COMMUNITY CASE STUDY published: 31 May 2021 doi: 10.3389/fpubh.2021.673504 Frontiers in Public Health | www.frontiersin.org 1 May 2021 | Volume 9 | Article 673504 Edited by: Ghassan M. Matar, American University of Beirut, Lebanon Reviewed by: Ralitsa Raycheva, Plovdiv Medical University, Bulgaria M. Rashad Massoud, University Research Co, United States *Correspondence: Chioma R. Achi cra37@cam.ac.uk Olaniyi Ayobami ayobamio@rki.de † These authors have contributed equally to this work and share first authorship Specialty section: This article was submitted to Public Health Policy, a section of the journal Frontiers in Public Health Received: 27 February 2021 Accepted: 04 May 2021 Published: 31 May 2021 Citation: Achi CR, Ayobami O, Mark G, Egwuenu A, Ogbolu D and Kabir J (2021) Operationalising One Health in Nigeria: Reflections From a High-Level Expert Panel Discussion Commemorating the 2020 World Antibiotics Awareness Week. Front. Public Health 9:673504. doi: 10.3389/fpubh.2021.673504 Operationalising One Health in Nigeria: Reflections From a High-Level Expert Panel Discussion Commemorating the 2020 World Antibiotics Awareness Week Chioma R. Achi 1,2 * † , Olaniyi Ayobami 3 * † , Godwin Mark 4 , Abiodun Egwuenu 5 , David Ogbolu 6 and Junaidu Kabir 7 1 Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom, 2 Department of Veterinary Public Health and Preventive Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria, 3 Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany, 4 Department of Internal Medicine, Federal Teaching Hospital Gombe, Gombe, Nigeria, 5 National AMR Programme, Nigeria Centre for Disease Control, Abuja, Nigeria, 6 Medical Microbiology Unit, Department of Medical Science, Ladoke Akintola University of Technology, Ogbomosho, Nigeria, 7 Department of Veterinary Public Health and Preventive Medicine, Ahmadu Bello University Zaria, Zaria, Nigeria Antimicrobial resistance (AMR) poses an important One Health challenge for all countries of the world. As human, animal and environmental health are closely linked, it is essential that interventions targeted at reducing the spread of AMR and those promoting antimicrobial stewardship are conducted with all sectors in mind. Tackling this global slow-moving pandemic (AMR) also requires action and strong commitment from all countries of the world. Nigeria, like many other countries, have made considerable progress in implementing the National Action Plan on Antimicrobial Resistance. The accomplishments and ongoing work led by the National Technical Working Group on AMR is commendable. However, gaps still exist in terms of operationalising One Health interventions for AMR, especially regarding rational antimicrobial use and antimicrobial stewardship. The 2020 World Antimicrobial Awareness Week presented an opportunity to convene a multi-sectoral expert panel from national government agencies, research, academia and the World Health Organisation across the Nigerian One Health space. The panel discussion analysed the progress made so far and identified the barriers and the opportunities for operationalising One Health interventions on AMR. The discussion highlighted poor awareness and the fear phenomenon, driven by technical and socio-economic factors, as a common cross-sectoral denominator at the heart of inappropriate antibiotic use within the country. At the system level, suboptimal use of antimicrobials fuelled by the ease of purchase, poor regulations and insufficient enforcement of prescription-only access to antimicrobials, and limited infection prevention and biosecurity measures resonated as drivers of AMR across One Health sectors in Nigeria. Looking forward, the panel discussion identified substantial investment in the governance of the existing One Health component structures, inclusive bottom-up institutional antimicrobial stewardship that fosters community participation and multi-level cross-sectoral collaborations as the next level strategic imperatives. In this