A layered strategy for tackling antimicrobial resistance: the Swiss cheese model for policy, prevention, and engagement

• The article introduces a Swiss cheese model applied to antimicrobial resistance (AMR). This model illustrates that while individual layers of defense against AMR have flaws (“holes”), aligning multiple imperfect layers reduces overall risk of failure. (ICARS)

• Proposed strategy: The authors propose 15 interdependent layers—spanning multiple sectors and interventions—that collectively form a robust, multitiered approach to AMR management. These layers include:

  • One Health contexts: Coordinated efforts across human health, animal health, plant systems, and environmental sectors.

  • Targeted interventions: Key measures like water, sanitation, and hygiene (WASH); infection prevention and control (IPC); antimicrobial stewardship; diagnostics; and awareness campaigns.

  • Resource allocation: Sustained investment, capacity development (workforce), and innovation in AMR countermeasures. (The Lancet, ICARS)

• Implementation challenges: The article emphasizes that AMR remains a critical global threat. However, barriers—including weak political will, competing healthcare priorities, underfunded systems, and insufficient policy action—continue to hinder comprehensive strategy execution. (ICARS)

• Key argument: Without sustained investment, strategic communication, and coordinated multi-layered action, AMR will continue to compromise global health, electoral investments in modern medicine, and economic stability. (ICARS)

Why It Matters

• The Swiss cheese model provides a compelling visual analogy and strategic framework—highlighting that no single approach can eradicate AMR, but a coordinated, layered defense can substantially reduce its impact.

• Emphasizing One Health, the commentary aligns with global consensus that AMR must be addressed through interdisciplinary collaboration.

• The attention to resources and innovation, alongside public awareness and stewardship, underscores that success depends on both policy and practical implementation.