Global policy review to identify links between climate change and antimicrobial resistance

OBJECTIVES: To identify explicit reference to the interdependence between antimicrobial resistance (AMR) and climate change (CC) within global policy for AMR and CC. STUDY DESIGN: This review uses the principles of systematic searching, qualitative evidence synthesis and framework analysis. METHODS: Two searches were conducted: (1) explicit AMR policy searching was conducted via searching country AMR National Action Plans (NAPs) on the World Health Organisation Website; and (2) CC policy searching was conducted by reviewing United Nations Framework Convention on Climate Change (UNFCCC) National Communication (NC) documents. Search and coding processes were conducted independently by two sets of researchers and discussions were held to resolve any discrepancies between findings. RESULTS: 155 NCs and 81 NAPs were included in the review. 10 (12 %) NAPs and 19 (12 %) NCs demonstrated reference to a relationship between CC and AMR. In most cases, these were limited to a single mention. The most common connection made was to "shared solutions" to the issues and to "CC driving AMR". The depth of the interconnection described is largely commentarial, lacking sufficient detail of modalities of interaction. CONCLUSIONS: Most CC and AMR global policy documents do not reference interdependence between CC and AMR. Where references occur, these are simplistic and do not detail pathways of interactions. Most references are within descriptive text and lack targeted action. This review highlights inadequate focus within policy on this important intersection. This review should inform future global policy development that focuses on integrated approaches to CC and AMR across the One Health system.