One Health Outlook volume 3 , Article number: 1 Cite this article. Metrics details. The Congress was organised by the One Health Platform, which summarises here in this Meeting report its interpretation of the key messages from the individual talks at the meeting.
The summaries are written entirely by members of the One Health Platform as indicated on the author list. One Health is an important lens through which to view antimicrobial resistance AMR because of the many factors involved: human, animal and environmental. However, relatively little work has been done to take a systems view and consider the feedback loops involved in AMR.
For example, antimicrobials in livestock can be excreted and spread on the land, leach into rivers and streams, and potentially turn up in the drinking water of animals. Feedback loops within the larger system can make it difficult to predict system behaviour, with sometimes unexpected and unintended consequences. A process was therefore started to model these different flows around a One Health system. The research aims to bring together human, animal and environmental health dimensions of AMR in New Zealand, and to model stakeholder understandings of the structure of the AMR system, with a focus on feedback loops.
The approach taken was System Dynamics Modelling which looks at feedback loops as reinforcing and balancing loops that essentially drive the behaviour of the overall system. In-depth interviews were carried out with participants from academia, research, policy, community, advocacy, industry, and clinical disciplines. Respondents were asked for their understanding of what drives AMR, and cognitive maps were generated leading to a set of causal loop diagrams.
The figure shows the causal loop diagram that incorporates all the feedback loops identified from the cognitive maps, and also incorporates a review of the literature on AMR system models. The feedback loops were categorized in different loops. These were the development of antimicrobials and the pharmaceutical economics; the use of antimicrobials and food animals; collaboration; water quality; vulnerability to infection; the pressure to prescribe; and fear of germs. This is the first participatory Systems Dynamic Model with professional stakeholders that integrates the human, animal and environmental aspects of AMR.
