title: Exploring the evidence base for national and regional policy interventions to combat resistance.
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.
authors.affiliation: Public Health England, London, UK; Chatham House Centre on Global Health Security, London, UK. Electronic address: osman.dar@phe.gov.uk.
authors.forename: Osman A
authors.initials: OA
authors.lastname: Dar
authors.affiliation: Aga Khan University, Karachi, Pakistan.
authors.forename: Rumina
authors.initials: R
authors.lastname: Hasan
authors.affiliation: School of Chemical & Biomedical Engineering, Nanyang Technological University, Singapore.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Schlundt
authors.affiliation: University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Harbarth
authors.affiliation: Médecins Sans Frontières, London, UK.
authors.forename: Grazia
authors.initials: G
authors.lastname: Caleo
authors.affiliation: Arabian Gulf University, Manama, Bahrain.
authors.forename: Fazal K
authors.initials: FK
authors.lastname: Dar
authors.affiliation: Christian Albrechts University, Kiel, Germany.
authors.forename: Jasper
authors.initials: J
authors.lastname: Littmann
authors.affiliation: Southern African Centre for Infectious Disease Surveillance, Sokoine University of Agriculture, Morogoro, Tanzania.
authors.forename: Mark
authors.initials: M
authors.lastname: Rweyemamu
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Emmeline J
authors.initials: EJ
authors.lastname: Buckley
authors.affiliation: Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, India.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Shahid
authors.affiliation: Royal Veterinary College, London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Kock
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Henry Lishi
authors.initials: HL
authors.lastname: Li
authors.affiliation: Arabian Gulf University, Manama, Bahrain.
authors.forename: Haydar
authors.initials: H
authors.lastname: Giha
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK; Research Alliance for Advocacy and Development, Karachi, Pakistan.
authors.forename: Mishal
authors.initials: M
authors.lastname: Khan
authors.affiliation: Sanford School of Public Policy and Duke Global Health Institute, Duke University, Durham, NC, USA.
authors.forename: Anthony D
authors.initials: AD
authors.lastname: So
authors.affiliation: Arabian Gulf University, Manama, Bahrain.
authors.forename: Khalid M
authors.initials: KM
authors.lastname: Bindayna
authors.affiliation: London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Anthony
authors.initials: A
authors.lastname: Kessel
authors.affiliation: WHO Regional Office for Europe, Copenhagen, Denmark.
authors.forename: Hanne Bak
authors.initials: HB
authors.lastname: Pedersen
authors.affiliation: WHO Regional Office for Europe, Copenhagen, Denmark.
authors.forename: Govin
authors.initials: G
authors.lastname: Permanand
authors.affiliation: University College London, London, UK; National Institute for Health Research Biomedical Research Centre, University College Hospitals NHS Trust, London, UK.
authors.forename: Alimuddin
authors.initials: A
authors.lastname: Zumla
authors.affiliation: 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.
authors.forename: John-Arne
authors.initials: JA
authors.lastname: Røttingen
authors.affiliation: Public Health England, London, UK; Chatham House Centre on Global Health Security, London, UK; London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: David L
authors.initials: DL
authors.lastname: Heymann
mesh_terms: D000822:Animal Husbandry / Q000379:methods; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000458:organization & administration / Q000592:standards; D024881:Drug Resistance, Bacterial; D019317:Evidence-Based Medicine; D018166:Health Care Reform; D006291:Health Policy; D006293:Health Promotion; D006801:Humans; D017053:Infection Control / Q000379:methods; D015397:Program Evaluation
chemical_list: D000900:Anti-Bacterial Agents