What is needed to improve One Health approaches? UK perspectives
This webinar is presented by Paul Flowers, Professor of Health Change at the University of Strathclyde, Scotland, UK. He is a fellow of the Academy of Social Scientists and is a behavioural and implementation scientist working across infectious disease and public health fields (e.g., HIV, COVID-19, AMR, Pandemic Influenza, sexually transmitted infections) usually in relation to the development and evaluation of complex interventions. He co-chairs the Behavioural sub group of the UK’s Advisory Committee on Antimicrobial Prescribing, Resistance and Healthcare Associated Infection.
Abstract
Synthesising experts’ perspectives of what is needed to deliver One Health antimicrobial resistance approaches
Paul Flowers, Rebecca Laidlaw, Fraser Smith, Jeni Park, Caroline King, Adele Dickson, Lucyna Gozdzielewska, Val Ness, Kareena McAloney-Kocaman, Mairi Young, Lesley Price, Kay Currie and Mark Davis
Background: One Health approaches to reduce antimicrobial resistance (AMR) are widely recognised as vital for the future but far less is known about their implementation across diverse real-world settings. This paper uses contemporary behavioural and implementation science to explore experts’ ideas of what could help, or hinder, the future implementation of One Health AMR approaches.
Methods: A heterogeneous sample of 20 ‘experts’ within the UK AMR field were interviewed about their knowledge and experience of putting One Health into practice. Interview transcripts were thematically analysed to identify barriers and facilitators to the implementation of One Health AMR approaches. The Behaviour Change Wheel was then used to specify evidence-based and theoretically informed recommendations for the practical application of One Health AMR approaches.
Results: Barriers to implementation included the heterogeneity of sectors involved and their diverse regulatory, governance and financial drivers. Blame and responsibility for AMR were often reciprocally attributed to ‘other’ sectors. Facilitators included scalable, cross-sector activity that focused on the deliberate creation of opportunities to bring together sectors and enable effective communication based on knowledge and data transfer. Recommendations to enhance future One Health AMR included the development of further shared infrastructure across sectors (encompassing governance, regulation, meetings and data sharing), One Health AMR education and training between sectors, the development of scalable role models for AMR leadership and the fostering of sector-specific responsibility for AMR as well as broader recognition of the systemic drivers of AMR.
Conclusions: The AMR threat requires movement beyond One Health rhetoric towards a co-ordinated and synchronised activities that foster and promote shared aims and objectives across the system of AMR stakeholders.