Evidence map›Paper›PMID 42419897›Full record

ArticleBMJ open2026

Implementing One Health governance approaches to mitigate antimicrobial resistance across institutional, social, economic and political contexts: a scoping review.

Chloe Clifford Astbury, Taylor Hecker, Jaskeerat Singh, Suzanne Garkay Naro, Lauren Wallace, Geneviève Boily-Larouche, Mathieu J P Poirier, Yahaya Ali Ahmed, Anand Balachandran, Zlatina Dobreva and 5 more

Abstract readScoping Review
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Chloe Clifford AstburyYork University, Global Strategy Lab, Toronto, Ontario, Canada castbury@yorku.ca.ORCID http://orcid.org/0000-0003-2955-7833
Taylor HeckerYork University, Global Strategy Lab, Toronto, Ontario, Canada.ORCID http://orcid.org/0009-0009-9767-0361
Jaskeerat SinghYork University, Global Strategy Lab, Toronto, Ontario, Canada.ORCID http://orcid.org/0009-0000-6174-372X
Suzanne Garkay NaroYork University, Global Strategy Lab, Toronto, Ontario, Canada.ORCID http://orcid.org/0009-0009-2846-8557
Lauren WallaceYork University, Global Strategy Lab, Toronto, Ontario, Canada.
Geneviève Boily-LaroucheYork University, Global Strategy Lab, Toronto, Ontario, Canada.
Mathieu J P PoirierYork University, Global Strategy Lab, Toronto, Ontario, Canada.
Yahaya Ali AhmedWorld Health Organization Regional Office for Africa, Brazzaville, Congo.
Anand BalachandranWorld Health Organization, Geneva, Switzerland.
Zlatina DobrevaWorld Health Organization, Geneva, Switzerland.
Walter FullerWorld Health Organization Regional Office for Africa, Brazzaville, Congo.
Laetitia GahimbareWorld Health Organization Regional Office for Africa, Brazzaville, Congo.
Yidnekachew Degefaw MazengiyaWorld Health Organization Regional Office for Africa, Brazzaville, Congo.
Bassem ZayedWorld Health Organization Regional Office for South-East Asia, New Delhi, India.
Arne RuckertYork University, Global Strategy Lab, Toronto, Ontario, Canada.ORCID http://orcid.org/0009-0000-6416-3560

Funding

Wellcome Trust
6 · The paper itself

Abstract

objectivesAntimicrobial resistance (AMR) poses a serious threat across human, animal and environmental health. The One Health approach emphasises multisectoral collaboration and is critical in addressing AMR. While One Health governance has gained recognition from international organisations, there remains limited understanding of how it can be effectively implemented across institutional, social, economic and political contexts. This scoping review aims to explore the design and implementation of One Health governance across contexts.

designScoping review DATA SOURCES: We searched PubMed, Scopus, Web of Science and grey literature sources in December 2024, updating our search in March 2026. ELIGIBILITY CRITERIA: Eligible sources included empirical and conceptual work on One Health governance. DATA EXTRACTION AND SYNTHESIS: We searched for and screened documents and extracted data following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. We then applied qualitative analysis to examine governance mechanisms; implementation contexts; conceptualisations of effectiveness; evidence of effectiveness and key barriers and facilitators.

resultsWe included 171 documents from over 50 countries. We explored six dimensions of One Health governance: participation, leadership, coordination, decision-making, resourcing and accountability. Existing governance structures and wider aspects of country context shaped One Health governance. While there was broad agreement on the goals of One Health governance-namely, to support disease prevention, detection and response-empirical evidence on effective approaches was relatively limited. Facilitators included strong political will and crisis-driven momentum, while barriers included siloed systems, sectoral dominance, limited accountability, inadequate funding and lack of institutionalisation.

conclusionsThis review highlights the range of approaches to One Health governance that exist and outlines how context may shape the design and implementation of One Health governance. Evaluative research should further explore which approaches to One Health governance are most effective in specific contexts. These insights are particularly relevant for AMR, where sustained cross-sectoral governance beyond outbreak-driven responses is essential to counter the 'silent pandemic'.

Indexed as

Drug Resistance, MicrobialOne HealthHealth PolicyHumansLeadershipPoliticsHealth policyPublic healthSystematic Review

Identifiers

PMID42419897
PMCPMC13347904

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.