Drivers for governance changes for AMR prevention | Mechanism for change | New perspective on AMR prevention governance | Objective | Suggested actions towards the new perspective governance for AMR prevention |
---|---|---|---|---|
Complexitya | Diffusiond | Network governance | Create a new academic/industrial/biotech skills mix based on systems thinking and complexity science. | Build inter-sectoral training in cooperation with schools of infectious disease, microbiology/hygiene, public health, business schools and policy. |
Increased accountability across healthcare and non-healthcare organizations. | Include HCPs, users, citizens and mass media in the governance approach and decision-making via independent agencies or organizations to implement new assessments and accountability frameworks. | |||
Diffusion and shared valuee | Include AMR as a goal at governmental and societal level, as a key component of sustainable development | Engage organizations far beyond those involved in AMR sectors or even health (other ministers such as finance minister, business leaders, users) [2] | ||
Inter-dependenceb | Diffusion | Multi-level governance | Control interactions and promote coherence between sectors by an alignment of priorities | Cooperation among the various levels, e.g. geographical (regions and countries), clinical (primary and secondary care), species (antibiotics in humans/animals/agriculture/wider environment) following the “One Health” concept [61]. |
Sharing information and experience | Pool reports of best and failed innovative practices in working with other organizations, groups, sectors via regular meetings for shared goals at the regional, national level and beyond. | |||
Mixing regulation and persuasion | Promote growing interest in nudge policiesf | Monitoring progress through a mixture of hard and soft governance mechanisms to engage for AMR. | ||
Co-productionc | Diffusion | Adaptive governance | Transparency | Users, public and private organizations must work together to define new indicators for monitoring change and progress in AMR with new measures, shared for all parties and accessible to the public. |
Flexible and adaptable systems approaches with self-organization and decentralized decision | Create a dedicated structure to assess and monitor governance at the local, national, and international level, to adapt governance mechanisms to innovations (i.e. new mode of communication). Cybernetic approachg utilizing communications and information for guidance and control. | |||
Democracy | Participatory governance, e-governance | Empower and involve users; public accountability; and strengthen health literacy | Dialogue with HCPs, users and citizens on AMR through new information and communication technologies (e.g. social media); open-data initiatives, tracking systems, digital and mobile approaches to strengthen health literacy. | |
Preparedness | Anticipatory governance | Finding solutions for a better future adaptation | Development of simulation models including feedback loops. Creation of new forecasting tools for anticipatory governance, shared for all actors and fields to deal with emergent events. |