TY - JOUR T1 - One Health WASH: an AMR-smart integrative approach to preventing and controlling infection in farming communities JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2022-011263 VL - 8 IS - 3 SP - e011263 AU - Chris E Pinto Jimenez AU - Sarai M Keestra AU - Pranav Tandon AU - Amy J Pickering AU - Arshnee Moodley AU - Oliver Cumming AU - Clare I R Chandler Y1 - 2023/03/01 UR - http://gh.bmj.com/content/8/3/e011263.abstract N2 - Summary boxWhile the One Health framework is now widely accepted as a strength in understanding antimicrobial resistance (AMR), its application in intervention design to prevent and control drug-resistant infections across humans, animals, and the environment remains weak.The potential for infection prevention and control measures to contribute to the AMR agenda is recognised in rhetoric, but evidence to guide action is patchy and uncoordinated.While water, sanitation, and hygiene (WASH) and on-farm biosecurity interventions are key strategies for preventing and controlling infections, they are frequently implemented separately for humans and animals. We argue for integration across these sectors to improve planning for AMR control.Prevention is a critical, yet neglected, cornerstone for the response to antimicrobial resistance (AMR).1 The importance of a multitude of preventative measures is recognised across the One Health spectrum, with attention drawn to the issue by multilateral institutions. The 2022 World Antimicrobial Awareness Week saw the World Health Organization, the Food and Agriculture Organization, the United Nations Environment Programme and the World Organisation for Animal Health focused their campaign on the theme ‘Preventing AMR together’ to improve awareness and understanding of AMR and encourage best practices.2 While a One Health framework is now promoted for conceptualising the complex problem of AMR, the evidence base of interventions designed within this rubric is thin. Outstanding questions remain, for example, about how best to prevent and control infection across humans, animals, and the environment.In public health, measures such as hygiene practices, biosecurity, vaccinations and other means to strengthen immunity, are commonly used to prevent and control infections. Highlighting the potential contribution of such measures to reducing AMR, the World Bank3 introduced the terms ‘AMR-sensitive’ and ‘AMR-specific’ to describe interventions that indirectly or directly contribute to reducing AMR, respectively. For example, measures to reduce the burden of … ER -