68 journal of law, medicine & ethics Asha Behdinan, B.A.&Sc., is an M.D. Candidate at the University of Toronto in Toronto, Canada and a Research Assistant at the Global Strategy Lab, Faculty of Law at the University of Ottawa in Ottawa, Canada. In summer 2015 she worked as an intern for the World Health Organization’s Regional Oice for Europe. Steven J. Hofman, B.H.Sc., M.A., J.D., is an As- sociate Professor of Law and Director of the Global Strategy Lab at the University of Ottawa with courtesy appointments as an Assistant Professor of Clinical Epidemiology & Biostatistics (Part-Time) at McMaster University and Adjunct Associate Professor of Global Health & Population at Harvard University. He previously worked for the Ontario Ministry of Health & Long-Term Care, World Health Organization, and the Executive Oice of the United Nations Secretary-General. Mark Pearcey, B.A., M.A., Ph.D., is a Research Associate at the Global Strategy Lab, Faculty of Law at the University of Ottawa in Ottawa, Canada, and a Contract Instructor with the Department of Political Science at Carleton University in Ottawa, Canada. He was previously a Research Associate with the Centre for Trade Policy & Law in Ottawa, Canada. Introduction This article assesses which policies for addressing antibiotic resistance (ABR) as part of a multi-pronged approach would beneit from legalization through an international legal agreement. Ten candidate policies were identiied based on a review of existing literature, especially The Lancet Series on Antimicrobial Resis- tance (AMR), 1 The Lancet Infectious Diseases Com- mission on AMR, 2 and the World Health Organization (WHO) Global Action Plan for AMR. 3 These policies were then grouped under the headings of access, con- servation, and innovation. 4 Each of the ten policies were assessed using four cri- teria developed by Hofman, Røttingen, and Frenk to help consider why their legalization may be helpful, necessary and/or justiied. 5 These criteria are: (1) the problem has a signiicant transnational dimension; (2) the goal justiies the coercive nature of law; (3) the outcome is likely to be beneicial; and (4) legalization represents the best commitment mechanism among competing alternatives. 6 Using these criteria as analytic benchmarks, we explore how several global policies for ABR depend on legally binding and enforceable commitments, how additional policies would beneit from legalization, and how other policies could helpfully contribute to a grand bargain that galvanizes support for the imple- mentation of these provisions. Of course, international law can also helpfully articulate principles or recom- mend national policies for states to consider adopting, but such use of international legal agreements is not the focus of this article. Global Access Policies Two policies fall under the access pillar; both address the underprovision of antibiotics, diagnostic tools, and infection control practices. 1. Mobilizing Financial Resources for Laboratory, Surveillance, and Health System Infrastructure in Resource-Poor Countries Development assistance is still necessary for health sys- tems strengthening in many low- and middle-income countries (LMICs). Strong health systems are the back- bone of reducing the global threat of ABR. For exam- ple, stronger laboratory and surveillance systems and infection prevention programs would lower the preva- lence of infectious disease and improve the quality of information on the spread of ABR. The inclusion of this policy in an international legal agreement could ensure that resource-poor countries have access to the inan- Some Global Policies for Antibiotic Resistance Depend on Legally Binding and Enforceable Commitments Asha Behdinan, Steven J. Hofman, and Mark Pearcey