Public Health England, London, UK; Chatham House Centre on Global Health Security, London, UK.
Aga Khan University, Karachi, Pakistan.
Lancet. 2016 Jan 16;387(10015):285-95. doi: 10.1016/S0140-6736(15)00520-6. Epub 2015 Nov 18.
The effectiveness of existing policies to control antimicrobial resistance is not yet fully understood. A strengthened evidence base is needed to inform effective policy interventions across countries with different income levels and the human health and animal sectors. We examine three policy domains-responsible use, surveillance, and infection prevention and control-and consider which will be the most effective at national and regional levels. Many complexities exist in the implementation of such policies across sectors and in varying political and regulatory environments. Therefore, we make recommendations for policy action, calling for comprehensive policy assessments, using standardised frameworks, of cost-effectiveness and generalisability. Such assessments are especially important in low-income and middle-income countries, and in the animal and environmental sectors. We also advocate a One Health approach that will enable the development of sensitive policies, accommodating the needs of each sector involved, and addressing concerns of specific countries and regions.
现有控制抗菌药物耐药性政策的效果尚不完全清楚。需要一个更有力的证据基础,为不同收入水平国家以及人类卫生和动物部门的有效政策干预措施提供信息。我们研究了三个政策领域——合理使用、监测以及感染预防和控制,并考虑了在国家和区域层面上哪些政策最有效。在不同的政治和监管环境下,这些政策在各个部门的实施存在许多复杂性。因此,我们提出了政策行动建议,呼吁使用标准化框架对成本效益和普遍性进行全面政策评估。此类评估在低收入和中等收入国家以及动物和环境部门尤为重要。我们还倡导采取一种“同一健康”方法,这将使制定敏感政策成为可能,满足各部门的需求,并解决特定国家和地区的关切。