Implementation determinants of national antimicrobial resistance strategies: a comparative policy analysis of the Russian federation and Nigeria

Abstract

Antimicrobial resistance (AMR) policies implementation across national health systems is still poorly understood, despite the growing global health burden. A comprehension of how different countries implement AMR policies will help identify effective and context-sensitive control measures. A comparative scoping review was carried out in accordance with PRISMA Scoping Review guideline. Grey literature and structured database searches were employed to find peer-reviewed literature, national policy documents, and institutional reports released between 2010 and 2025. The One Health framework served as the basis for the analysis, which encompassed cross-sectoral coordination, pharmaceutical regulation, antimicrobial stewardship, governance structures, surveillance systems, and funding sources. The findings were narratively synthesised, with a focus on implementation capacity rather than policy formulation. National action plans that were in conformity with the WHO Global action plan were adopted by both nations in 2017; however, their implementation approaches were substantially different. Integrating stewardship and prescription control into formal institutional structures proved practicable in the Russian Federation, with centralised governance authority, structured surveillance advancement, and continuous domestic funding. Implementation of AMR in Nigeria operates in a setting of poorly coordinated government, weak enforcement, donor-dependent funding, a dysfunctional medical sector and weak data-to-policy correlation. Implementation performance across domains is more about institutional coherence than policy alignment in isolation. AMR containment is essentially an implementation challenge. Cross-country analysis highlights phased adaptation to institutional capabilities rather than direct replication of external policy models.