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Prioritising antimicrobial resistance interventions from a One Health perspective: lessons and applied tools for diverse contexts

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Antimicrobial resistance (AMR) is a complex and multifaceted One Health challenge. Its inherently interconnected and cross-sectoral nature complicates the evaluation and prioritisation of interventions, particularly when inter-sectoral One Health effects are relevant. Despite growing recognition of the need to assess AMR interventions from a One Health perspective, significant methodological gaps remain – particularly in quantifying the connections between the human, animal and environmental sectors and incorporating these interdependencies into the prioritisation of interventions. This article summarises a set of tools that have been developed and implemented to support more comprehensive assessments of AMR interventions by the Selecting Efficient Farm-level Antimicrobial Stewardship Interventions from a One Health perspective, or SEFASI, consortium. The tools are grouped into four categories based on the type of insight they provide: i) quantifying and characterising AMR burden, ii) understanding AMR dynamics, iii) understanding sector-specific intervention impacts and iv) evaluating cross-sectoral economic costs and effects. These tools utilise a range of methods including statistical, mathematical, static and dynamic modelling techniques. Although the use of tools presented is constrained by the availability of epidemiological and economic data, they represent an important step towards addressing the cross-sectoral complexity of AMR. This work introduces practical approaches and highlights how integrating methods with diverse objectives across contexts can enhance understanding and prioritisation of cross-sectoral strategies. It also underscores the value of conceptual and applied frameworks to guide data collection, strengthen capacity for evaluating One Health AMR interventions, and support evidence-based decision-making.

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