'When global health meets global goals': assessing the alignment between antimicrobial resistance and sustainable development policies in 10 African and Asian countries.

Abstract

Background: Sustainable development goals (SDGs) may play a pivotal role in mitigating antimicrobial resistance (AMR). This study examines how countries can integrate AMR mitigation with sustainable development strategies, providing evidence on the prioritisation of AMR-related efforts within both agendas.

Methods: We conducted a comparative analysis of the international global action plan (GAP) and national action plan (NAP) on AMR and SDGs across 10 countries in Africa and Asia. We employed content analysis to map actions to AMR drivers, descriptive statistics to summarise the coverage and focus of the actions and inferential statistics to explore factors associated with the level of policy alignment.

Results: Our findings highlight gaps in the current AMR policy landscape, where drivers are at risk of being redundantly addressed, narrowly focused or entirely overlooked. At the international level, over 50% of AMR drivers are addressed by both frameworks, but national-level overlap is lower (10.5%-47.4%), with Asian countries showing stronger alignment than African countries. Asian countries show a higher proportion of shared drivers than African countries. A considerable proportion of drivers are addressed solely by AMR-NAPs (23.7%-60.5%) or SDG-NAPs (13.2%-31.6%), raising concerns that actions may benefit either sustainable development or AMR at the expense of the other. Finally, 10.5%-26.3% of drivers, mostly distal, are not acknowledged by either framework, highlighting potential policy blind spots.

Conclusions: The Agenda 2030 includes ambitious and cross-cutting goals with GAP-AMR, therefore it can facilitate intersectoral collaboration in addressing AMR. The effective implementation of both agendas will depend on national governments' capacity to ensure that efforts in combating AMR also contribute to sustainable development.