Understanding antimicrobial resistance from the perspective of public policy: a multinational knowledge, attitude, and practice survey to determine global awareness

Abstract

Abstract Background Minimizing the effect of antimicrobial resistance (AMR) requires an adequate policy response that relies on good governance and coordination. We have previously demonstrated a knowledge gap on infectious diseases within the general public, but equivalent data from a policy context are still lacking. The aim of this study is to have a better comprehension of how AMR is understood and perceived among policy makers and stakeholders in tackling AMR on a global level. Methods A digital survey was designed to capture the knowledge, attitude, and practices (KAP) towards AMR. A self-reporting questionnaire was distributed to politicians, policy advisors and relevant stakeholders, and survey responses were collected between November 2020 and March 2021. Results A total of 351 individuals participated in this study with 80% from high-income countries (HIC) and 20% from low- and middle-income countries (LMIC). Fifteen different countries were represented, and the majority of participants were from the Netherlands, Spain and Myanmar. Overall, participants had sufficient knowledge regarding AMR and reported the importance of political willingness in tackling AMR. More than half (65%) of participants from LMIC reported antibiotics misuse, and almost half (48%) claimed to be unaware of this health problem. Politicians and stakeholders from LMIC demonstrated a higher knowledge on AMR but showed poor perception and attitude toward antimicrobial use compared to those from HIC regions. HIC participants emphasized the role of the veterinary sector in particular, as well as the environmental dissemination of antibiotics and drug residues. The lack of funding resources was especially reported by participants from LMIC. Conclusion Inter-regional differences in KAP regarding AMR exist among politicians, policy advisors and relevant stakeholders. Overall, participants demonstrated to have a sufficient level of knowledge and awareness of AMR. This study characterizes a multi-national policymaker and stakeholder mapping that can be used to propose further policy implementation on various governance levels.