Governing antibiotic resistance through One Health: Insights from the political and legal landscape in Senegal

Antimicrobial resistance (AMR), especially antibiotic resistance (ABR), could cause up to 10 million deaths per year by 2050. While ABR is a natural phenomenon, it is exacerbated by antibiotic misuse, poor sanitation, insufficient health infrastructure, weak biosecurity, and environmental contamination. The cross-transmission of resistant bacteria between humans, animal and the environment requires a multi-sectoral response inspired by the One Health concept. With the support of international partners and in line with global policies, Senegal has established a national One Health platform and legal measures to combat ABR. Our study proposes to examine the One Health governance capacities for managing ABR in Senegal, and to identify ways of improvement from a One Health perspective. A qualitative approach was adopted, combining the review of 64 legal instruments and 26 semi-structured interviews conducted between January and August 2023 with actors from governmental, private and non-governmental institutions. The analysis focused on governance structure, legal instrument development and implementation, and ABR surveillance programmes. The thematic analysis of the interview contents highlighted factors influencing the One Health governance capacities in Senegal. One Health governance has been institutionalized in Senegal since 2017 with the creation of the national One Health platform housed at the Prime Minister's Office. However, its effectiveness is limited by weak formalization, inadequate resources, and reliance on external funding. Outdated and poorly enforced legal frameworks hinder ABR management, while rural areas lack sufficient laboratory infrastructure, leading to inappropriate antibiotic use and weak surveillance systems. Power imbalances among stakeholders impede collective action and data-sharing. Despite progress toward international standards, systemic barriers persist. Strengthening the legal framework, improving healthcare infrastructure, and enhancing the One Health platform's status and funding are critical. Institutionalization must connect global orientations with local realities to avoid inequities. Sustainable ABR management requires inclusive, context-sensitive policies, robust domestic investment, and equitable collaboration among stakeholders across the sectors of human, animal, and environmental health.