What makes a leader? Antimicrobial resistance leadership among 29 European countries

This paper investigates which countries are seen as leaders in combatting AMR in Europe, and why they are seen as leaders. We do this by testing the explanatory capacity of three models specifying features of leaders attractive to followers. They are (1) performance, (2) power and (3) common interests. We use data from a survey among experts in the AMR field in 29 European countries, along with empirical indicators, to measure the three models. Our findings show that only eight of the 29 European countries are seen as leaders and that Denmark, Sweden and the Netherlands are considered the three top AMR leaders in Europe. Denmark is the top leader in the animal sector and Sweden in the human sector. We also find demand for several possible types of leadership and followership in the AMR problem. Performance explains the leading role of the top three countries, as they all score low on indicators of the severity of AMR. Power and influence explain why France, Germany and the UK are seen as AMR leaders. We also find support for the role of common interests. This factor may explain why neighbouring countries are often seen as leaders in AMR.