Peer-reviewedCC BYClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Antimicrobial Resistance and One Health: Lessons on One Health Governance and Implementation from the Fleming Fund.
31 affiliations
- 1Institute of Development Studies, University of Sussex, Falmer, Brighton, United Kingdom.
- 2Itad Ltd, Brighton, United Kingdom.
- 3One Health Consultant, Portsmouth, United Kingdom.
- 4Université Paris Cité, Paris, France.
- 5Mott MacDonald, Bangkok, Thailand.
- 6Council for Scientific and Industrial Research (CSIR)-Water Research Institute, Accra, Ghana.
- 7Mott MacDonald, Delhi, India.
- 8Animal & Plant Health Agency, Addlestone, United Kingdom.
- 9Mott MacDonald, London, United Kingdom.
- 10University of Melbourne, Melbourne, Australia.
- 11College of Environmental and Life Sciences, Murdoch University, Perth, Australia.
- 12Massey University, Palmerston North, New Zealand.
- 13University of Exeter, Exeter, United Kingdom.
- 14School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana.
- 15DAI, Jakarta, Indonesia.
- 16Menzies School of Health Research, Darwin, Australia.
- 17Division of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.
- 18East, Central and Southern Africa Health Community, Arusha, Tanzania.
- 19DAI, Islamabad, Pakistan.
- 20Mott MacDonald, Kampala, Uganda.
- 21Mott MacDonald, Accra, Ghana.
- 22Department of Medical Microbiology, University of Ghana Medical School, Accra, Ghana.
- 23DAI, Dhaka, Bangladesh.
- 24Department of Microbiology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
- 25Ajisefini Consulting, Abuja, Nigeria.
- 26International Livestock Research Institute, Nairobi, Kenya.
- 27University of Copenhagen, Frederiksberg, Denmark.
- 28Centre for Environment, Fisheries and Aquaculture Science (CEFAS), Weymouth, United Kingdom.
- 29Independent Consultant, Redgrave, United Kingdom.
- 30Member, Fleming Fund Expert Advisory Group, Geneva, Switzerland.
- 31Regional Office for Asia and the Pacific, Food and Agriculture Organization of the United Nations, Bangkok, Thailand.
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.
Related
- Fleming Fund Implementation in Kenya: What Have We Learned About Strengthening One Health Antimicrobial Resistance Surveillance for Decision-making?
- The Fleming Fund: Key Features of Design and Approach to Strengthening Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries.
- Surveillance Data Use Through the Fleming Fund: Informing Action on Antimicrobial Resistance in Low- and Middle-Income Countries.
- Generating Actionable Data From Antimicrobial Resistance Surveillance: Insights From the Fleming Fund's International Experience.
- Agricultural governance to strengthen the multisectoral response to antimicrobial resistance: the experience of Bolivia.
BibTeX
@article{abbas2026antimicrobial,
title = {{Antimicrobial Resistance and One Health: Lessons on One Health Governance and Implementation from the Fleming Fund.}},
author = {Syed Shahid Abbas and Rebecca Maudling and Antoine Andremont and Yu Nandar Aung and Regina Ama Banu and Manisha Bista and Roderick M Card and Eileen Chappell and Etienne Chevanne and Mauricio Coppo and Stanley Fenwick and Nigel French and William H Gaze and Joanna McKenzie and Noah Obeng-Nkrumah and Garima Singh and Desrina Sitompul and Mark Stevenson and Shawn Ting and Jaap A Wagenaar and Evelyn Wesangula and Anke Wiethoelter and Timothy Worth and Qadeer Ahsan and Winfred Christine Amia and Mathias Ayuk Besong and Eric Sampane Donkor and James Fairfax and Heidi Hopkins and Easrat Jahan and Anis Karuniawati and Toby Leslie and Ayodele Majekodunmi and Arshnee Moodley and Athina Papadopoulou and Shahriar Rizvi and Tim Shorten and Steven Uggowitzer and Tom Weaver and Muhammad Usman Zaheer},
journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
year = {2026},
month = oct,
doi = {10.1093/cid/ciag517},
url = {https://europepmc.org/article/MED/42895837},
note = {CC BY},
}
RIS
TY - JOUR
TI - Antimicrobial Resistance and One Health: Lessons on One Health Governance and Implementation from the Fleming Fund.
AU - Syed Shahid Abbas
AU - Rebecca Maudling
AU - Antoine Andremont
AU - Yu Nandar Aung
AU - Regina Ama Banu
AU - Manisha Bista
AU - Roderick M Card
AU - Eileen Chappell
AU - Etienne Chevanne
AU - Mauricio Coppo
AU - Stanley Fenwick
AU - Nigel French
AU - William H Gaze
AU - Joanna McKenzie
AU - Noah Obeng-Nkrumah
AU - Garima Singh
AU - Desrina Sitompul
AU - Mark Stevenson
AU - Shawn Ting
AU - Jaap A Wagenaar
AU - Evelyn Wesangula
AU - Anke Wiethoelter
AU - Timothy Worth
AU - Qadeer Ahsan
AU - Winfred Christine Amia
AU - Mathias Ayuk Besong
AU - Eric Sampane Donkor
AU - James Fairfax
AU - Heidi Hopkins
AU - Easrat Jahan
AU - Anis Karuniawati
AU - Toby Leslie
AU - Ayodele Majekodunmi
AU - Arshnee Moodley
AU - Athina Papadopoulou
AU - Shahriar Rizvi
AU - Tim Shorten
AU - Steven Uggowitzer
AU - Tom Weaver
AU - Muhammad Usman Zaheer
PY - 2026
DA - 2026/10/01
JO - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
DO - 10.1093/cid/ciag517
UR - https://europepmc.org/article/MED/42895837
AB - 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.
SN - 1058-4838
SN - 1537-6591
ER -