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Background The World Health Organization developed the Global Action Plan on Antimicrobial resistance (AMR) as a priority because of the increasing threat posed to human health, animal health and agriculture. Countries around the world have been encouraged to develop their own National Action Plans (NAPs) to help combat AMR. The objective of this review was to assess the content of the NAPs and determine alignment with the Global Action Plan on Antimicrobial Resistance using a policy analysis approach. Body National Action Plans were accessed from the WHO Library and systematically analysed using a policy analysis approach for actors, process, context and content. Information was assessed using a ‘traffic light’ system to determine agreeance with the five WHO Global Action Plans objectives. A total of 78 NAPs (70 WHO approved, eight not approved) from the five global regions were analysed. National action plans which provided more information regarding the consultative process and the current situation regarding AMR allowed greater insight to capabilities of the country. Despite the availability of guidelines to inform the development of the plans, there were many differences between plans with the content of information provided. High income countries indicated greater progression with objectives achievement while low and middle-income countries presented the need for human and financial resources. Conclusion The national action plans provide an overview of activities underway to combat AMR globally. This analysis reveals how disconnected the process has been and how little information is being gathered globally.

Background Antimicrobial resistance (AMR) is a growing problem worldwide in need of global coordinated action. With the endorsement of the Global Action Plan (GAP) on AMR in 2015, the 194 member states of the World Health Organization committed to integrating the five objectives and corresponding actions of the GAP into national action plans (NAPs) on AMR. The article analyzes patterns of alignment between existing NAPs and the GAP, bringing to the fore new methodologies for exploring the relationship between globally driven health policies and activities at the national level, taking income, geography and governance factors into account. Methods The article investigates the global governance of AMR. Concretely, two proxies are devised to measure vertical and horizontal alignment between the GAP and existing NAPs: (i) a syntactic indicator measuring the degree of verbatim overlap between the GAP and the NAPs; and (ii) a content indicator measuring the extent to which the objectives and corresponding actions outlined in the GAP are addressed in the NAPs. Vertical alignment is measured by the extent to which each NAP overlaps with the GAP. Horizontal alignment is explored by measuring the degree to which NAPs overlap with other NAPs across regions and income groups. In addition, NAP implementation is explored using the Global Database for Antimicrobial Resistance Country Self-Assessment. Findings We find strong evidence of vertical alignment, particularly among low-income countries and lower-middle-income countries but weaker evidence of horizontal alignment within regions. In general, we find the NAPs in our sample to be mostly aligned with the GAP’s five overarching objectives while only moderately aligned with the recommended corresponding actions. Furthermore, we see several cases of what can be termed ‘isomorphic mimicry’, characterized by strong alignment in the policies outlined but much lower levels of alignment in terms of actual implemented policies. Conclusion To strengthen the alignment of national AMR policies, we recommend global governance initiatives based on individualized responsibilities some of which should be legally binding. Our study provides limited evidence of horizontal alignment within regions, which implies that regional governance institutions (e.g., WHO regional offices) should primarily act as mediators between global and local demands to strengthen a global governance regime that minimizes policy fragmentation and mimicry behavior across member states.

The Transforming Care national plan for England to develop community services and close hospital beds for people with intellectual disabilities and/or autism was published in October 2015 and is due to finish in March 2019. In this editorial the key plan objectives are evaluated, with particular reference to people with intellectual disabilities and/or autism who offend or are at risk of offending. The conclusion is that, to date, the plan has failed to meet its targets to reduce the number of in-patients with intellectual disabilities and/or autism and to invest in community services, and the number of patients in independent sector beds is increasing.

Background: Antimicrobial resistance (AMR) is a global threat that affects humans, animals, plants, the environment, societies, and economies—requiring urgent coordinated action. In May 2015, the World Health Assembly (WHA) adopted the Global Action Plan (GAP) on AMR, urging member states to develop and implement their own National Action Plans (NAPs) using a One Health approach. Objective: Both South Africa and Eswatini have developed NAPs and are currently in the implementation phase. However, no study has explored policymakers’ perceptions regarding NAP implementation particularly concerning coordination, accountability, resourcing, regulation and ownership. Methods: This qualitative study employed a narrative approach to explore these perceptions in South Africa and Eswatini. A total of 36 key informants were recruited using purposive and snowball sampling methods. Data was collected between November 2018 and March 2019 and transcribed verbatim. Results: Findings revealed that while governance structures for implementing NAPs exist in South Africa and Eswatini, several critical areas require urgent attention. These include limited accountability across One Health sectors, the absence of dedicated national budgets for NAP implementation, poor intra- and inter- ministerial coordination, weak medicine regulation and enforcement, and delayed multisectoral ownership of the NAPs. Conclusions: To address AMR effectively, both countries must allocate dedicated budgets, improve multisectoral integration, and strengthen regulatory frameworks regarding antimicrobial access and use across all One Health sectors. A firm commitment from all sectors is required—not just formal endorsement of the NAPs—to ensure sustainable implementation and ownership.

Background Antimicrobial resistance (AMR) poses an increasing public health threat to low- and lower-middle income countries. Recent studies found that in fact poor governance and transparency correlate more strongly with AMR than factors such as antibiotic use. While many African countries now have national action plans (NAPs) on AMR, it is unclear whether information is publicly available on their implementation, surveillance and financing. Methods Here, the transparency of information related to AMR national action plans in 15 African countries is assessed, based on a governance framework for AMR action plans. Public availability is assessed for AMR documents, progress reports, AMR surveillance data, budget allocations, as well as bodies and persons responsible for implementation of NAPs. Government websites and search engines were perused using search terms related to the studied criteria and countries. Results Results show that most countries have a national action plan publicly available. AMR surveillance data was available for a few countries, but systematic progress reports and funding allocations were absent in all but one country. Information on a body mandated to coordinate NAP implementation was available for most countries, but their functionality remain unclear. Most countries have nominated at least one person responsible for AMR nationally. In general, information was often fragmented and frequently available on external, non-government websites. It appears that commitments on AMR made in the often comprehensive NAPs are rarely met in a timely manner, exhibiting rather weak accountability for AMR results. The article provides concrete policy recommendations on how transparency and accountability may be improved with little effort. Conclusions Making information available can enable stakeholders such as civil society to demand accountability for results and lead to much needed specific actions on curbing AMR in countries.

In the article, the task to evaluate the condition of the Russian economy amid slumping energy prices and «exchange of sanctions» is addressed. It also aimes to define the priority directions of the economic policy of the Russian Federation as the full-service institutions capable to maintain the stability and consistency of development. The process of ensuring the spatial structure development of the Russian territories by means of involvement in the development processes the regional and municipal opportunities is offered to initiate with the optimization of the inter-budgetary relations of «municipality — region — federal centre.» All Russian citizens are recommended to treat more strictly and more responsibly the Constitution as the Basic Law supported by the populace and defining the strategic development priorities of the country on a long-term outlook. The methodology of the optimization of the inter-budgetary relations between the Federation, its subjects and municipalities is proved by the evidence-based delineation of powers and responsibility of each level for socio-economic results of work. It is offered to develop the national plan of socio-economic and social development engaging in work the experts and public; its main priorities have to be the improvement of the quality and productivity of the public administration and the spatial structure of the Russian territories. The mechanisms and institutions that help to involve the regions and territories to the implementation of the national plan are proved. The findings and recommendations offered in the paper may be used by the federal authorities in the development and adoption of laws and other regulations on the distribution of authority and optimization of the budgetary process. They are also may be useful for the regional and municipal authorities for the planning and development of the regional spatial structure.

The 2009 “pesticide package” changed the European Union’s approach to increasing its resilience to synthetic pesticides’ detrimental effects and health risks. It promoted the common goals of reducing volumes, reducing treatment frequency, improving efficacy, reducing risks of pesticide usage, reducing impact, reducing pesticide use in specific areas, and increasing public knowledge and awareness of plant protection products (PPP) usage and effects. Part of the “pesticide package,” Directive 2009/128/EC demanded that each EU MS crystalize by 2012 their approach to these goals in National Action Plans (NAPs) designed to systematically assess the situation and propose objectives and measures to achieve the Directive’s aims. This article presents a dynamic analysis of the changes that took place between the first (by 2012) and second (by 2019) generation of NAPs and evaluates in measures and a timetable the observed progress in achieving the first goal of Directive 2009/128/EC We assess how the EU MS approach to minimizing risks to public health has changed in this intrinsically environmental policy. We show that improvements-proposing measures designed to achieve the Directive’s first goal in all EU MS can be observed, but increasing coherence in measures, timetables, and indicators is needed to accomplish the SUD and EU Green Deal goals.

Background Vaccination can reduce antibiotic use by decreasing bacterial and viral infections and vaccines are highlighted in the WHO Global Action Plan on Antimicrobial Resistance (AMR) as an infection prevention measure to reduce AMR. Our study aimed to analyze whether WHO Member States have developed AMR national action plans that are aligned with the Global Action Plan regarding objectives on vaccination. Methods We reviewed 77 out of 90 AMR national action plans available in the WHO library that were written after publication of the Global Action Plan in 2015. Each plan was analyzed using content analysis, with a focus on vaccination and key components as defined by WHO (I. Strategic plan (e.g. goals and objectives), II. Operational plan, III. Monitoring and Evaluation plan). Results Vaccination was included in 67 of 77 AMR plans (87%) across all WHO Regions (Africa: n  = 13/13, the Eastern Mediterranean: n  = 15/16, Europe: n  = 10/14, the Americas: n  = 8/8, South-East Asia: n  = 8/11, and the Western Pacific: n  = 13/15). Pneumococcal and influenza vaccination were most frequently highlighted ( n  = 12 and n  = 11). We found indications that vaccination objectives are more often included in AMR plans from lower income countries, while higher income countries more often include specific vaccines. The key WHO components of national action plans were frequently not covered (I. 47% included, II. 57%, III. 40%). In total, 33 countries (43%) included indicators (e.g. strategic objectives) to capture the role of vaccines against AMR. Conclusions While vaccination to reduce AMR is seen as an important global public health issue by WHO, there appears to be a gap in its adoption in national AMR plans. Country income levels seem to influence the progress, implementation and focus of national action plans, guided by a lack of funding and prioritization in developing countries. To better align the global response to AMR, our review suggests there is a need to update national action plans to include objectives on vaccination with more focus on specific vaccines that impact antibiotic use.

The WHO, FAO, and OIE (the Tripartite) promote One Health (OH) as the guiding frame for national responses to antimicrobial resistance (AMR). Little is known, however, about how much national action plans (NAPs) on AMR actually rely on the OH measures outlined by the Tripartite. The paper investigates attention to OH through a systematic content analysis of 77 AMR NAPs to discern regional and income patterns in the integration of these OH measures. Our findings suggest that (1) AMR NAPs almost universally address the three key sectors of OH, namely, human, animal, and environmental health; (2) AMR NAPs primarily apply OH measures in policies related to human health care, food production, hygiene, and agriculture, whereas the level of attention to OH measures in sanitation, aquaculture, waste management, and water governance is generally low and mainly present in NAPs from low-income countries; (3) AMR NAPs of low-income and lowermiddle-income countries’display greater congruence with OH measures than NAPs from upper-middle-income and high-income countries; and (4) the level of OH attention on paper appears to matter little for the extent of multisectoral collaboration in practice.

Background: The WHO Regional Office for Africa developed a Member States (MS)-endorsed regional strategy to fast-track the implementation of MS’ national action plans (NAP) on Antimicrobial resistance (AMR). This study explored the perspectives of AMR’s national focal points in MS on the implementation of the priority interventions of the regional strategy in their countries. Methods: An online survey consisting of ratings and discussions covering the implementation of the six priority interventions was conducted. Sums of the scores per priority intervention were obtained, and their percentage to the total possible scores were calculated to categorize the implementation as inadequate (0–25%), basic (26–50%), intermediate (51–75%), or advanced (76–100%). Results: Thirty-six of the forty-seven national AMR focal points responded to the survey between 12 November 2023 and 8 January 2024. The implementations were rated as 37–62% (basic-to-intermediate), with the multisectoral coordination and collaboration committee receiving the highest overall rating (62%, 421/684), while the promotion of sustainable investment for the NAP on AMR received the least overall rating (37%, 257/700). The focal points mainly recommended awareness campaigns, capacity building, and regulations and guidelines to improve the implementation of the AMR strategy. Conclusions: The survey revealed a need to enhance awareness campaigns, support the establishment and functioning of AMR evaluation and monitoring systems, and build the capacity of AMR staff with cost-benefit analysis and budgeting skills. It also showed the necessity to improve awareness and conduct education on AMR, streamline evidence generation through One Health Surveillance systems, integrate initiatives to reduce hospital-acquired infections in the antimicrobial stewardship programs, and enhance regulations and guidelines to optimize the use of antimicrobials.