Antimicrobial resistance: interdisciplinary approach and co-production process

The research project had both important interdisciplinary and transdisciplinary dimensions. Diversity of backgrounds was critical to provide relevant information about the current and future engagement of involved organisations.

Regarding the interdisciplinary collaboration, the team had several prominent members. Prof. Nicolas Levrat is an international lawyer knowledgeable about global and regional governance. In Geneva, we collaborated with the professors Didier Pittet and Stephan Harbarth based at the Geneva University Hospital. Both of them are clinicians with long-term experience working with the World Health Organization (WHO). Regarding the collaboration with the University of Hong Kong, the director of the School was Professor Keiji Fukuda, who was Assistant Director General at WHO and strongly involved in addressing antimicrobial resistance (AMR). Prof. Ben Cowling and Malik Peiris, also based at the University of Hong Kong, have experience in the broader field of infectious diseases.

In terms of interdisciplinary approach, we created a framework to capture the main elements and interactions of the regime complex on AMR. This interdisciplinary framework involved the combination of two dimensions. From the medical side, we identified six main challenges of global collective action regarding AMR based on a review of the literature. This approach shed light on the nature of the problem and the main priorities/strategies to address it. In terms of international relations, we discussed the main functions of international organisations and other global stakeholders based on the literature. Additionally, we described the relevance of these elements in several sectors including human health, animal health, food production, and the environment, where antimicrobials are used or have an impact. This was really helpful to understand that the governance system usually exerts a range of functions ranging from the production and synthesis of information; the production of norms; advocacy and awareness raising; funding, procurement and delivery; and oversight, monitoring, and evaluation. The interdisciplinary framework based on sound theories was useful for data collection and for organising and interpreting the findings.

Regarding the co-production process, the main collaboration was with the United Nations Foundation based in New York City. They conducted interviews with people working in the relevant international organisations, while our work focused mainly on desktop research. The main advantage of their approach was to provide additional data about a few activities missed by desktop research, about how international organisations perceive their own role, and finally about their future engagement with AMR. On the other hand, the information that you get from an organisation depends on the person with whom you talk. Sometimes, it can be challenging to talk to the right person in an organisation.

During the research process from January to September 2018, frequent exchanges took place between the interdisciplinary team. After the initial findings, each organisation was discussed regarding its current activities. This was a way to avoid missing important things. Diversity of backgrounds in the interdisciplinary team was critical to provide relevant information about the current and future engagement of these organisations. As for the collaboration with the United Nations Foundation, there were also regular meetings. The two approaches for data collection were complementary. Due to the far distances between the team members’ domiciles, most meetings took place through audio and video conferencing.

We look forward to reading your comments.

Author: Dr. Didier Wernli