The promises and pitfalls of polysemic ideas: ‘One Health’ and antimicrobial resistance policy in Australia and the UK

Abstract

Recent scholarship posits that ambiguous ('polysemic') ideas are effective for coalition building between diverse stakeholders: their capacity to be interpreted differently attracts different interests. Hence, in search of political solutions to 'wicked' and similarly complex problems, deploying polysemic ideas would be critical to effective policy-making. This paper scopes the policy-making potential of polysemic ideas by examining the impact of an ambiguous concept known as 'One Health' on responses to antimicrobial resistance (AMR) in Australia and the UK. It offers two primary arguments. Firstly, polysemic ideas can help mobilise broad attention to complex problems: since One Health became associated with AMR, political and administrative attention has grown more intense and coordinated than previously. Secondly, however, a polysemic idea alone may be insufficient to generate effective action: the contrast between Australian and UK AMR policies illustrates that polysemic ideas do not suspend interests, institutions, or ideas that can be readily deployed.

Exploring the One Health Perspective in Sweden’s Policies for Containing Antibiotic Resistance

“…A study of the One Health concept and its effect on antimicrobial resistance (AMR) policies in the UK and Australia shows that the UK policies mentions the concept less than the Australian equivalent [ 38 ]. However, this is not reflected in their actions to contain AMR, where Australia has much less surveillance of antibiotic use outside the human sector [ 38 ].…”

“…A study of the One Health concept and its effect on antimicrobial resistance (AMR) policies in the UK and Australia shows that the UK policies mentions the concept less than the Australian equivalent [ 38 ]. However, this is not reflected in their actions to contain AMR, where Australia has much less surveillance of antibiotic use outside the human sector [ 38 ]. We conclude that using the One Health concept might be useful for agenda setting but that in policy making, other factors, such as the way a country’s institutions work (centralised government in the UK vs. multilevel federal system in Australia), are more important for success and that “forcing” policies to fit one concept might lead to ignoring actionable ideas [ 38 ].…”

“…However, this is not reflected in their actions to contain AMR, where Australia has much less surveillance of antibiotic use outside the human sector [ 38 ]. We conclude that using the One Health concept might be useful for agenda setting but that in policy making, other factors, such as the way a country’s institutions work (centralised government in the UK vs. multilevel federal system in Australia), are more important for success and that “forcing” policies to fit one concept might lead to ignoring actionable ideas [ 38 ]. In Sweden, the policies to contain AMR are made at the central level but implemented by local actors.…”

Changes in the Framing of Antimicrobial Resistance in Print Media in Australia and the United Kingdom (2011–2020): A Comparative Qualitative Content and Trends Analysis

“…Discussion of the risks to human health from antibiotic use in agriculture have been present throughout the period sampled in the UK. Despite the importance of One Health approaches in policy making in both jurisdictions [6], this has only recently been raised as a concern in reporting in Australia (Figure 5). After a peak mid-decade, representations of AMR endangering the practice of hightechnology modern medicine in Australian media are declining.…”

“…Perhaps because of the significant real-world impacts of C. diff and E. coli outbreaks, media coverage in the UK has included greater discussion of other potential measures such as improving surveillance, infection control, and hygiene (Figure 7). [6,26,30]. This change has been more rapid in the UK where antibiotic prescribing/use is now much more tightly controlled in healthcare and agriculture following a series of regulatory reforms earlier in the decade.…”