LSE academics develop tool to help combat global Antimicrobial Resistance

Microbes are constantly adapting to resist our attempts to fight them, so it is vital that policies put in place to combat AMR are also flexible
- Dr Michael Anderson
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Academics from LSE and the European Centre for Disease Prevention and Control (ECDC) have developed a comprehensive governance framework to combat Antimicrobial Resistance (AMR). The framework, published in The Lancet, sets out the 18 steps that will enable policy makers globally to put in place the right policies, tools and processes of evaluation to effectively combat AMR[1]. 

Antimicrobial resistance (AMR) - the ability of a microbe to resist the effects of medication that once could successfully treat the microbe - is one of the most pressing and complex issues the world faces today. The drivers of AMR operate across the human, animal and environmental health sectors, making the development and management of policies to combat AMR particularly challenging. To tackle this problem, the World Health Organisation has asked that every country develop and implement a national action plan. 

The new framework is designed to enable policy makers to develop and improve their AMR National Action Plans (NAP), to ensure the right tools are in place to implement each plan, and to increase accountability. Policy design is concerned with issues such as wide participation, coordination across multiple sectors and defining who is responsible and what accountability mechanisms exist. Implementation consists of essential interventions such as surveillance, antimicrobial stewardship, infection prevention and control, and the research and develop of novel antimicrobials and alternatives. Finally, to ensure that NAPs can adapt and continually improve, the framework outlines steps for monitoring and evaluation to ensure that NAPs can continually adapt and improve. 

Professor Elias Mossialos, Head of the Department of Health Policy at LSE and senior author of the study said: “We are proud to publish a comprehensive AMR governance framework which can provide essential guidance to countries looking to improve their national action plans.” 

Dr. Michael Anderson, Research Officer at the Department of Health Policy at LSE and lead author of the study, said: “A key challenge to combating AMR is that microbes are constantly adapting and evolving to resist our attempts to fight them. It is therefore vital that any policies put in place to combat AMR are also flexible and dynamic. A major advantage of this framework is its cyclical nature which allows for continuous improvement and adaptation of national action plans. This means the framework is responsive to different contexts and equally applicable to countries with varying experience in developing national action plans.” 

To develop and refine the framework, the authors reviewed health system frameworks, international guidance from the WHO, the Food and Agriculture Organisation, the World Organisation for Animal Health, and the European Commission, and sought the input of 25 experts from international organisations, government ministries, policy institutes, and academic institutions. The result is a tool which can be used by countries seeking to strengthen governance both during the development and assessment of national action plans on AMR. 

Read ‘A governance framework for development and assessment of national action plans on antimicrobial resistance.'

Behind the article

[1] The framework sets out 18 areas under three governance areas: 

Policy design: Strategic vision; Participation; Coordination; Accountability; Transparency; Sustainability; Equity.
Implementation tools: Surveillance; Antimicrobial stewardship; Infection prevention and control; Education; Public awareness; Medicines regulation; Fostering R&D and facilitating; Market access to novel products.
Monitoring and evaluation: Reporting; Feedback mechanisms; Effectiveness; AMR research.