Framing Implementation of Vietnam’s National Action Plan to Mitigate Antimicrobial Resistance with a Just Transition Lens: A Case Study of Stakeholders in the Red River Delta

Abstract The Vietnam National Action Plan (NAP) for antimicrobial resistance (AMR) mitigation is a guiding document in the fight against AMR, which outlines policies to slow down the AMR progression and reduce its impact. However, progress in NAP implementation has been uneven. This study implemented 10-stakeholder consultations to explore the NAP implementation through the Just Transition lens with particular focus on tensions, trade-offs, inequalities, and unintended consequences that may inhibit progress. There were 89 participants representing healthcare staff, community members, farmers, drug suppliers, meat handlers, and government agencies responsible for environmental management, sanitation, and hygiene. We used the Just Transition framework to explore perspectives and experiences of NAP implementation in Ha Noi and Nam Dinh province, Vietnam. We found limited contributions of stakeholders to NAP activities and low awareness about its impact. They lacked dedicated resources to implement NAP activities and an effective collaboration mechanism across sectors. Cross-sectoral collaboration has the potential to improve efficiency but may also introduce conflict among stakeholders. Just Transition framing highlights how greater involvement in decision-making and planning could increase visibility, buy-in, and motivation for action among different stakeholders, while making tensions explicit could help with balancing competing interests and ensuring fair distribution of limited resources.