In 2010, the World Health Organisation (WHO) identified AMR as one of the top 10 public health crises that need to be addressed (WHO, 2010). At a United Nation General Assembly in 2016, world leaders committed to take a broad, coordinated approach to address AMR and its root causes (including but not limited to human health, animal health and agriculture) (WHO, 2016).
This is mirrored by the European Union with the EU One Health Action Plan coordinated by the European Commission as well as with the creation of National Action Plans by Member States (EC, 2017). However, because the EU One Health Action Plan is not legally binding, adoption of its recommendations has been a mixed bag. In a 2019 EPHA study, researchers found only 51% of surveyed EU countries had established a national action plan (NAP) that follows the One Health Plan (EPHA, 2019). While this was a necessary first step to place AMR on member state’s political agendas, further coordination with member states at the national level is still needed to fully implement these actions plans.
In 2014, G7 leaders committed to working alongside the WHO to establish a global action plan on AMR (European Observatory on Health Systems and Policies, 2015). The following year, WHO introduced the Global Action Plan that presented strategic objectives for governments to work towards in their policies against AMR (WHO, 2015). In Europe, several countries stand out for their commitment to fighting AMR. Of those, the UK, the Netherlands, France, Germany, and Sweden are prime examples. Since 2006, antibiotic usage in animal husbandry as growth promoters has been banned in all EU member states (Regulation IP/05/1687).
Under the Swedish EU presidency in 2009, antimicrobial development was made a priority (European Observatory on Health Systems and Policies, 2019). The UK, Denmark, Sweden, and Norway already publish joint annual AMR surveillance reports that are meant to facilitate cooperation and data sharing. The Netherlands has routinely had the lowest average systemic consumption of antibiotics as well the lowest mean consumption in hospitals within the EU/EEA population; the highest being Greece and Malta respectively (European Observatory on Health Systems and Policies, 2019).
Outside of Europe, the US, China, and India have also taken necessary strides to put political emphasis on the issue. All three countries as well as European countries have established an AMR surveillance system to track the progression of resistance in animals and humans (WHO, 2019). According to the WHO, both the US and China have enacted targeted nationwide policies that attempt to change the behaviours of key stakeholders over the last 2-5 years (WHO, 2019).
Individual countries that have put AMR at the top of their political agenda include: