ArticleNature medicine2026
Evaluation of antimicrobial resistance governance across 193 countries to inform the 2026 Global Action Plan update.
Article in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Aquaculture Pathogens and Antimicrobial Resistance: A One Health Perspective.International journal of molecular sciences · 2026Review
- Antibiotic Resistance and the Return to a Pre-Antibiotic Era: A Critical Narrative Review of a Global Catastrophe.Biomedicines · 2026Review
- Article
- Environmental effectiveness of the National Action Plan to Contain Antimicrobial Resistance: evidence from Chinese soil.National science review · 2026Article
- Mapping One Health antimicrobial resistance policy and implementation in Bangladesh: A scoping review.One health (Amsterdam, Netherlands) · 2026Review
- A Narrative Review of Antibiotic Prescribing Practices and Antimicrobial Resistance Challenges in Conflict-Affected Sudan.Antibiotics (Basel, Switzerland) · 2026Review
- Economic Barriers to Antimicrobial Susceptibility Testing as a Structural Contributor to Antimicrobial Resistance in Low- and Middle-Income Countries: A Narrative Review.Infection and drug resistance · 2026Review
- Agricultural governance to strengthen the multisectoral response to antimicrobial resistance: the experience of Bolivia.Frontiers in veterinary science · 2026Article
- Reassessing antimicrobial resistance governance in Latin America: the case for antimicrobial consumption as the primary metric of implementation success.Frontiers in public health · 2026Article
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Authors and funding
33 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Antimicrobial resistance (AMR) poses a major global health threat, yet the effectiveness of national action plans (NAPs) remains uncertain. Here we developed a multidimensional One Health governance index through a structured Delphi expert consultation to evaluate AMR governance across 193 countries (2017-2022), integrating 269 policy documents, expert-weighted indicators and multinational survey and surveillance datasets. Difference-in-differences and joinpoint regression analyses were used to link governance to antimicrobial use, AMR prevalence and AMR-related mortality. Global governance scores improved from 30.7 to 44.5/100, although implementation and monitoring lagged behind policy design, particularly in animal and environmental sectors. A significant increase in AMR prevalence scores was observed only 5 years after NAP adoption (two-stage difference-in-differences, β = 2.43, 95% confidence interval (CI) 1.02-3.85, P < 0.05), underscoring the delayed impact of policy. Multisector engagement (early-adopting countries, β = 0.05, 95% CI 0.02-0.08, P < 0.01) and antimicrobial use surveillance system (early-adopting countries, β = 0.05, 95% CI 0.03-0.07, P < 0.01) showed the strongest associations with improvement in AMR outcomes. As the 2026 Global Action Plan update approaches, sustained financing and integrated One Health surveillance, with stronger environmental and agricultural engagement, are essential for translating NAPs into sustained reductions in resistance.
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