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Antimicrobial resistances (AMR) present an emerging concern in human and animal health policy, as well as in water policy as a consequence of the pollution of water resources by antibiotic substances stemming from manure and sewage treatment plants. In 2017, the European Commission passed an AMR Action Plan and urged member states to develop national action plans to coordinate action across human, animal and environmental health. Building on the literature on policy integration we conduct comparative case studies in order to explore how European countries address the AMR challenge and if policies respond to the cross-sectoral character of AMR. We find that policy integration varies across countries provide explanations for why this is the case and come to three main conclusions: Firstly, and confirming previous research, a pronounced executive capacity, the presence of green parties in parliament, and a consensus democracy are each necessary but not sufficient conditions in configurations leading to policy integration. Secondly, executive capacity only results in policy integration if there is no important agricultural sector articulating its interests. Thirdly, even if there is an important agricultural and/or livestock sector, green parties in parliament or consensus democracies can balance these interests towards a successful policy integration.

Antimicrobial resistance policies in European countries – a comparative analysis of policy integration in the water-food-health nexus