Leviathan versus the super bugs: free riding drives support for EU power over antimicrobial resistance

ABSTRACT

The Covid-19 pandemic has spurred a discussion about the role of the European Union (EU) in the governance of cross-border health threats. Antimicrobial resistance (AMR) is another major global health challenge that requires international collective action to be resolved. By using survey data from experts on AMR from 29 European countries, this paper investigates the support for an increase in the power of EU over AMR. Based on insights from collective action theory, we hypothesize that experts who believe that other countries free ride, will be more supportive of EU as a Leviathan in the European response to AMR. The results show that the experts generally were strongly in favor of expanding the authority of the EU over AMR. Furthermore, in line with theoretical expectations, experts who think that other countries free ride, are particularly supportive of more EU power over AMR.

KEYWORDS:

• Collective action
• antimicrobial resistance
• free riding
• the European Union
• experts

Acknowledgments

Financial support for this research was provided by the Swedish Research Council grant number 2018-01330 and the Centre for Antibiotic Research (CARE), at the University of Gothenburg. We are grateful for the constructive and helpful comments by the reviewers. We would like to thank LORE at the University of Gothenburg for their excellent research assistance in administrating the survey.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. Regulation (EC) No 1831/2003, EU (2005).

2. E.g. the Antimicrobial Resistance and causes of Non-prudent use of Antibiotics (ARNA) project, funded by the EU. The project’s objective is to promote prudent use of antibiotics in the EU,

3. https://antibiotic.ecdc.europa.eu/sv/european-antibiotic-awareness-day-eaad-2020

4. Belgium (13), Bulgaria (7), Estonia (4), Finland (59), France (27), Greece (16), Ireland (7), Italy (9), Latvia (1), Lithuania (6), Luxemburg (10), Poland (7), Portugal (2), Romania (2), Slovenia (5), Spain (3), Sweden (3), the Czech Republic (3), Germany (3), the UK (6), Austria (3).

5. Cyprus, Denmark, Greece, Ireland, Croatia, Latvia, Lithuania, Malta, the Netherlands, Norway, Portugal, Slovakia, Spain, Sweden, Germany, Hungary, and France.

6. In all the regressions, the standard errors are adjusted for the 29 clusters in the panel indicator variable ‘country’.

Additional information

Funding

This work was supported by the The Centre for Antibiotic Research (CARE), University of Gothenburg [2020–2022]; The Swedish Research Council [2018-01330].