Antimicrobial Resistance and One Health: Lessons on One Health Governance and Implementation from the Fleming Fund

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ID: 332998
2026
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Ranked #588 of 626 articles by views in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

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Abstract
Abstract This paper reflects upon the experience of the Fleming Fund in designing and implementing One Health antimicrobial resistance (AMR) programs in 25 countries and identifies practical lessons for the design of future One Health programs. The Fleming Fund experience highlights key priorities for implementing One Health effectively within AMR programs–though many of the insights should be applicable to other contexts as well, such as emerging infectious diseases and health security. One Health should be treated as an approach to problem framing and action rather than a program output, with flexibility for national adaptation. Meaningful implementation requires sustained investment beyond human health, particularly in animal and environmental sectors, to avoid symbolic engagement. Surveillance systems should consider both the role of the sector and sector-specific needs, supported by capacity for joint interpretation and use of evidence. The costs of multisectoral coordination should be explicitly resourced and both formal governance mechanisms and informal professional networks recognized as essential for building trust, sustaining collaboration, and translating data into policy-relevant action.
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Authors Syed Shahid Abbas, Rebecca Maudling, Antoine Andremont, Yu Nandar Aung, Regina Ama Banu, Manisha Bista, Roderick M. Card, Eileen Chappell, Etienne Chevanne, Mauricio J. C. Coppo, Stanley G. Fenwick, Nigel Peter French, William H. Gaze, Joanna S. McKenzie, Noah Obeng‐Nkrumah, Garima Singh, Desrina Sitompul, Mark Stevenson, Shawn Ting, Jaap A. Wagenaar, Evelyn Wesangula, Anke Wiethoelter, Timothy Worth, Qadeer Ahsan, Winfred Christine Amia, Mathias Ayuk Besong, Eric Sampane Donkor, James Fairfax, Heidi Hopkins, Easrat Jahan, Anis Karuniawati, Toby J Leslie, Ayodele Oluwakemi Majekodunmi, Arshnee Moodley, Athina Papadopoulou, Shahriar Rizvi, Tim Shorten, Steven Uggowitzer, Tom Weaver, Muhammad Usman Zaheer
Journal Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Year 2026
DOI
10.1093/cid/ciag517
URL
https://doi.org/10.1093/cid/ciag517
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