How law can help solve the collective action problem of antimicrobial resistance

Hoffman, Steven J.; Bakshi, Reema; Rogers Van Katwyk, Susan

The first step is to change global governance structures so that they address the root social causes of AMR. While AMR is usually considered a natural microbiological or medical challenge, the problem to humans is that we are accelerating microbial evolution through the currently established social contexts in which we live and use antimicrobial medicines, leading to the unnecessary abuse of this precious resource. Resistance itself will always occur, as it is a natural biological process-one that Sir Alexander Fleming high- In terms of global market failures, using the lens of political economy, there are some clear game-theoretic problems that make current government actions rational but that lead to suboptimal global collective actions overall. For example, the free-rider problem is often present when we are attempting to achieve greater innovation. The theory is that the free-rider problem occurs when people or countries can benefit from a public good or service without making a significant investment themselves. This ultimately results in a lack of provision of those products. 20 When a public good is available to all, and is costly to produce, rational actors will attempt to free-ride on the work of others. The economic assumption is that international standards that apply to all countries to invest in antimicrobial innovation and regulate the use of antimicrobials-albeit appropriately differentiated according to national circumstance-is the only cost-effective and sustainable way of solving this free-rider problem. 21 In the absence of such an international collective approach, it is difficult to convince any government to invest in antimicrobial innovation when each can simply wait for another country,