Dr Jackline Kiarie
Director of Programmes, Health Systems Strengthening Unit, Amref Health Africa
Dr Martin Muchangi
Director for Population Health and Environment, Amref Health Africa
One Health offers a practical blueprint for integrating health approaches and interventions to build resilience, translating complexity into coordinated, effective action.
In Africa, one in five bacterial infections1 is already showing signs of Antimicrobial Resistance (AMR). One Health approaches systematically tackle this, guided by the AMR National Action Plans (NAPs).
Turning integration into impact
Yet, implementation lags across Africa. Weak leadership and coordination of One Health platforms across national and subnational levels, coupled with fragmented, sector-specific resourcing of the human, animal and environmental sectors, often leads to siloed implementation.
In Kenya’s semi-arid Marsabit County, the highest levels of animal-human and environmental interactions happen in nomadic pastoralist communities. We facilitate the formation of One Health Units and health outreaches with health workers, veterinarians and environmental health specialists, to expand community access to AMR health promotion, education and mitigation efforts. Ninety-seven percent of users report them as their nearest point of care, and 100% express satisfaction with the service.2
Structured community dialogues are critical for convening the community, local leaders, One Health service providers and government actors to raise awareness on AMR drivers and to devise contextualised mitigation solutions.
Ultimately, this approach creates feedback loops that strengthen AMR surveillance, accelerate response and ensure that investments deliver lasting value.
Structured community dialogues are critical for
convening the community, local leaders, One Health
service providers and government actors to raise awareness
on AMR drivers and to devise contextualised mitigation solutions.
Strong strategies for impactful, locally driven action
Partnering with Kenyan AMR governance agencies, Amref supports development of county-level One Health ‘action plans’ that reflect local realities and considerations for AMR mitigation.
County Antimicrobial Stewardship Interagency Committees (CASICs) at the sub-national level convene human, animal and environmental health actors to align policy with frontline action. These platforms support coordinated surveillance, stewardship and response planning, while helping counties integrate AMR priorities into existing health systems and budgets.
Integrated, community-driven models, like One Health Units, are scalable with proper resourcing and integration; transitioning from pilots to system-level solutions that anticipate and adapt to climate shocks, disease outbreaks and evolving resistance patterns.
Country-level implementation evidence is also informing regional AMR policy. With the Africa Centres for Disease Control and Prevention, we consulted on the development of the African Union AMR Framework 2026–2030, aiming to deliver funded national programmes, functional One Health governance and visible improvements in patient safety and productivity.
With targeted investment, these approaches can transform local success into a global standard.
[1] WHO. (2025). Global antibiotic resistance surveillance report 2025. https://tinyurl.com/2kjthxc4.
[2] Siobhan M. Mor, Micol Fascendini, Sara Imbach, Metalign Ayehu, Kebadu Belay, On behalf of the HEAL Consortium, Community-Designed One Health Units as a Model for Integrated Service Delivery in Pastoralist Areas of Africa (March 2024)
