AMR-Intervene, a social-ecological framework for AMR interventions
The global threat of AMR requires coordinated actions by and across different sectors. Increasing attention at the global and national levels has led to different strategies to tackle the challenge.
The diversity of possible actions to address AMR is currently not well understood from a One Health perspective.
AMR-Intervene provides a broadly applicable framework, which can inform the design, implementation, assessment and reporting of interventions to tackle AMR and, in turn, enable faster uptake of successful interventions to build societal resilience to AMR.
AMR-Intervene is the first framework built to emphasize the characterization of AMR interventions from a social-ecological perspective and the identification of resilience factors of virtually all types of AMR interventions. While few interventions are currently designed to build resilience, the AMR-Intervene framework underpins the creation of a database and learning platform of interventions, which will be the first of its kind, acknowledging the significant variety of interventions targeting AMR and the diversity of contexts in which they are implemented worldwide.
Ultimately, the application of the framework and associated database will help to improve how interventions are identified, conceptualized, described, reported, and assessed. As is strongly recommended for experimental trials or systematic reviews, the systematic description will also help to improve the quality of interventions and provide a minimum standard for publication of the intervention. Thus, the framework and associated database of interventions will be useful for further research as well as an evidence-based source of information for decision and policy makers.
AMR-Intervene, an interdisciplinary social–ecological framework, describes interventions to tackle AMR in terms of six components:
(i) core information about the publication;
(ii) social system;
(iii) bio-ecological system;
(iv) triggers and goals;
(v) implementation and governance; and
(vi) assessment.
AMR-Intervene, a database for research at science/policy interface
Both the WHO Global Action Plan adopted in 2015 and the United Nations General Assembly High-Level meeting on AMR in 2016 have stressed the need for coordinated national action on AMR. While many interventions have been implemented to tackle AMR, many of them at the local level and/or limited to one sector, there is a need for making sense of the diversity of interventions, evaluate their (cost-) effectiveness, and understand the factors that underpin success and failure.
The first working package of the AMResilience project (PI Didier Wernli, Geneva Transformative Governance Lab, University of Geneva, Switzerland) aims to build a database of interventions on AMR. The AMR intervene database aims to provide a broad assessment of variables that are relevant to characterize interventions on AMR, not only regarding the biological components but also the multiple dimensions of the social system.
The database is built using an open source content management system and is currently being populated with AMR interventions focusing on ESBL/CRE. As it has become critical to provide access to data in order to build the science of intervention on AMR, it is planned to make the data gradually accessible as a resource to the wider community. As the database aims to be a dynamic learning system, a versioning system as well as a way for external contribution to the database will be created.
AMR-Intervene, a platform for and with stakeholders
Recognizing the responsibility of the scientific community to produce understanding that will steer societies toward living out of the threat of AMR within a finite planet while meeting the basic needs of every living entity, the AMR-Intervene platform increase the transfer of useful knowledge towards essential actors.
The AMR-Intervene platform aims to:
- Develop a hub for researchers and policy makers based on scientific evidence and experience;
- Generate evidence for AMR governance instruments and mechanisms;
- Enhance knowledge sharing between AMR actors via an open source platform;
- Develop new cross-disciplinary tools, methods and theories to study challenges of AMR interventions.
Wernli, D., Jørgensen, P. S., Parmley, E. J., Troell, M., Majowicz, S., Harbarth, S., … & Carson, C. (2020). Evidence for action: a One Health learning platform on interventions to tackle antimicrobial resistance. The Lancet Infectious Diseases.