Antimicrobial Resistance and One Health: Lessons on One Health Governance and Implementation from the Fleming Fund
Syed Shahid Abbas, Rebecca Maudling, Antoine Andremont, Yu Nandar Aung, Regina Ama Banu, Manisha Bista, Roderick M Card, Eileen Chappell, Etienne Chevanne, Mauricio Coppo, Stanley Fenwick, Nigel French, William H Gaze, Joanna 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 Leslie, Ayodele Majekodunmi, Arshnee Moodley, Athina Papadopoulou, Shahriar Rizvi, Tim Shorten, Steven Uggowitzer, Tom Weaver, Muhammad Usman ZaheerAbstract
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.