Much Can Be Learned about Addressing Antibiotic Resistance from Multilateral Environmental Agreements.

Antibiotic resistance (ABR) is a common-pool resource challenge. This means that efforts to address ABR can learn from similar collective action problems faced within the environmental sector. Multilateral environmental agreements are the backbone of global environmental governance. Their ability to effectively solve environmental problems depends on the problem structure and the regime's problem-solving capacity. The success or failure of environmental agreements is mainly determined by the problem structure, including the degree of political consensus and scientific certainty. But agreements' institutional design also matter because they can change the problem structure and problem-solving capacity. Based on experiences with environmental agreements, an international ABR agreement should contain robust reporting/verification procedures, sanctions for non-compliance, assistance for implementation, majority vote decision-making rules, a strong secretariat, an independent scientific panel, and specific commitments. More research on global strategies for achieving collective action is needed to help inform future institutional designs that are both effective and politically feasible.