Analyzing antimicrobial resistance as a series of collective action problems

Abstract

Antimicrobial resistance (AMR) causes over 1.27 million deaths annually, making it one of today's most urgent health threats. Given its urgency, there are often calls for large-scale global initiatives to address AMR. However, theories of collective action have yet to be applied to the problem in a systematic and holistic manner. Fuller engagement with collective action theory is necessary to avoid three risks, namely: mischaracterizing the kinds of challenges that AMR presents; over-simplifying the problem by reducing it to a single type of collective action problem while ignoring others; and overstating the ability of collective action theory to formulate effective solutions. This article relies on the work of Elinor Ostrom to develop an analytical framework for collective action problems around public and common goods. When analyzed through this framework, we find that AMR poses at least nine distinct collective action problems. This more granular framing of AMR provides, in our view, a better basis to develop policy solutions to address this multifaceted challenge. We conclude with proposals for future research.

Keywords: collective action, antimicrobial resistance, global health