Understanding what citizens think about Antimicrobial Resistance: Deliberative Polling® in six middle-income countries.

Background: The pandemic of antimicrobial resistance (AMR) will only be mitigated by policy action and innovation and importantly, supported by local and community action. With the United Nations General Assembly high level meeting on AMR taking place in September 2024, we decided to ascertain citizens' understanding of the issues and prioritisation for action. Methods: From June to August 2024, while intergovernmental negotiations on the outcome document were taking place, we used Deliberative Polling Results: In total 2419 participants were randomised to deliberation intervention (written and video information, facilitated online small group discussions, and expert plenary sessions) or control groups who only completed the pre- and post-deliberation surveys. Support increased significantly through deliberation for 3/4 of the proposals (>90% for 2/3), as well as on knowledge about AMR and internal political efficacy. Proposals relating to infection prevention were most heavily supported across all six countries. We found regional variation in support for proposals relating to informal antibiotic access and the use of antibiotics in food production, with less support for selected proposals from South America. Conclusions: Deliberative polling is a powerful method of large scale community engagement and this is new for AMR helping us to understand the views of the public relating to policies that will require their support to enact.