Using implementation science to bridge the gaps between political commitment and action in antimicrobial resistance governance under the one health approach in the WHO Southeast Asia and Western Pacific regions

Abstract

<p>The WHO Southeast Asia and Western Pacific regions, home to more than half of the world's population, bear a disproportionate burden of antimicrobial resistance (AMR), including some of the most severe resistance patterns. The convergence of rapidly growing economies and persistent health system challenges in these regions creates a critical platform for understanding the dynamics of AMR and developing scalable governance approaches relevant to other low- and middle-income countries. This Viewpoint reviews current progress in AMR governance globally and study regions, with a focus on country-specific National Action Plans, and highlights the discrepancies between policy intentions and actual implementation. Implementation science, developed to address research-to-practice gaps, provides a systematic framework for identifying and overcoming barriers to implementation, thereby translating political commitments into actionable interventions. Given the cross-sectoral complexity of AMR, we propose novel strategic priorities to enhance AMR governance by embedding implementation science within the One Health approach. This involves a four-step process: selecting and adapting evidence-based practices, assessing multilevel barriers and enablers, selecting, using and adapting implementation strategies, and evaluating and sustaining their impact. Together, this framework provides a blueprint for localising and operationalising overarching policy concepts into concrete, context-specific actions, with potential lessons for other regions globally.</p>