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  1. Coevolutionary Governance of Antibiotic and Pesticide Resistance
    Søgaard Jørgensen P, Folke C, Henriksson PJG, Malmros K, Troell M, Zorzet A, et al.
    Trends Ecol Evol, 2020 Jun;35(6):484-494.
    PMID: 32396815 DOI: 10.1016/j.tree.2020.01.011
    Development of new biocides has dominated human responses to evolution of antibiotic and pesticide resistance. Increasing and uniform biocide use, the spread of resistance genes, and the lack of new classes of compounds indicate the importance of navigating toward more sustainable coevolutionary dynamics between human culture and species that evolve resistance. To inform this challenge, we introduce the concept of coevolutionary governance and propose three priorities for its implementation: (i) new norms and mental models for lowering use, (ii) diversifying practices to reduce directional selection, and (iii) investment in collective action institutions to govern connectivity. We highlight the availability of solutions that facilitate broader sustainable development, which for antibiotic resistance include improved sanitation and hygiene, strong health systems, and decreased meat consumption.
  2. Scope and applicability of social-ecological resilience to antimicrobial resistance
    Wernli D, Søgaard Jørgensen P, Parmley EJ, Majowicz SE, Lambraki I, Carson CA, et al.
    Lancet Planet Health, 2023 Jul;7(7):e630-e637.
    PMID: 37438004 DOI: 10.1016/S2542-5196(23)00128-6
    Social-ecological systems conceptualise how social human systems and ecological natural systems are intertwined. In this Personal View, we define the scope and applicability of social-ecological resilience to antimicrobial resistance. Resilience to antimicrobial resistance corresponds to the capacity to maintain the societal benefits of antimicrobial use and One Health systems' performance in the face of the evolutionary behaviour of microorganisms in response to antimicrobial use. Social-ecological resilience provides an appropriate framework to make sense of the disruptive impacts resulting from the emergence and spread of antimicrobial resistance; capture the diversity of strategies needed to tackle antimicrobial resistance and to live with it; understand the conditions that underpin the success or failure of interventions; and appreciate the need for adaptive and coevolutionary governance. Overall, resilience thinking is essential to improve understanding of how human societies dynamically can cope with, adapt, and transform to the growing global challenge of antimicrobial resistance.
  3. Fulltext Is scientific evidence enough? Using expert opinion to fill gaps in data in antimicrobial resistance research
    Cousins M, Parmley EJ, Greer AL, Neiterman E, Lambraki IA, Graells T, et al.
    PLoS One, 2023;18(8):e0290464.
    PMID: 37616319 DOI: 10.1371/journal.pone.0290464
    BACKGROUND: Antimicrobial Resistance (AMR) is a global problem with large health and economic consequences. Current gaps in quantitative data are a major limitation for creating models intended to simulate the drivers of AMR. As an intermediate step, expert knowledge and opinion could be utilized to fill gaps in knowledge for areas of the system where quantitative data does not yet exist or are hard to quantify. Therefore, the objective of this study was to identify quantifiable data about the current state of the factors that drive AMR and the strengths and directions of relationships between the factors from statements made by a group of experts from the One Health system that drives AMR development and transmission in a European context.

    METHODS: This study builds upon previous work that developed a causal loop diagram of AMR using input from two workshops conducted in 2019 in Sweden with experts within the European food system context. A secondary analysis of the workshop transcripts was conducted to identify semi-quantitative data to parameterize drivers in a model of AMR.

    MAIN FINDINGS: Participants spoke about AMR by combining their personal experiences with professional expertise within their fields. The analysis of participants' statements provided semi-quantitative data that can help inform a future of AMR emergence and transmission based on a causal loop diagram of AMR in a Swedish One Health system context.

    CONCLUSION: Using transcripts of a workshop including participants with diverse expertise across the system that drives AMR, we gained invaluable insight into the past, current, and potential future states of the major drivers of AMR, particularly where quantitative data are lacking.

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