TY - JOUR

T1 - The governance of antimicrobial resistance in Brazil

T2 - Challenges for developing and implementing a one health agenda

AU - Corrêa, Juliana Silva

AU - Zago, Luiz Felipe

AU - Da Silva-Brandão, Roberto Rubem

AU - de Oliveira, Sandi Michele

AU - Fracolli, Lislaine Aparecida

AU - Padoveze, Maria Clara

AU - Cordoba, Gloria

N1 - Publisher Copyright: © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

PY - 2023

Y1 - 2023

N2 - This article explores stakeholders’ perceptions of the challenges for developing a One Health agenda to tackle antimicrobial resistance (AMR) in Brazil, including the development and implementation of the Brazilian National Action Plan (BR-NAP). The data originate from 27 interviews conducted with human, environmental, and animal health stakeholders, including academics, managers, and policymakers involved in developing the BR-NAP. Through thematic analysis, we identified three interconnected themes: governance, the health system, and technical and scientific challenges. The findings draw particular attention to failures in the agenda-setting process, revealed by interviewees strongly emphasising that AMR is not considered a policy priority in Brazil. The lack of political will and awareness of the clinical, social, and economic impacts of AMR are considered the main impediments to the agenda’s progress. The joint work across disciplines and ministries must be reinforced through policymaker engagement and better environmental sector integration. The agenda must include sustainable governance structures less affected by political winds. Policies should be designed jointly with state and local governments to create strategies to engage communities and improve their translation into effective implementation.

AB - This article explores stakeholders’ perceptions of the challenges for developing a One Health agenda to tackle antimicrobial resistance (AMR) in Brazil, including the development and implementation of the Brazilian National Action Plan (BR-NAP). The data originate from 27 interviews conducted with human, environmental, and animal health stakeholders, including academics, managers, and policymakers involved in developing the BR-NAP. Through thematic analysis, we identified three interconnected themes: governance, the health system, and technical and scientific challenges. The findings draw particular attention to failures in the agenda-setting process, revealed by interviewees strongly emphasising that AMR is not considered a policy priority in Brazil. The lack of political will and awareness of the clinical, social, and economic impacts of AMR are considered the main impediments to the agenda’s progress. The joint work across disciplines and ministries must be reinforced through policymaker engagement and better environmental sector integration. The agenda must include sustainable governance structures less affected by political winds. Policies should be designed jointly with state and local governments to create strategies to engage communities and improve their translation into effective implementation.

KW - Antimicrobial resistance

KW - global public health

KW - governance

KW - health policy

KW - one health

U2 - 10.1080/17441692.2023.2190381

DO - 10.1080/17441692.2023.2190381

M3 - Journal article

C2 - 36934430

AN - SCOPUS:85150483747

VL - 18

JO - Global Public Health

JF - Global Public Health

SN - 1744-1692

IS - 1

M1 - 2190381

ER -