School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.
Global Economic Dynamics and the Biosphere, Royal Swedish Academy of Sciences, Stockholm, Sweden.
Front Public Health. 2022 Jul 6;10:831097. doi: 10.3389/fpubh.2022.831097. eCollection 2022.
Antimicrobial resistance (AMR) is a growing global crisis with long-term and unpredictable health, social and economic impacts, with which climate change is likely to interact. Understanding how to govern AMR amidst evolving climatic changes is critical. Scenario planning offers a suitable approach. By envisioning alternative futures, stakeholders more effectively can identify consequences, anticipate problems, and better determine how to intervene. This study explored future worlds and actions that may successfully address AMR in a changing climate in a high-income country, using Sweden as the case.
We conducted online scenario-building workshops and interviews with eight experts who explored: (1) how promising interventions (, and ) could each combat AMR in 2050 in Sweden given our changing climate; and (2) actions to take starting in 2030 to ensure success in 2050. Transcripts were thematically analyzed to produce a narrative of participant validated alternative futures.
Recognizing AMR to be a global problem requiring global solutions, participants looked beyond Sweden to construct three alternative futures: (1) "Tax Burn Out" revealed as a low-impact intervention that creates inequities and thus would fail to address AMR without other interventions, such as infection prevention measures. (2) "Addressing the Basics" identified as highly impactful at containing AMR in 2050 because they would contribute to achieving the Sustainable Development Goals (SDGs), which would be essential to tackling inequities underpinning AMR and climate change, and help to stabilize climate-induced mass migration and conflicts; and (3) "Siloed Nations" described a movement toward nationalism and protectionism that would derail the "Addressing the Basics" scenario, threatening health and wellbeing of all. Several urgent actions were identified to combat AMR long-term regardless which future un-folds, such as global collaboration, and a holistic approach where AMR and climate change are addressed as interlinked issues.
Our participatory scenario planning approach enabled participants from different sectors to create shared future visions and identify urgent actions to take that hinge on global collaboration, addressing AMR and climate change together, and achieving the SDGs to combat AMR under a changing climate.
抗菌药物耐药性（AMR）是一场日益严重的全球性危机，其对健康、社会和经济的影响具有长期性和不可预测性，而且可能与气候变化相互作用。了解如何在不断变化的气候条件下管理 AMR 至关重要。情景规划提供了一种合适的方法。通过设想替代未来，利益相关者可以更有效地识别后果、预测问题，并更好地确定如何进行干预。本研究以瑞典为例，探讨了在高收入国家中，气候变化背景下成功应对 AMR 的未来世界和行动。
我们开展了在线情景构建研讨会和对 8 名专家的访谈，探讨了以下问题：（1）考虑到我们不断变化的气候，在瑞典，每一种有希望的干预措施（、和 ）如何在 2050 年对抗 AMR；（2）为确保在 2050 年取得成功，从 2030 年开始采取的行动。对记录的访谈内容进行了主题分析，生成了一份经参与者验证的替代未来的叙述。
参与者认识到 AMR 是一个全球性问题，需要全球性的解决方案，因此他们超越了瑞典，构建了三种替代未来：（1）“税收耗尽”揭示了 作为一种低影响的干预措施，由于会造成不平等，因此如果没有其他干预措施（如感染预防措施），它将无法解决 AMR 问题。（2）“解决基本问题”确定 作为在 2050 年控制 AMR 的高影响力措施，因为它们将有助于实现可持续发展目标（SDGs），这对于解决 AMR 和气候变化所带来的不平等问题以及帮助稳定因气候引发的大规模移民和冲突至关重要，有助于稳定气候引发的大规模移民和冲突；（3）“孤立的国家”描述了一种走向民族主义和保护主义的运动，这将破坏“解决基本问题”的情景，威胁到所有人的健康和福祉。无论未来如何发展，都需要采取一些紧迫的行动来长期对抗 AMR，例如全球合作，以及采取一种整体方法，将 AMR 和气候变化视为相互关联的问题。
我们的参与式情景规划方法使来自不同部门的参与者能够共同构建未来愿景，并确定需要采取的紧迫行动，这些行动取决于全球合作、共同应对 AMR 和气候变化，以及实现可持续发展目标以在气候变化下对抗 AMR。
