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Erik Baekkeskov, Olivier Rubin, Louise Munkholm, and Wesal Zaman

Antimicrobial resistance (AMR) is a global health crisis estimated to be responsible for 700,000 yearly deaths worldwide. Since the World Health Assembly adopted a Global Action Plan on AMR in 2015, national governments in more than 120 countries have developed national action plans. Notwithstanding this progress, AMR still has limited political commitment, and existing global efforts may be too slow to counter its rise. The article presents five characteristics of the global AMR health crisis that complicate the translation from global attention to effective global initiatives. AMR is (a) a transboundary crisis that suffers from collective action problems, (b) a super wicked and creeping crisis, (c) the product of trying to solve other global threats, (d) suffering from lack of advocacy, and (e) producing distributional and ethical dilemmas. Applying these five different crisis lenses, the article reviews central global initiatives, including the Global Action Plan on AMR and the recommendations of the Interagency Coordination Group on AMR. It argues that the five crisis lenses offer useful entry points for social science analyses that further nuance the existing global governance debate of AMR as a global health crisis.


Rational choice theory builds from a very simple foundation. To wit: individuals are presumed to pursue goal-oriented behavior stemming from rational preferences. Rational choice theory benefits from the very precise formulations of its assumptions. Individual-level rationality is generally defined as having complete and transitive preferences. Both completeness and transitivity have precise, formal definitions. From complete and transitive preferences, one can develop utility function presentations reflecting those preferences. Utility functions have the advantage of establishing a measure and allowing one to assess attitudes toward risk. That is, utility functions can reflect risk acceptance, risk neutrality, or risk aversion. Although some rational choice theorists focus on individual-level decision making, most rational choice theorists consider the ways in which individuals’ decisions are aggregated into some sort of social outcome or social preference order. The aggregation of individuals’ preferences occurs in both social choice and game theoretic models. Arrow’s theorem is the best-known result in social choice theory. Arrow showed that the rationality of individuals’ preferences could not be readily preserved at the group level when those individuals’ preferences were aggregated. That is, individual-level rationality does not ensure group-level rationality. Put slightly differently, irrationality at the group level cannot impugn rationality at the individual level. Other examples highlighting the difficulty of aggregating individuals’ preferences into a collective outcome abound. For instance, game theoretic presentations of the collective action problem highlight how individually rational decisions can lead to suboptimal outcomes. Rational choice models have been used to model interactions in a wide array of political institutions. Rational choice models have been developed to tackle some of the most challenging concepts in the social sciences, even in areas long thought impenetrable to rational choice theorizing. For instance, concepts such as ideology or personal identification have typically been used as preestablished descriptors. In contrast to treating those concepts as extant descriptors, rational choice theorists have modeled the endogenous development of ideologies and personal identification. Given the complexity of social phenomena, the relative parsimony and the clarity of rational choice models can be particularly helpful. The usefulness of rational choice models stems from their parsimony and their applicability to a wide range of settings.