Opportunities and challenges in antimicrobial resistance policy including animal production systems and humans across stakeholders in Argentina: a context and qualitative analysis

ALLEL, KASIM; FERNANDEZ MIYAKAWA, M. ; GAZE, W; PETRONI, A.; CORSO, A; BARCELONA, L; SANCHEZ BRUNI S. (AMR POLICY RESEARCH GROUP); SANCHEZ BRUNI S.; BODEN, L.; PITCHFORTH, E.

BMJ OPEN

Wholly-owned by the BMJ Publishing Group

Lugar: LONDON; Año: 2024

2044-6055

Introduction. Gaps in antimicrobial resistance (AMR) surveillance and control, including implementation ofnational action plans (NAP), are evident internationally. Countries’ capacity to translate political commitmentinto action is crucial to cope with AMR at the human-animal-environment interface.Methods. We employed a two-stage process to understand opportunities and challenges related to AMRsurveillance and control at the human-animal interface in Argentina. First, we compiled the central AMRpolicies locally and mapped vital stakeholders around the NAP and the national commission against bacterialresistance. Second, we conducted qualitative interviews using a semi-structured questionnaire coveringstakeholders’ understanding and progress towards AMR and NAP. We employed a mixed deductive-inductiveapproach and used the constant comparative analysis method. We created categories and themes to cluster subthemes and determined crucial relationships among thematic groups.Results. Crucial AMR policy developments have been made since 1969, including gradually banning colistin infood-producing animals. In 2023, a new government decree prioritises AMR following the 2015 NAP launch.Our qualitative analyses identified seven major themes for tackling AMR: (I) Cultural factors and socio-politicalcountry context hampering AMR progress, (II) Fragmented governance, (III) Antibiotic access and use (IV)AMR knowledge and awareness throughout stakeholders, (V) AMR surveillance, (VI) NAP efforts, and (VII)External drivers. We identified a fragmented structure of the food production chain, poor cross-coordinationbetween stakeholders, limited surveillance and regulation among food-producing animals, and geographical disparities over access, d agnosis and treatment. The country is moving to integrate animal and food productioninto its surveillance system, with most hospitals experienced in monitoring AMR through antimicrobialstewardship programs.Conclusion. AMR accountability should involve underpinning collaboration at different NAP implementation levels and providing adequate resources to safeguard long-term sustainability. Incorporating a multisectoralcontext-specific approach relying upon different One Health domains is crucial to strengthening local AMRsurveillance