Multilevel governance of antimicrobial resistance risks: a literature review

Antimicrobial resistance (AMR) is increasing and spreading throughout the world. Many academic publications address the human health care, veterinary, food safety and environmental aspects of this cross-border challenge. This paper focuses on the broader issue of the governance of AMR at multiple levels, from local to global. The paper provides a literature overview on the full complexity of the governance of the risk. A structured search strategy for the period 2002–2016 was applied using online databases. The literature is analyzed and presented along five themes that were distilled: levels, sectors, responsibilities, uncertainties, and values. On top of the medical-technical dimension of AMR, these five themes need to be taken into account for the governance of AMR risks.