Disrupting antimicrobial resistance in food systems from a One Health perspective: a complex systems analysis in Canada, Senegal and the Netherlands.

Abstract

Background: Food systems are a key contributor to antimicrobial resistance (AMR). Given the multi-sectoral nature of AMR, a One Health perspective has been advocated. Recent research situates AMR as an emerging property of a complex system, a perspective which can help identify root drivers of AMR and theorise the impacts of proposed solutions. This study aims to combine systems modelling and a One Health perspective to identify system-level dynamics and priority actions for addressing AMR in food systems.

Methods: We used group model building, a participatory approach to systems modelling, in three countries: Canada, Senegal, and the Netherlands. Stakeholders from policy, research, civil society and industry developed qualitative systems models and identified priority actions for AMR mitigation. Workshop outputs were synthesised in the form of causal loop diagrams and iteratively refined with stakeholders to ensure they appropriately reflected their perspectives. Diagrams were analysed using systems archetypes, a conceptual tool for diagnosing recurring dynamics in complex systems, to identify common structural drivers of AMR and potential intervention points across countries. We then drew on systems theory and the priority actions identified by stakeholders to highlight potential paths to disrupting these archetypes, thereby reducing the contribution of food systems to AMR.

Results: Across the countries, 39 stakeholders participated in workshops. The archetypes analysis highlighted how short-term exploitation of shared resources, reliance on antimicrobials at the expense of investing in alternative solutions, and dominance of antimicrobial-intensive production systems may contribute to AMR. Priority actions that were positioned to disrupt these archetypes included regulation, education, consumer engagement, and shift towards different production systems.

Conclusions: AMR in food systems arises from recurring structural dynamics that require context-appropriate, systems-informed solutions. Countering short-term exploitation of shared antimicrobial resources calls for regulation, surveillance and education. Addressing overreliance on antimicrobials requires balanced strategies pairing judicious use with sustained investment in alternatives such as livestock management, infection prevention and vaccination. Disrupting the dominance of antimicrobial-intensive production systems calls for regulatory measures and consumer pressure to level the playing field with lower-use systems. Together, these findings point to solutions that employ a systems perspective on design, implementation and evaluation to enable long-term effectiveness in AMR mitigation.