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Antimicrobial resistance (AMR) is a biological mechanism whereby a micro-organism evolves over time to develop the ability to become resistant to antimicrobial therapies such as antibiotics. The drivers of and potential solutions to AMR are complex, often spanning multiple sectors. The internationally recognised response to AMR advocates for a 'One Health' approach, which requires policies to be developed and implemented across human, animal, and environmental health. To date, misaligned economic incentives have slowed the development of novel antimicrobials and limited efforts to reduce antimicrobial usage. However, the research which underpins the variety of policy options to tackle AMR is rapidly evolving across multiple disciplines such as human medicine, veterinary medicine, agricultural sciences, epidemiology, economics, sociology and psychology. By bringing together in one place the latest evidence and analysing the different facets of the complex problem of tackling AMR, this book offers an accessible summary for policy-makers, academics and students on the big questions around AMR policy.

Drug resistance. --- Drug development. --- Development of drugs --- Drugs --- New drug development --- Pharmacology --- Pharmacy --- Resistance to drugs --- Development --- health systems --- health policies --- health administration --- health economics --- health management --- public policy --- agricultural sciences --- epidemiology --- superbugs --- antibiotic resistance --- drug resistance --- antiobiotic stewardship

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Alcohol policies have significant potential to curb alcohol-related harms, improve health, increase productivity, reduce crime and violence, and cut government expenditure. The WHO Global Strategy to reduce the harmful use of alcohol provides a menu of policy options based on international consensus, which the OECD has used as a starting point in identifying a set of policies to be assessed in an economic analysis based on a computer simulation approach. This working paper provides a comprehensive illustration of the modelling approach, input data and underlying assumptions that have been used to carry out the analyses. The policies assessed in three country settings – Canada, the Czech Republic and Germany – include price policies, regulation and enforcement policies, education programmes and health care interventions. The results of the OECD analyses show that brief interventions in primary care, typically targeting high-risk drinkers, and tax increases, which affect all drinkers, have the potential to generate large health gains. The impacts of regulation and enforcement policies as well as other health care interventions are more dependent on the setting and mode of implementation, while school-based programmes show less promise. Alcohol policies have the potential to prevent alcohol-related disabilities and injuries in hundreds of thousands of working-age people in the countries examined, with major potential gains in their productivity. Most alcohol policies are estimated to cut health care expenditures to the extent that their implementation costs would be more than offset. Health care interventions and enforcement of drinking-and-driving restrictions are more expensive policies, but they still have very favourable cost-effectiveness profiles.

Social Issues/Migration/Health

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This paper provides an overview of past and projected future trends in adult overweight and obesity in OECD countries. Using individual-level data from repeated cross-sectional national surveys, some of the main determinants and pathways underlying the current obesity epidemic are explored, and possible policy levers for tackling the negative health effect of these trends are identified. First, projected future trends show a tendency towards a progressive stabilisation or slight shrinkage of pre-obesity rates, with a projected continued increase in obesity rates. Second, results suggest that diverging forces are at play, which have been pushing overweight and obesity rates into opposite directions. On one hand, the powerful influences of obesogenic environments (aspects of physical, social and economic environments that favour obesity) have been consolidating over the course of the past 20-30 years. On the other hand, the long term influences of changing education and socio-economic conditions have made successive generations increasingly aware of the health risks associated with lifestyle choices, and sometimes more able to handle environmental pressures. Third, the distribution of overweight and obesity in OECD countries consistently shows pronounced disparities by education and socio-economic condition in women (with more educated and higher socio-economic status women displaying substantially lower rates), while mixed patterns are observed in men. Fourth, the findings highlight the spread of overweight and obesity within households, suggesting that health-related behaviours, particularly those concerning diet and physical activity, are likely to play a larger role than genetic factors in determining the convergence of BMI levels within households.

Social Issues/Migration/Health

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This paper provides an overview of past and projected future trends in adult overweight and obesity in OECD countries. Using individual-level data from repeated cross-sectional national surveys, some of the main determinants and pathways underlying the current obesity epidemic are explored, and possible policy levers for tackling the negative health effect of these trends are identified. First, projected future trends show a tendency towards a progressive stabilisation or slight shrinkage of pre-obesity rates, with a projected continued increase in obesity rates. Second, results suggest that diverging forces are at play, which have been pushing overweight and obesity rates into opposite directions. On one hand, the powerful influences of obesogenic environments (aspects of physical, social and economic environments that favour obesity) have been consolidating over the course of the past 20-30 years. On the other hand, the long term influences of changing education and socio-economic conditions have made successive generations increasingly aware of the health risks associated with lifestyle choices, and sometimes more able to handle environmental pressures. Third, the distribution of overweight and obesity in OECD countries consistently shows pronounced disparities by education and socio-economic condition in women (with more educated and higher socio-economic status women displaying substantially lower rates), while mixed patterns are observed in men. Fourth, the findings highlight the spread of overweight and obesity within households, suggesting that health-related behaviours, particularly those concerning diet and physical activity, are likely to play a larger role than genetic factors in determining the convergence of BMI levels within households.

Social Issues/Migration/Health