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Lancet. 2016 Jan 16;387(10015):285-95. doi: 10.1016/S0140-6736(15)00520-6. Epub 2015 Nov 18.

Exploring the evidence base for national and regional policy interventions to combat resistance.

Author information

1
Public Health England, London, UK; Chatham House Centre on Global Health Security, London, UK. Electronic address: osman.dar@phe.gov.uk.
2
Aga Khan University, Karachi, Pakistan.
3
School of Chemical & Biomedical Engineering, Nanyang Technological University, Singapore.
4
University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
5
Médecins Sans Frontières, London, UK.
6
Arabian Gulf University, Manama, Bahrain.
7
Christian Albrechts University, Kiel, Germany.
8
Southern African Centre for Infectious Disease Surveillance, Sokoine University of Agriculture, Morogoro, Tanzania.
9
London School of Hygiene & Tropical Medicine, London, UK.
10
Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, India.
11
Royal Veterinary College, London, UK.
12
London School of Hygiene & Tropical Medicine, London, UK; Research Alliance for Advocacy and Development, Karachi, Pakistan.
13
Sanford School of Public Policy and Duke Global Health Institute, Duke University, Durham, NC, USA.
14
WHO Regional Office for Europe, Copenhagen, Denmark.
15
University College London, London, UK; National Institute for Health Research Biomedical Research Centre, University College Hospitals NHS Trust, London, UK.
16
Norwegian Institute of Public Health, Oslo, Norway; Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA; Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
17
Public Health England, London, UK; Chatham House Centre on Global Health Security, London, UK; London School of Hygiene & Tropical Medicine, London, UK.

Abstract

The effectiveness of existing policies to control antimicrobial resistance is not yet fully understood. A strengthened evidence base is needed to inform effective policy interventions across countries with different income levels and the human health and animal sectors. We examine three policy domains-responsible use, surveillance, and infection prevention and control-and consider which will be the most effective at national and regional levels. Many complexities exist in the implementation of such policies across sectors and in varying political and regulatory environments. Therefore, we make recommendations for policy action, calling for comprehensive policy assessments, using standardised frameworks, of cost-effectiveness and generalisability. Such assessments are especially important in low-income and middle-income countries, and in the animal and environmental sectors. We also advocate a One Health approach that will enable the development of sensitive policies, accommodating the needs of each sector involved, and addressing concerns of specific countries and regions.

PMID:
26603921
DOI:
10.1016/S0140-6736(15)00520-6
[Indexed for MEDLINE]

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