RT Journal Article
SR Electronic
T1 Setting the standard: multidisciplinary hallmarks for structural, equitable and tracked antibiotic policy
JF BMJ Global Health
JO BMJ Global Health
FD BMJ Publishing Group Ltd
SP e003091
DO 10.1136/bmjgh-2020-003091
VO 5
IS 9
A1 Kirchhelle, Claas
A1 Atkinson, Paul
A1 Broom, Alex
A1 Chuengsatiansup, Komatra
A1 Ferreira, Jorge Pinto
A1 Fortané, Nicolas
A1 Frost, Isabel
A1 Gradmann, Christoph
A1 Hinchliffe, Stephen
A1 Hoffman, Steven J
A1 Lezaun, Javier
A1 Nayiga, Susan
A1 Outterson, Kevin
A1 Podolsky, Scott H
A1 Raymond, Stephanie
A1 Roberts, Adam P
A1 Singer, Andrew C
A1 So, Anthony D
A1 Sringernyuang, Luechai
A1 Tayler, Elizabeth
A1 Rogers Van Katwyk, Susan
A1 Chandler, Clare I R
YR 2020
UL http://gh.bmj.com/content/5/9/e003091.abstract
AB There is increasing concern globally about the enormity of the threats posed by antimicrobial resistance (AMR) to human, animal, plant and environmental health. A proliferation of international, national and institutional reports on the problems posed by AMR and the need for antibiotic stewardship have galvanised attention on the global stage. However, the AMR community increasingly laments a lack of action, often identified as an ‘implementation gap’. At a policy level, the design of internationally salient solutions that are able to address AMR’s interconnected biological and social (historical, political, economic and cultural) dimensions is not straightforward. This multidisciplinary paper responds by asking two basic questions: (A) Is a universal approach to AMR policy and antibiotic stewardship possible? (B) If yes, what hallmarks characterise ‘good’ antibiotic policy? Our multistage analysis revealed four central challenges facing current international antibiotic policy: metrics, prioritisation, implementation and inequality. In response to this diagnosis, we propose three hallmarks that can support robust international antibiotic policy. Emerging hallmarks for good antibiotic policies are: Structural, Equitable and Tracked. We describe these hallmarks and propose their consideration should aid the design and evaluation of international antibiotic policies with maximal benefit at both local and international scales.