Prioritising antimicrobial resistance interventions from a One Health perspective: lessons and applied tools for diverse contexts

Antimicrobial resistance (AMR) is a complex and multifaceted One Health challenge. Its inherently interconnected and cross-sectoral nature complicates the evaluation and prioritisation of interventions, particularly when inter-sectoral One Health effects are relevant. Despite growing recognition of the need to assess AMR interventions from a One Health perspective, significant methodological gaps remain – particularly in quantifying the connections between the human, animal and environmental sectors and incorporating these interdependencies into the prioritisation of interventions.<br/><br/>This article summarises a set of tools that have been developed and implemented to support more comprehensive assessments of AMR interventions by the Selecting Efficient Farm-level Antimicrobial Stewardship Interventions from a One Health perspective, or SEFASI, consortium. The tools are grouped into four categories based on the type of insight they provide: i) quantifying and characterising AMR burden, ii) understanding AMR dynamics, iii) understanding sector-specific intervention impacts and iv) evaluating cross-sectoral economic costs and effects. These tools utilise a range of methods including statistical, mathematical, static and dynamic modelling techniques.<br/><br/>Although the use of tools presented is constrained by the availability of epidemiological and economic data, they represent an important step towards addressing the cross-sectoral complexity of AMR. This work introduces practical approaches and highlights how integrating methods with diverse objectives across contexts can enhance understanding and prioritisation of cross-sectoral strategies. It also underscores the value of conceptual and applied frameworks to guide data collection, strengthen capacity for evaluating One Health AMR interventions, and support evidence-based decision-making.