antimicrobial resistance (AMR) policies. Here we introduce a quantitative method to analyse AMR policies. The AMR-Policy Analysis Coding Toolkit (AMR-PACT) uses several categorical variables. Thirteen AMR action plans from five countries (China, Japan, Norway, the UK and the USA) were used to develop the tool and identify possible values for each variable. The scope and capability of AMR-PACT is demonstrated through the 2015 WHO’s Global Action Plan and 2017 Hong Kong AMR Action Plan (HKAP). Majority of policies were aimed at either human or animal sector with less attention given to the environment, plant or food sector. Both plans shared the same two strategic focus areas, namely the conservation of antibiotics and the improved surveillance of resistance. There were no policies dedicated to improving access to antibiotics in the HKAP. These empirical results provide useful insights into the priorities and gaps of AMR policies. The method proposed here can help understand countries’ priorities regarding AMR, support the creation of AMR policy database and foster innovative policymaking.

  • medical microbiology
  • health policy
  • other study design

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  • Contributors KF and DW designed the study. All authors contributed to the design of the methodology. AO and OC collected the data. DW, KF, AO, OC and HHP analysed and interpreted the data. DW, AO and OC drafted the article. Critical revision of the article was conducted by DW, AO, HHP, JL, NM, NO, XL and KF.

  • Funding This work was supported with funding from the Policy Innovation and Co-ordination Office of the Government of Hong Kong Special Administrative Region under the Strategic Public Policy Funding Scheme (S2017.A8.005.17S).

  • Disclaimer The funders had no role in the study design, data collection, data analysis, data interpretation or writing of this publication.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data, database and codebook are available upon request.

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