One Health communications and AMR: Policy, practice and politics

Thursday 1 July 2021, 3-4pm via zoom

Australia’s National Antimicrobial Resistance Strategy: 2020 & Beyond (2019) adopts a ‘One Health communications’ approach, resonating with international policy frameworks. Specifically, the strategy advocates for “coordinated action across all sectors where antimicrobials are used in the country, as well as close coordination with global action” (page 3). One Health is explained as the “interconnection between people, animals, plants and their shared environment” (page 5). The One Health approach is widely accepted and applied in many policy and communications framings of AMR, but presents some challenges for shared and agreed understanding. Moreover, to be effective, the practical and political dimensions of One Health policy settings need to be acknowledged and ‘baked in’.

This SSN roundtable event considers how One Health communications approaches might be profitably translated into action. Discussants will consider framings of One Health from the points of view of policy decision-making, health care practice and social research. They will also discuss how shared understanding of One Health can support goals and targets that will help us know that we are making a difference in efforts to mitigate AMR.

Join us for this opportunity to debate the ways forward for AMR policy and communications.

One Health AMR communications: What can we learn from medicines policy?

Dr Jonathan Dartnell, NPS MedicineWise

Video: https://youtu.be/qmoFbOmy8F0

AMR is not a new challenge. In Australia, the Antibiotic Guidelines was first published in 1979 to target and address emerging AMR concerns in Melbourne teaching hospitals. The guidelines became a precursor and catalyst for innovations in implementation science, as well as leadership, development and implementation of national policy. Implementation of early guidelines were supported with novel interventions such as sophisticated advertising, key opinion leaders, audit and feedback, and drug and therapeutic committees. The guidelines themselves grew to address all therapeutic areas. Academic detailing was trialled, tested and rolled out. The state of knowledge and commitment were captured in national policies including the Policy on the Quality Use of Medicines (QUM) in 1994, National Medicines Policy (NMP) in 2000 and National Strategy for QUM in 2002. The NMP aims to support the medicine needs of Australia and optimise health outcomes and economic objectives. It has been effective because effector arms have been in place to support the policy including the TGA, PBS and NPS MedicineWise. While Australians may not be aware of NMP, they recognise the importance of access to safe and efficacious medicines, which individuals and the community can afford.

The first (2015) and second (2020) National AMR Strategies have been well supported by stakeholders but community awareness is low. More importantly, Australians probably cannot articulate what they should expect from government policy in the way they could for medicines and NMP.

Jonathan Dartnell is Manager of Programs and Clinical Services at NPS MedicineWise. His stream develops national educational programs and resources to support the quality use of medicines in health priority areas. Prior to NPS he led the editorial and production teams at Therapeutic Guidelines, including the development of their first electronic products. Previously he led the drug usage evaluation program at Royal Melbourne Hospital while completing a PhD in that field. He began his career as a hospital pharmacist in Australia and the UK, and in pharmacy training in Belize.

The promises and pitfalls of polysemic ideas: ‘One Health’ and antimicrobial resistance policy in Australia and the UK (https://doi.org/10.1007/s11077-020-09390-3)

Dr Erik Baekkeskov, University of Melbourne 

Video: https://youtu.be/kPbzo4QJN-o

One Health has in recent years gained promotion by health authorities as the key strategy against emerging infectious disease challenges like antimicrobial resistance. In turn, recent social science scholarship posits that ambiguous (‘polysemic’) ideas are effective for coalition building between diverse stakeholders: their capacity to be interpreted differently attracts different interests. Hence, in search of political solutions to ‘wicked’ and similarly complex problems, deploying polysemic ideas would be critical to effective policy-making. A recent article by the presenter and co-author Adam Hannah scopes the policy-making potential of polysemic ideas by examining the impact of ‘One Health’ on responses to AMR in Australia and the UK. It offers two primary arguments. Firstly, One Health is a polysemic idea, and can help mobilise broad attention to complex problems; since One Health became associated with AMR, political and administrative attention has grown more intense and coordinated than previously. Secondly, however, a polysemic idea alone may be insufficient to generate effective action: the contrast between Australian and UK AMR policies illustrates that polysemic ideas do not suspend interests, institutions, or ideas that can be readily deployed.

Erik Baekkeskov is a Senior Lecturer in Public Policy at The University of Melbourne. He researches and teaches policy-making at the intersection of public health and crisis management. His theoretical work has particularly focused on roles of science and experts, and related logics of decision-making. His empirical work has focused on cases of pandemics and other health threats, including the 2009 H1N1 pandemic, 2014 Ebola, 2020 COVID-19, and the growing antimicrobial resistance crisis. His work is published in leading public policy, public administration, and public health journals and volumes.

One Health approach - applications for an effective public health response to AMR

Dr Mihaela Ivan, Victorian Department of Health and Human Services

Video: https://youtu.be/86lKGDTqMp4

Stakeholder engagement and clear communication are essential in developing effective health policies and public health interventions. The application of a ‘One Health’ approach in the public health response to AMR will be explored, with a focus on policy development and integrated surveillance systems.

Dr Mihaela Ivan is the Policy Advisor AMR/Senior Medical Advisor in the Department of Health.  In her current role Dr Ivan is leading the department’s public health response to AMR. She is a public health physician and medical epidemiologist with over 20 years work experience in public health, and expertise in prevention and control of communicable diseases, policy development and epidemiological and clinical research.