Policy Entrepreneurship and Problem Brokering in the Global Governance of AMR

Abstract This chapter addresses the apparent puzzle that an increase in global attention and agenda setting does not appear to have produced an equivalent increase in actual implementation of AMR response initiatives. By drawing on the multiple streams approach, the chapter differentiates between problem brokerage, aimed at turning societal challenges into explicit policy problems, and then policy entrepreneurship, focused on the actual formulation and execution of policies. It is argued that health experts have successfully acted as problem brokers in the 2010s by placing the threat of AMR on the global agenda. However, they have been less successful as policy entrepreneurs in translating this increase of attention into concrete policy initiatives. Although health experts are not well-equipped to act as policy entrepreneurs, they still continue to constitute the backbone of policy entrepreneurship on AMR management. A broader coalition of powerful actors is needed for translating agenda setting into actual policies and programs. The chapter argues for the need to foster a stronger advocacy ecology around AMR. The political challenge for effective AMR response is not only to increase scientific awareness but also to mobilize sufficient numbers and kinds of powerful actors to push forward policy and its implementation. The chapter recommends more focus and funds for network and coalition-building activities that extend beyond the health sector.