The four worlds of politics and administration in the EU: how institutional arrangements shape the struggle against antimicrobial resistance

Abstract

ABSTRACT Do basic administrative arrangements in the national public sector affect the prevalence of antimicrobial resistance (AMR), and if so, how? AMR, one of humanity’s most pressing challenges according to the World Health Organization, is typically caused by factors inherent to the natural sciences. In this paper, however, we investigate the indirect causal effect of politics and administration on the management of AMR. In a mixed-methodological approach drawing on a panel regression combined with 46 semi-structured interviews with senior bureaucrats and experts from all member states of the European Union (EU), we derive four distinct clusters of countries in AMR governance. The analysis shows that politico-administrative arrangements in the EU follow a north-to-south and east-to-west pattern in the prevalence of AMR. We apply institutional theories of path dependency and administrative autonomy to explain such ‘worlds’ of AMR governance.