Institutionalising One Health Strategies for Addressing Antimicrobial Resistance in the Environment in the Context of Scottish-UK Governance Dynamics

<ns3:p>Background Antimicrobial resistance (AMR) presents a complex global health challenge requiring coordinated responses across human, animal, and environmental sectors. This study explores how a One Health approach to AMR is being implemented within the United Kingdom’s and Scotland’s multi-level governance frameworks, with a particular focus on the integration of environmental considerations. Methods The research draws on qualitative data from semi-structured interviews with stakeholders across government, academia, and relevant sectors. The analysis examines multisectoral collaboration, governance structures, leadership, and mechanisms for accountability and evaluation, using the 2019–2024 UK National Action Plan for AMR as a contextual frame. Results Findings highlight the importance of strategic coherence and goal alignment in navigating complex governance arrangements. Effective implementation of One Health principles depends on coordination across health, environmental, and academic sectors. However, challenges persist, including reliance on informal networks, unclear institutional responsibilities, scientific uncertainty, and gaps in cross-sectoral data systems and monitoring indicators—particularly in relation to the environmental dimension. Conclusions The study underscores the need for integrated strategies and sustained stakeholder engagement to operationalise a One Health approach to AMR. While the approach offers significant potential, its success relies on long-term cross-sectoral collaboration and clearer governance mechanisms.</ns3:p>