Global Strategy Lab, Dahdaleh Institute for Global Health Research, Faculty of Health and Osgoode Hall Law School, York University, 4700 Keele Street, Dahdaleh Building 2120, Toronto, ON, M3J 1P3, Canada.
School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
Health Care Anal. 2023 Mar;31(1):9-24. doi: 10.1007/s10728-020-00393-y.
Antimicrobial resistance (AMR) is an urgent threat to global public health and development. Mitigating this threat requires substantial short-term action on key AMR priorities. While international legal agreements are the strongest mechanism for ensuring collaboration among countries, negotiating new international agreements can be a slow process. In the second article in this special issue, we consider whether harnessing existing international legal agreements offers an opportunity to increase collective action on AMR goals in the short-term. We highlight ten AMR priorities and several strategies for achieving these goals using existing "legal hooks" that draw on elements of international environmental, trade and health laws governing related matters that could be used as they exist or revised to include AMR. We also consider the institutional mandates of international authorities to highlight areas where additional steps could be taken on AMR without constitutional changes. Overall, we identify 37 possible mechanisms to strengthen AMR governance using the International Health Regulations, the Agreement on the Application of Sanitary and Phytosanitary Measures, the Agreement on Trade-Related Aspects of Intellectual Property Rights, the Agreement on Technical Barriers to Trade, the International Convention on the Harmonized Commodity Description and Coding System, and the Basel, Rotterdam, and Stockholm conventions. Although we identify many shorter-term opportunities for addressing AMR using existing legal hooks, none of these options are capable of comprehensively addressing all global governance challenges related to AMR, such that they should be pursued simultaneously with longer-term approaches including a dedicated international legal agreement on AMR.
抗菌素耐药性（AMR）是对全球公共卫生和发展的紧迫威胁。减轻这一威胁需要在关键 AMR 优先事项上采取大量短期行动。虽然国际法律协议是确保国家间合作的最强有力机制，但谈判新的国际协议可能是一个缓慢的过程。在本期特刊的第二篇文章中，我们考虑利用现有的国际法律协议是否有机会在短期内增加对抗 AMR 目标的集体行动。我们强调了十个 AMR 优先事项，并提出了一些战略，利用现有“法律挂钩”来实现这些目标，这些挂钩利用了管理相关事项的国际环境、贸易和卫生法的要素，这些法律可以在现有基础上使用或修改，以纳入 AMR。我们还考虑了国际机构的机构任务，以突出在不进行宪法改革的情况下在 AMR 方面可以采取额外步骤的领域。总体而言，我们确定了 37 种可能的机制，以利用《国际卫生条例》、《实施卫生与植物卫生措施协定》、《与贸易有关的知识产权协定》、《技术性贸易壁垒协定》、《商品名称及编码协调制度国际公约》和《巴塞尔公约》、《鹿特丹公约》和《斯德哥尔摩公约》来加强 AMR 治理。虽然我们利用现有法律挂钩确定了许多短期解决 AMR 的机会，但这些选择都无法全面解决与 AMR 相关的所有全球治理挑战，因此应与包括专门的 AMR 国际法律协议在内的长期方法同时推进。
