The Workstreams

Workstream 1 aims to define, from a multi-stakeholder, UK perspective, the potential impact(s) of AMR-focused interventions by bringing together expertise and facilitate hitherto neglected discussions on impact e.g. who is affected, at what scale, over what time horizon and how this can be measured. The overall aim is to characterise the areas of the AMR burden where intervention can achieve most impact, actively engage with members from across academia, One Health sectors, and wider society through existing and new networks. 

Objectives

Explore the dimensions, and relevant metrics, of the AMR burden and where interventions can achieve impact

Allow appropriate consideration of health inequalities, ethics and acceptability, including challenging questions on impact of interventions on deprived groups

Generate inclusive definitions enabling evaluation of the technical effectiveness of interventions integrating dimensions

Activities

Initial broad-scope online stakeholder workshops to elicit expert opinion, build relationships, and inform onward engagement approaches

Desk-based analysis of the AMR burden and potential avertable burden

Series of engagement events, online and in person, involving information exchange, sandpits for new ideas and nominal-group and/or multi-voting techniques, with a range of groups

Desk-based synthesis of outputs together with analysis of the avertable burden of AMR by quantitative measures, to provide an orientation for recognising the nature and size of potential impacts of AMR interventions in different contexts

Workstream 2 aims to define a process and framework to represent different potential intervention effects to help the AMR community and decision makers to identify and to prioritise the most cost-effective approaches, where cost is measured in terms of all the benefits and costs associated with different interventions. WS2 involves scholars from environmental and agricultural economics, planetary and public health, ethics, veterinary science, epidemiology and psychology.

Objectives

Assume that interventions can impact AMR in multiple ways, and can be more or less effective in achieving this, as well as having positive or negative ancillary effects. It also recognises that prioritisation must account multiple criteria, including economic, public/societal acceptability, behavioural and cultural feasibilities, political feasibility and uncertainty

Initiate focused discussion on which dimensions interreact or are complementary or mutually exclusive. The framework will collate best available scientific evidence to guide AMR investments and allow the community to continually identify and interrogate measure-specific evidence and research gaps as a basis for a post network phase

Develop an abatement cost schedule using a process we have previously developed successfully in a transdisciplinary collaboration to prioritise greenhouse gas emissions mitigation measures

Activities

Review of prioritisation and evaluation frameworks and processes used in similar policy spheres – e.g; climate change mitigation (IPCC, Committee on Climate Change) and national pollution control strategies

Interdisciplinary and transdisciplinary mapping approaches and Delphi exercises to frame and re-conceptualise the evaluation challenge and the use of alternative appraisal frameworks accommodating measure/intervention feasibilities

Evaluation framework development – collaborative development of three working papers on structure and data challenges

Proof of concept exercise to prioritise interventions in at least one One Health setting

Workstream 3 operates across four evidence domains to map existing intervention evidence and develop new proposals to design and evaluate interventions (from a UK perspective) based on evidence gaps and the framework developed in WS2.

WS3 undertakes two phases of activities:

  • A mapping phase to evaluate existing evidence and feed into WS1 and WS2.
  • A proposal development phase to address gaps identified and pilot the framework developed in WS2.

While the focus is on well-developed interventions, WS3 recognises that interventions can have a range of developmental maturities as well as the potential impacts of untested interventions.

Objectives

Undertake a mapping phase to evaluate existing evidence and feed into WS1 and WS2

Undertake a proposal development phase to address gaps identified and pilot the framework developed in WS2

Produce a long-list of interventions and the evidence for their impacts on different outcomes as well as their feasibility, equity, and ethical dimensions

Activities

Desk-based reviews to map evidence, existing impacts, existing prioritisation criteria

Expansion of long-lists of intervention options and evidence of feasibility, equity, and ethical dimensions of implementation through domain-specific workshops and a survey

Domain-specific workshops to catalyse research proposals that can fill gaps and pilot the framework from WS2

Foster collaborations and catalyse new connections within the AMR community

Curate and share latest evidence on interventions prioritisation, as well as knowledge generated through the IMPACT AMR Network

Support interchange of ideas around latest AMR intervention prioritisation efforts

Support the internal communication within the WSs and our external communities

Create diverse and inclusive spaces for discussions, where voices are heard, values, and empowered

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