Bridging the Policy-to-Practice Gap in One Health Approaches to Antimicrobial Resistance: A Thematic Evidence Synthesis (2020–2025)
1
Department of Global and Public Health, McGill University, Montreal, Canada
2
Center for Health Policy, Asian Development Research Institute, Patna, India
3
Department of Health Surveillance, Evandro Chagas National Institute of Infectious Diseases - Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A182
ABSTRACT
INTRODUCTION:
Antimicrobial resistance (AMR) poses a critical global health threat, undermining modern medicine and disproportionately affecting low- and middle-income countries [1]. Although the One Health approach integrating human, animal, and environmental health has been widely endorsed and embedded within National Action Plans (NAPs), progress remains stalled due to persistent gaps between policy adoption and effective implementation [2]. This review examines how integrated One Health interventions contribute to AMR policy implementation and identifies the systemic factors shaping their success or failure.
METHODS:
A critical narrative review methodology was employed. A systematic search of PubMed, Scopus, and Web of Science was conducted for English-language publications from 2020 to 2025. From 13227 initial records, 58 studies meeting inclusion criteria were selected after screening. Data were extracted and analysed using thematic synthesis to identify cross-cutting themes influencing policy implementation.
RESULTS:
The evidence confirms that integrated OH interventions are effective but hindered by systemic barriers. Three interdependent themes were pivotal: governance, financing, and surveillance. Successful implementation was associated with strong inter-ministerial governance structures, dedicated long-term financing, and integrated surveillance systems with shared data platforms. Conversely, the implementation gap was driven by political silos, reliance on short-term project funding, and fragmented, sector-specific data collection. Country-level analyses illustrate how the interplay of these factors determines outcomes, from the sustained progress seen in high-income countries to the significant challenges faced in many resource-constrained settings [3].
CONCLUSIONS:
The AMR crisis is stalled by an implementation gap rooted in political, financial, and technical systems. Bridging this gap requires moving beyond policy endorsement to actionable measures: institutionalising mandated OH governance with dedicated budgets, reforming international financing to support integrated systems, and prioritising the development of shared surveillance platforms to enable collaborative accountability and targeted interventions.
Antimicrobial resistance (AMR) poses a critical global health threat, undermining modern medicine and disproportionately affecting low- and middle-income countries [1]. Although the One Health approach integrating human, animal, and environmental health has been widely endorsed and embedded within National Action Plans (NAPs), progress remains stalled due to persistent gaps between policy adoption and effective implementation [2]. This review examines how integrated One Health interventions contribute to AMR policy implementation and identifies the systemic factors shaping their success or failure.
METHODS:
A critical narrative review methodology was employed. A systematic search of PubMed, Scopus, and Web of Science was conducted for English-language publications from 2020 to 2025. From 13227 initial records, 58 studies meeting inclusion criteria were selected after screening. Data were extracted and analysed using thematic synthesis to identify cross-cutting themes influencing policy implementation.
RESULTS:
The evidence confirms that integrated OH interventions are effective but hindered by systemic barriers. Three interdependent themes were pivotal: governance, financing, and surveillance. Successful implementation was associated with strong inter-ministerial governance structures, dedicated long-term financing, and integrated surveillance systems with shared data platforms. Conversely, the implementation gap was driven by political silos, reliance on short-term project funding, and fragmented, sector-specific data collection. Country-level analyses illustrate how the interplay of these factors determines outcomes, from the sustained progress seen in high-income countries to the significant challenges faced in many resource-constrained settings [3].
CONCLUSIONS:
The AMR crisis is stalled by an implementation gap rooted in political, financial, and technical systems. Bridging this gap requires moving beyond policy endorsement to actionable measures: institutionalising mandated OH governance with dedicated budgets, reforming international financing to support integrated systems, and prioritising the development of shared surveillance platforms to enable collaborative accountability and targeted interventions.
| eISSN: | 2654-1459 |
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