The Global Governance of Antibiotic Stewardship: A One Health Scoping Review and the Integrated Polycentric Glocal Governance Framework (IPGF)
Bibliographic record
Abstract
Antimicrobial resistance (AMR) poses a serious and growing threat to global public health, undermining decades of progress in infectious disease control. Antibiotic stewardship (ABS) — aimed at optimizing antimicrobial use across human, animal, and environmental health — has become central to this response. This article presents a scoping review of 203 academic and grey literature sources to examine the global governance architecture of ABS. Anchored in a One Health lens and drawing on multi-level and polycentric governance theory, the review maps key actors, institutional arrangements, and policy mechanisms shaping international stewardship efforts. Despite growing consensus, stewardship governance remains fragmented, underfunded, and marked by stark disparities between high-income and low- and middle-income countries. To address these challenges, the paper proposes an original Integrated Polycentric Glocal Governance Framework (IPGF) and applies it to two case studies in the Middle East and North Africa (MENA) region. This model emphasizes decentralized coordination, stakeholder inclusivity, and adaptive learning to better align global norms with local realities. The findings call for structural reform and innovative governance approaches to strengthen global antibiotic stewardship and mitigate the accelerating AMR crisis.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.039 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.011 | 0.014 |
| Science and technology studies | 0.001 | 0.003 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".