Coordination Capacity and Performance in Fighting Antimicrobial Resistance

Journal article, 2026

We explore the role of horizontal and vertical coordination in the governance of the work against antimicrobial resistance (AMR). We describe AMR as largely a coordination problem and develop a typology of coordination mechanisms. The empirical analysis draws on a series of interviews with senior AMR experts across Europe. The interviews highlight the substantial governance challenges in vertical and horizontal coordination in many countries. Experts in high-resource countries suggest incremental improvements to governance structures and the cultivation of personal relationships as a response to the coordination challenge. Experts from low- and middle-income countries point to centralization as the solution.