Stakeholder analysis for 'One Health' approach to tackle antimicrobial resistance

Antimicrobial resistance (AMR) and interventions to mitigate it are multisectoral, exhibiting super-wicked features that require intersectoral collaboration and synergy. Although AMR and mitigation strategies are pressing issues, their solutions are complex, ethically challenging, multilayered and often conflict at various levels and among diverse stakeholders. The main objective of this study was to identify the values and potential contributions of stakeholder analysis related to AMR and potential interventions from a case study that is being undertaken in Nepal using a 'One Health' approach. A total of 33 representatives from human, animal, agricultural and environmental sectors attended a stakeholder meeting in Kathmandu to discuss AMR, its ethical and practical challenges, opportunities and potential interventions. Using a five-pillar framework for stakeholder analysis, we demonstrate its relevance for addressing AMR and propose practical considerations for implementing effective interventions in Nepal. Beyond the practical discussions on AMR and its interventions at the policy, implementation and practice levels, this study underscores the critical value of its methodological reflections for informing ongoing interventions both within Nepal and in similar contexts globally.