A Just Transitions framework for equitable and sustainable mitigation of antimicrobial resistance

The AMR Circus Project is a community-driven engagement campaign to raise awareness of antimicrobial resistance (AMR). This project is part of a body of work on AMR engagement in Southeast Asia overseen by the co-lead of the JT AMR group, Professor Phaik Yeong Cheah. The campaign was co-created by the Cambodian Ministry of Health, Mahidol Oxford Tropical Medicine Research Unit (MORU), and the Cambodia-Oxford Medical Research Unit (COMRU), in partnership with a non-profit arts school, Phare Ponleu Selpak, and local health departments and the Siem Pang-based youth advisory group on health and research engagement.

Across four live shows in Siem Reap and Battambang, circus performers used humour, acrobatics, and familiar social scenarios to bring to life common misconceptions about antibiotics, such as using antibiotics for viral illnesses and receiving unlabelled mixed medicines. The highlight of the performance featured a symbolic battle between an antibiotic and a resistant bacterium, followed by a health professional character discussing good antibiotic practices.

Performances were supported by a range of visual and print materials, including brochures, posters, and watercolour artworks made by young artists. To extend the project’s reach beyond live audiences, circus performers featured on social media videos highlighting the dangers of antibiotic misuse. A short documentary was also produced to capture and visualize the entire project. You can see the documentary on YouTube.

AMR has claimed an estimated 3,000 lives a year in Cambodia since 1990, however awareness of AMR remains low. The project highlights the power of an accessible community approach to address this health challenge.

Rashaad Wijntuin, Campaign Manager and visiting postgraduate student, MORU said: “In Cambodia, antibiotics are sold almost everywhere-at pharmacies, grocery stalls, and often in unlabelled bags. Taking them for everyday ailments has become a cultural norm, passed down through generations and reinforced by community suggestions.

“That’s why co-creation was so important: from the script to the logos and videos, making sure local partners shaped the project in their own way was crucial to engage the public effectively.

“The circus performers and visual artists drew on experiences they knew well, which made the stories resonate even more with the audience, and with themselves. As a result, many said they learned a lot and felt eager to bring that knowledge back to their families and communities.”

Dr Tom Peto, Research Epidemiologist, MORU, said: "When we combine research with creative community engagement, we can break through traditional barriers to health education. What we found encouraging was how effectively the circus performances conveyed complex concepts about antibiotic resistance to young audiences who are often difficult to reach through conventional health messaging.”

This blog is based on the article: Tracing epistemic injustice in global antimicrobial resistance research, Trends in Microbiology, 2025

Why is antimicrobial resistance (AMR) such a complex and multi-faceted challenge? In this interview, Phaik Yeong Cheah reflects on the multiple ethical tensions prevalent in efforts to mitigate AMR. She also explains why AMR is a secondary problem and even a distant issue for many people and why it disproportionately burdens poor and marginalised communities, and how the multi-disciplinary Just Transitions for AMR convening group is trying to tackle the issue.

The Just Transitions for AMR working group has made a formal submission to the United Nations Committee on Economic, Social and Cultural Rights (CESCR) to provide input into a General Comment (no. 27) that this committee is expected to issue towards the end of February 2025 about sustainable development.

Our input relates to the urgency to recognise a right to a healthy, sustainable and clean microbial environment for sustainable development. In particular, the submission highlights the threats of unsustainable consumption and production patterns on microbiota, arguing that the human right to a healthy, clean and sustainable environment implicit in the International Covenant on Economic, Social and Cultural Rights (the Covenant) encompasses a legal obligation to manage the microbial commons sustainably.

Read the submission in full by following the arrow below and selecting submission no. 37 – Just Transitions for AMR Working Group (joint submission).

Sonia Lewycka, co-lead of the global convening programme, talks about how One Health interventions in the community can help combat antimicrobial resistance. Antimicrobial resistance can be viewed through a One Health lens across humans, animals and the environment. Focussing on primary care, tests offered at point-of-care in Vietnam to curb antibiotic overuse yielded promising but nuanced results. The Just Transition initiative, examining justice implications of AMR policies globally, aims to align efforts with climate change mitigations for mutual benefits.

Researchers from Stellenbosch University facilitated five dialogue sessions with participants from the fields of health, food science, agriculture, animal health, and the environment as well as science communication and journalism. The dialogues, made possible through a Knowledge Translation Grant from the British Academy, provided an opportunity for sharing insights and concerns with one another as well as co-create solutions for the mitigation of AMR that are just and equitable and suitable for the local context of South Africa.

This two-day workshop, hosted by One Health Trust, and funded by WHO and the British Academy, focused on how social and economic inequities related to gender and caste in India can affect the emergence and spread of drug-resistant infections. It also investigated how gender inequity and climate change influence AMR. A diverse group of researchers looked at potential solutions and strategies to ensure gender, caste and climate considerations are included in important policies and health practices.

CATIE (Tropical Agricultural Research and Higher Education Center) hosted an international dialogue event to deepen discussion on the challenges and opportunities of antimicrobial resistance (AMR) from a just transition perspective.

The activity was held within the framework of the British Academy’s Global Convening Programme 2026. This is an initiative that promotes intersectoral thinking and dialogue among academia, civil society organisations, community activists, and regional entities on complex global health challenges.

Read the CATIE advances a global agenda press release.

CATIE (Tropical Agricultural Research and Higher Education Center), in coordination with the University of Oxford, held the workshop “Integrating Climate Change Adaptation and Antimicrobial Resistance: From Agendas to Action” at its campus.

The event served as a knowledge translation space aimed at fostering dialogue among decision-makers, academia, and practitioner teams.

Read the CATIE and the University of Oxford press release.

Antimicrobial resistance (AMR) is among the most urgent and complex global health challenges of our time. But it is also a human rights and social justice crisis, deeply entwined with planetary environmental crises.

A new Special Issue in 'Public Humanities, Antimicrobial Resistance: Just Transitions for Shared Futures' brings together scholars from the humanities, social sciences and global health to re‑imagine how we live with AMR and our microbial world. Guest edited by Dr Sheila Varadan, Dr Sara de Wit, Dr Miriam Waltz and Dr Claas Kirchhelle, the issue applies “just transitions” – a concept rooted in climate justice – to draw out the societal, ethical and ecological dimensions of AMR.

The editors argue that while current AMR governance has historically focused on research and innovation, drug stewardship and individual behavioural approaches, it has failed to address the deeper inequities and environmental pressures driving resistance. For communities already living with polluted water, working in unsafe conditions or coping with little or no access to health care, drug‑resistant infections are not a future threat – they are an everyday reality.

With humanities and social science scholars from over 20 countries, this issue interrogates AMR through a global lens using four interlinked themes: justice, equity, inclusivity and governance. Authors explore how justice must extend to marginalised communities and even non‑human life; how structural inequalities shape vulnerability and access to treatment; how inclusive, participatory governance can improve public engagement; and how global policy must move beyond short‑term stewardship to the sustainable and equitable management of microbial environments.

This special use calls for a widening in the AMR discourse from a public health crisis to a human rights and environmental justice issue – intimately connected to climate change, biodiversity loss and pollution. It calls for a shift in the narrative from a “war against microbes” to a long‑term process of negotiation and co‑existence, recognising that microbes are essential to sustaining all life on Earth. By applying a “just transitions” lens, the editors argue for an open‑ended, equitable approach to managing AMR that values diverse knowledge systems, and prioritises sustainability and solidarity.

As we mark the 10th anniversary of the WHO Global Action Plan on AMR, this special issue offers both a vision and a roadmap. It urges stakeholders – governments, civil society, the private sector, communities – to move beyond the apocalyptical scenarios towards sustainability solidarity, resilience and shared futures.

As lead guest editor Dr Sheila Varadan explains, “a just transition offers a different vantage point to reflect on our shared future with microbial environments – one that is grounded in equity and sustainability over fear and catastrophe.”

Read the full Antimicrobial Resistance: Just Transitions for Shared Futures Special Issue, available Open-Access.

Find out more about the “Just Transitions for AMR Global Convening Programme”, funded by the British Academy.

For further inquiries or questions, please contact Sheila Varadan (Guest Editor, [email protected]) Claas Kirchhelle (Guest Editor, [email protected]) or Sonia Lewycka (Co-Principal Investigator, Just Transitions for AMR Working Group, [email protected])

A new journal from Cambridge University Press, 'Public Humanities' is a venue for scholars, students, activists, journalists, policy-makers, professionals, practitioners, and non-specialists to connect and share knowledge about human creativity and culture. The journal combines rigorous peer-reviewed research with accessible writing, delivering of-the-moment knowledge about about the intersections of humanities scholarship and public life in free-to-read articles.

The final global convening meeting of the “Just Transitions for AMR” group was hosted at the Tropical Agricultural Research and Higher Education Centre (CATIE) in Costa Rica, from 26 to 29 January 2026.

The event included a dialogue session that brought together researchers, civil society and institutional leaders to explore antimicrobial resistance (AMR) through the intersecting lenses of justice, environmental sustainability and climate action.

The event highlighted the need for integrated, equitable responses that connect health, the environment, and community participation, moving from awareness to action to build resilient and fair approaches to AMR globally. Find out more about the dialogue event and the rest of the convening.

On 4 November 2027, 47 researchers, science communicators, and artists from Europe, Africa, Asia, and Latin America gathered at the British Academy's London offices for a full-day symposium exploring the social justice perspectives of public communication and engagement around AMR. The event formed part of the Just Transitions for Antimicrobial Resistance (JT4AMR) global convening and focused on how antimicrobial resistance (AMR) is communicated across diverse social and cultural contexts.

Delegates explored how communication practices shape public understanding of AMR, influence behaviour, and intersect with broader questions of equity, power and justice. A central theme across the discussions was the need to move beyond awareness-raising approaches. Speakers highlighted growing evidence that simply increasing public knowledge of AMR is insufficient to drive meaningful change. Instead, more dialogical, participatory and context-sensitive forms of communication are needed, including approaches that recognise lived experience, local knowledge and the social conditions shaping antibiotic use.

Sessions addressed AMR communication across diverse societal settings, examined how metaphors and framing shape risk perception, and showcased creative, arts-based engagement methods. Storytelling, theatre, cartoons, exhibitions and playful learning were presented as powerful ways to open new conversations about AMR that resonate beyond technical or biomedical narratives. Issues of justice and decolonisation featured prominently. Contributors emphasised that AMR communication cannot be separated from historical and structural inequalities, particularly in global health. Co-creation with communities, attention to language and culture, and an explicit focus on power relations were identified as essential to supporting more just transitions in addressing AMR.

The symposium concluded by reaffirming the importance of treating AMR not only as a biomedical challenge but also as a social one. Participants will be invited to contribute to an upcoming special issue of the Journal of Science Communication on AMR communication, helping to extend the impact of the discussions beyond the event.

Dr. Lamisa Rahman, Senior Research Associate at the Centre of Excellence for Health Systems and Universal Health Coverage (CoE-HS&UHC), presented a poster titled “A Just Transitions Framework for Equitable Antimicrobial Resistance Containment: Insights from Five Deliberative Community Workshops in Bangladesh” at the International Conference on Antimicrobial Resistance (AMR) and Genomics 2025, held at Monash University Malaysia in November 2025.

As a member of the project team contributing to the JT4AMR project at CoE-HS&UHC, Dr Rahman has helped to organise nine stakeholder workshops in Bangladesh, engaging participants across multiple levels, from national policymakers to grassroots actors, including formal and informal healthcare providers and representatives from the livestock, agriculture, and poultry sectors.

The poster showcased findings from deliberative community workshops conducted in Bangladesh under the British Academy-funded JT4AMR project. The presentation highlighted community perspectives on equity, justice, and the feasibility of AMR mitigation strategies in low- and middle-income countries. The session facilitated engagement with international researchers and practitioners working at the intersection of AMR, genomics, health systems, and social justice, contributing to broader cross-disciplinary dialogue on just transitions for AMR containment.

Several members of the “Just Transitions for AMR” global convening participated in a panel discussion at the 2025 Oxford Global Health and Bioethics International Conference, held on 8–9 July 2025 at the Mathematics Institute, University of Oxford. Among them, Dr Tess Johnson co-presented a talk (with fellow convening member Professor Phaik Yeong Cheah) titled ‘A Just War on Bugs? Ethical Differences Between Antimalarial Resistance and Antibacterial Resistance’.

“It was rewarding to receive feedback from an academic audience on this work, which originated from the Global Convening Programme's meetings,” Tess reflected afterwards.

“We have been discussing antimalarial resistance since our convening meeting in Bangkok a few years ago. In particular, Phaik Yeong and I have been considering whether differences between pathogens might influence how we prioritise research and interventions to combat AMR. We believe that antimalarial resistance warrants greater prioritisation than it currently attracts. It was encouraging to hear both support for this view and challenges, particularly regarding the feasibility and appropriateness of eradicating malaria. This feedback will inform our subsequent revisions of a paper, which is currently under review at a leading journal.”

On 8 July 2025, the Just Transitions for AMR Working Group organised a 75-minute panel discussion at the Oxford Global Health and Bioethics International Conference held at the University of Oxford, UK. The aim of the panel was to gather feedback on the strengths and limitations of our approach, identify any gaps, and explore areas for further work. The panel was chaired by Phaik Yeong Cheah (Mahidol Oxford Tropical Medicine Research Unit, Thailand), who introduced the topic. This was followed by a series of six five-minute presentations by members of the working group.

Sonia Lewycka (Oxford University Clinical Research Unit, Vietnam) explained the origins and development of the Just Transitions approach and its application in the context of antimicrobial resistance (AMR). Sonia described how we are adapting the "just transitions" concept, which is used in climate change mitigation, to promote fair and equitable policy shifts toward sustainable, low-carbon economies. She highlighted parallels between climate change and AMR: both are “super-wicked” problems, both disproportionately impact disadvantaged populations, and both require collective action.

Tess Johnson (Ethox Centre) discussed various conceptions of justice being considered by the group in relation to AMR, and noted forms of justice often overlooked by traditional Just Transitions frameworks, such as epistemic justice and ubuntu justice.

Deepshika Batheja (Indian School of Business and One Health Trust, India) illustrated how AMR affects different populations unequally, including disparities between men and women and among different caste groups in India.

Duy Minh Vu (Oxford University Clinical Research Unit, Vietnam) shared insights from a project in Vietnam in which his team engaged primary care doctors, healthcare stakeholders, and community members to explore their views on AMR.

Edna Mutua (KEMRI-Wellcome Trust, Kenya) presented an overview of policies surrounding AMR containment in low- and middle-income countries and illustrated gaps in governance mechanisms – most of which are adapted from the Global Action Plan and implemented in a top-down manner.

Finally, Sheila Varadan (University of Leiden, the Netherlands) drew connections between Just Transitions for AMR and climate justice, summarised key points from the panel, and highlighted important gaps in the current Just Transitions framework.

The session concluded with a Q&A segment. Participants raised questions about the practical implementation of the framework and whether different approaches should be considered for different microbes and pathogens.

'Bugs and drugs’ were featured on the menu at the 2025 Summer Showcase of the British Academy, with four members of the ‘Just Transitions for Antimicrobial Resistance’ (AMR) working group leading a science café on 21 June. Nearly 30 members of the public gathered for an open conversation about antibiotics, ethics, and the future of healthcare.

“I found the discussion fascinating, especially the debate about equity in healthcare,” said computer scientist Anthony Kesterton. “I never realised how interconnected the use of antibiotics is to so many aspects of our lives.” (Anthony also captured the featured photo of the British Academy during the event.)

Discussion points ranged from antibiotic use in farming, the influence of ‘big pharma’ in encouraging overuse and the role of ‘good’ versus ‘bad’ bugs. “It was interesting to hear people’s views on the connections between antibiotic drugs and our modern lives and systems, and what drug resistance means for our relationships with microbes. This included the ‘should we have more dirt in childhood?’ debate, and how porous boundaries should be, such as nurses and surgeons wearing scrubs to cafes near to their hospitals”, Professor Clare Chandler remarked.

Professor Caesar Atuire highlighted some of the key tensions between public health ideals and global economic pressures, such as the desire to farm less intensively and how it contrasts with growing demands on food production. He also highlighted the ethical challenges of donating near-expired drugs to developing countries.

For Professor Sonia Lewycka, who leads the ‘Just Transitions for AMR’ project, one conversation stood out: Some people spoke about using as little medicine as possible, while others described using medicines regularly to stay well. “The first perspective made me think of the Hippocratic belief in the natural ability of the body to heal itself, while the second perspective reminded me of conversations about traditional medicine in Vietnam, where, based on Confucian principles, medicines are used to keep the body in balance.” This conversation provided me with some good ideas about how to explore the use of antibiotics in Vietnam further, she added.

“I found the event useful as a way to reflect on my communication of some of my work,” Dr Tess Johnson remarked. “Sometimes, particularly as an ethicist, you get wrapped up in the details of an argument or the specifics of a case, and it's hard to take a step back and see the big picture of what you're trying to do. An event like this is a valuable reality check about people’s concerns and the ethical issues they care about. I am reminded of why we're undertaking this research and where my priorities should lie.”

Johnson brought along a World Health Organisation (WHO) poster showing a hand reaching into a bowl of sweets mixed with antibiotics. While some attendees saw the image as a call for greater access to antibiotics, others viewed it as a warning against their misuse. The differing interpretations sparked reflection among the facilitators. “This example illustrates why it’s essential to pre-test health communication materials with your audience,” added Professor Marina Joubert. “People may read a message very differently from what the scientists or designers intended.”

From 21–22 May 2025, three members of the BA-funded Just Transitions for AMR Working Group (Professor Sonia Lewycka; Dr Sheila Varadan and Dr Tess Johnson) participated in a two-day interdisciplinary workshop titled “AMR and Transitional Justice: What Can We Learn from the Climate Transition?” Hosted by the University of Graz, the event was part of the Austrian Science Fund (FWF) project: A Political Conception of Transitional Justice and supported by Climate Change Graz.

The workshop brought together scholars and practitioners to explore how insights from climate justice can inform approaches to justice in transitions, particularly in the context of antimicrobial resistance (AMR). By examining the parallels between AMR and climate change, participants considered how justice frameworks might support more equitable and inclusive transitions.

The Just Transitions for AMR Working Group was invited to share its expertise on how the just transitions framework can address the trade-offs and unequal burdens associated with AMR and related interventions.

Professor Sonia Lewycka presented on epistemic injustice in AMR research, highlighting how certain groups are unfairly marginalised in the production, dissemination, and application of AMR knowledge.

Dr Sheila Varadan discussed the dual nature of just transitions in AMR, emphasising both the potential to promote sustainability and equity, and the challenges posed by competing priorities, power imbalances, and global inequalities in AMR governance.

Dr Tess Johnson examined the ethical justifications presented for coercive antimicrobial stewardship measures. She argued in favour of more structured analysis of potential justifications and their theoretical and empirical foundations before justifications like 'this measure will promote solidarity' or 'this measure holds those responsible for antimicrobial resistance accountable' are presented to publics by policymakers.

Participants left the workshop with a deeper and more nuanced understanding of justice, drawing on transitional justice concepts from the climate change field. These perspectives offer valuable tools for addressing the complex challenges of just transitions in AMR. A key theme that emerged was the importance of language – particularly the term epistemic injustice – in shaping how injustice is identified and addressed. This reflection is expected to influence future research and writing in the field.

The workshop not only enriched the intellectual foundation of the Just Transitions for AMR initiative but also opened new avenues for collaboration and partnership. It provided a productive space for reimagining how we understand and respond to the global challenge of AMR.

Public communication and engagement around antimicrobial resistance (AMR) was on the agenda at the 2025 Public Communication of Science and Technology (PCST) Conference, held from 24–27 May in Aberdeen, Scotland. A panel titled “Breaking Barriers: Refocusing Public Communication about AMR” brought together international experts to explore innovative strategies for addressing this global health challenge.

Convened by Marina Joubert (Stellenbosch University, South Africa), a member of the ‘Just Transitions for AMR’ working group, the panel featured diverse perspectives on the complexities of AMR communication.

Marina Joubert opened the session with findings from a scoping review that identified key challenges and potential solutions in AMR communication. Brigitte Gschmeidler (Life Sciences in Dialogue, Austria) emphasised the importance of regional context in shaping effective AMR messaging. Mary Chambers (Oxford University, Vietnam) explored how decolonising science communication can address the “super-wicked” nature of AMR in Southeast Asia. Paul Flowers (University of Strathclyde, UK) discussed strategies for fostering meaningful public engagement on AMR.

Katharine Richter (University of Adelaide, Australia) showcased how public events like Pint of Science, Soapbox Science, and National Science Week are used to connect Australian audiences with AMR research. Bruno Pinto (Agência Nacional para a Cultura Científica e Tecnológica, Portugal) concluded the session with a creative look at how comics can serve as powerful tools for AMR communication.

The panel sparked lively discussion, guided by four thought-provoking questions:

1. How can we overcome the ‘language’ and ‘image’ problem of ‘antimicrobial resistance’?

2. When should culture and local knowledge be embraced in science communication—and when might they pose challenges?

3. What evidence base can we build for effective public engagement on AMR?

4. Can storytelling enhance our ability to communicate AMR?

Stay Connected: To stay informed about future events or research related to AMR communication, contact Marina Joubert at [email protected]

Gender and other socio-economic disparities significantly contribute to the impact of antimicrobial resistance (AMR), affecting both healthcare access and the success of strategies to combat antimicrobial resistance (AMR). Despite this, current National Action Plans (NAPs) often fail to consider gender and equity concerns.

To bridge this gap, Dr Deepshikha Batheja (from the Indian School of Business and One Health Trust) convened a meeting of experts on ‘gender and AMR’, hosted at the British Academy in London on 15 January 2025, with a focus on how equity concerns can be effectively incorporated into AMR research and policy.

The programme for the day included insightful contributions from a distinguished panel of speakers, including UK parliamentarian Baroness Natalie Bennett, WHO experts Anand Balachandran and Zlatina Dobreva, along with researchers Professor Sonia Lewycka, Dr Deepshikha Batheja, Dr Rosie Steege, Victoria Saint, Susan Nayiga, and Srishti Goel.

The group discussions, chaired by Dr Edna Mutua, focused on actionable strategies for researchers, policymakers, funders, and healthcare providers to ensure gender-responsive, inclusive, and equitable AMR mitigation efforts across high-income and low- and middle-income countries. This meeting served as a crucial step toward embedding gender and equity considerations in AMR policies, reinforcing the need for inclusive, community-driven, and people-centered approaches to tackling this global challenge.

Held on 15 January 2025 in London, Deepshikha Batheja convened a roundtable meeting titled “AMR in the Community: Mainstreaming Gender and Equity in National Action Plans and AMR Governance.” The meeting was organised in collaboration with the Max Institute of Healthcare Management at the Indian School of Business and One Health Trust, The British Academy, and the World Health Organization (WHO), and was funded by a Knowledge Translation Grant from The British Academy.

Biological factors contribute to higher antibiotic use among women, and these are further compounded by socio-cultural barriers and systemic discrimination that limit women’s access to quality healthcare and health information. These intersecting inequities increase disease burden and the risk of antimicrobial misuse. Despite this, AMR governance frameworks and National Action Plans (NAPs) often overlook equity considerations and the cultural dimensions shaping health behaviours.

The primary aim of the meeting was to convene experts to examine how antimicrobial resistance (AMR) intersects with gender and other socioeconomic factors. Building on WHO’s People-Centered Approach (PCA), the roundtable focused on policies for integrating social justice into AMR research, surveillance, and interventions, as well as on strengthening collaboration among stakeholders to address AMR from a broader, more inclusive perspective. The meeting built on discussions from a gender and AMR workshop held in Bangalore in 2024, with the shared goal of advancing inclusive frameworks for AMR governance and improving global health policy.

Baroness Natalie Bennett, UK Parliamentarian, delivered the keynote address. Additional speakers included:

Dr Sonia Lewycka (Oxford University Clinical Research Unit), who outlined the origins and evolution of the Just Transitions approach and its relevance to AMR.

Anand Balachandran (World Health Organization), who presented work on advancing equity through a people-centred approach to addressing AMR.

Dr Rosie Steege (Liverpool School of Tropical Medicine), who discussed GEAR UP’s work in catalysing action on gender and equity in AMR.

Victoria Saint (Bielefeld University), who spoke on strengthening evidence, research, and action to address the equity dimensions of AMR.

Zlatina Dobreva (World Health Organization), who presented WHO recommendations for addressing gender inequality in National Action Plans.

Dr Deepshikha Batheja (Indian School of Business and One Health Trust) and Srishti Goel (One Health Trust), who shared quantitative evidence on unequal AMR impacts across populations, including gender-based disparities.

The meeting concluded with a facilitated group discussion chaired by Dr Edna Mutua (KEMRI–Wellcome Trust), focusing on inclusive governance and research approaches to addressing AMR, with particular attention to gender, income, race, and other intersecting vulnerabilities.

Output from the meeting: Batheja, D., Saint, V., Dobreva, Z., Goel, S., Lewycka, S., Mutua, E., ... & Balachandran, A. (2025). “Integrating gender and equity commitments in the revised global action plan on antimicrobial resistance.” The Lancet.

A recent article in Trends in Microbiology examines why engagement and justice considerations are essential for effective AMR mitigation. The authors argue that technical solutions alone are insufficient and that inclusive, context-sensitive engagement strategies are critical to ensuring fair and sustainable AMR responses.

· Co-authors from the JT4AMR team: Phaik Yeong Cheah and Sonia Lewycka

· Link to Engagement and Justice in AMR Migration article.

A new paper in the Journal of Antimicrobial Chemotherapy analyses pharmaceutical sales data from 70 countries over more than two decades (2000–2022) to examine how gender inequality shapes patterns of antibiotic use. The findings reveal systematic associations between gendered social structures and antibiotic use, underscoring the importance of addressing inequality as part of equitable and effective AMR strategies.

Co-authors from the JT4AMR team: Deepshikha Batheja and Sonia Lewycka

Link to new paper in the Journal of Antimicrobial Chemotherapy.

A new review in Lancet Planetary Health, produced with the Pharma Pollution Hub at Exeter, assesses the environmental impacts of UK healthcare-related pharmaceutical pollution and potential mitigation options. The paper considers both technical fixes and upstream interventions, highlighting opportunities to reduce environmental harms while supporting broader AMR and sustainability goals.

Co-author from the JT4AMR team: Claas Kirchelle

Link to new review in Lancet Planetary Health.

Published in Lancet Microbe, this article examines the unintended consequences that can arise from AMR policies and interventions. The paper is particularly timely in light of the new draft Global Action Plan, offering critical reflections on how AMR strategies can be designed to avoid reinforcing inequities or creating new harms.

Co-authors from the JT4AMR team: Claas Kirchhelle, Stephen Hinchliffe, Sonia Lewycka, Sassy Molyneux, Edna Mutua, and Clare Chandler

Link to Lancet Microbe article.

Published in the Journal of Public Health in Africa, this paper presents insights from a multidisciplinary workshop examining how climate change is reshaping risks and responses to antimicrobial resistance. The article highlights governance challenges, knowledge gaps, and priorities for integrated climate–health–AMR approaches, with particular attention to low- and middle-income country contexts.

Co-authors from the JT4AMR team: Deepshikha Batheja and Esmita Charani

Link to article in Journal of Public Health in Africa.

A new Special Issue in 'Public Humanities, Antimicrobial Resistance: Just Transitions for Shared Futures' brings together scholars from the humanities, social sciences and global health to re‑imagine how we live with AMR and our microbial world. Guest edited by Dr Sheila Varadan, Dr Sara de Wit, Dr Miriam Waltz and Dr Claas Kirchhelle, the issue applies “just transitions” – a concept rooted in climate justice – to draw out the societal, ethical and ecological dimensions of AMR.

With humanities and social science scholars from over 20 countries, this issue interrogates AMR through a global lens using four interlinked themes: justice, equity, inclusivity and governance. Authors explore how justice must extend to marginalised communities and even non‑human life; how structural inequalities shape vulnerability and access to treatment; how inclusive, participatory governance can improve public engagement; and how global policy must move beyond short‑term stewardship to the sustainable and equitable management of microbial environments.

Read the full Public Humanities, Antimicrobial Resistance: Just Transitions for Shared Futures Special Issue, available Open-Access.

Find out more about the “Just Transitions for AMR Global Convening Programme”, funded by the British Academy:

For further inquiries or questions, please contact Sheila Varadan (Guest Editor, [email protected]) Claas Kirchhelle (Guest Editor, [email protected]) or Sonia Lewycka (Co-Principal Investigator, Just Transitions for AMR Working Group, [email protected])

A new journal from Cambridge University Press, Public Humanities is a venue for scholars, students, activists, journalists, policy-makers, professionals, practitioners, and non-specialists to connect and share knowledge about human creativity and culture. The journal combines rigorous peer-reviewed research with accessible writing, delivering of-the-moment knowledge about about the intersections of humanities scholarship and public life in free-to-read articles.

In this commentary, Deepshikha Batheja, Sonia Lewycka, Srishti Goel and others argue that gender and equity considerations should be central to the revised Global Action Plan (GAP) on Antimicrobial Resistance (AMR) to ensure responses are effective, inclusive, and sustainable.

The authors propose that each GAP pillar explicitly incorporates gender and equity concerns, highlighting how social and structural determinants influence exposure, vulnerability, and access to AMR-related interventions. The paper provides concrete recommendations for embedding these commitments across AMR governance, surveillance, communication, policy development, and implementation, demonstrating that addressing inequities is essential to strengthening global AMR action.

Link to Revised Global Action Plan (GAP) on Antimicrobial Resistance (AMR) article.

In this commentary, Tess Johnson, Lorenz von Seidline and Phaik Yeong Cheah argue that antimalarial resistance and antibacterial resistance raise distinct ethical considerations. Unlike antibacterial resistance, mitigating antimalarial resistance has well-defined goals and does not involve environmental factors or the use in livestock. These differences make it clear that not all microbes should be addressed in the same way, and that interventions must be tailored accordingly.

Published in BMJ Global Health 2025;10:e018943.

Link to A just war on bugs? Ethical differences between antimalarial resistance and antibacterial resistance article.

In this comment, 'Beyond breakpoint – reconceptualising AMR as a symptom of planetary stress', Kirchhelle and Roberts (2025) challenge conventional clinical framings of antimicrobial resistance (AMR) by redefining it as a symptom of planetary ecosystem stress, thereby embedding it in the broader discourse on planetary health. They argue that AMR acts as a microbial barometer of anthropogenic disturbance and is consequently a vital indicator of ecological imbalance.

The authors illustrate how the global proliferation of AMR reflects the destabilisation of microbial ecosystems under relentless chemical and environmental pressures. Recognising AMR as an ecological stress signal could reframe stewardship approaches and lead to a paradigm shift in AMR governance.

This situates microbial health within international legal frameworks while advocating for policies that safeguard the microbial commons, potentially a significant step forward towards more holistic planetary stewardship.

Link to Beyond breakpoint – reconceptualising AMR as a symptom of planetary stress article.

This commentary explores whether there is epistemic injustice in global antimicrobial resistance (AMR) research – who sets priorities, who produces knowledge, and which types of knowledge are valued. We argue that epistemic injustice may have created blind spots in policy. Addressing this requires a commitment to diversity, equity, and inclusion.

This issue of 'Monash Bioethics Review' explores antimicrobial resistance (AMR) as a threat to global health, and focuses particularly on the social justice implications of measures to prevent, reduce, and innovate against AMR. Whilst AMR poses harm across the globe, these harms are not uniformly distributed among populations, either temporally or geographically. This is one facet of considering justice in the AMR context. Furthermore, the risks of resistance developing are not uniformly distributed, implying that there may be AMR ‘hotspots’ (in time and space) for which it is more effective to intervene using stewardship, surveillance, and/or innovation.

The burdens of these interventions ought to be considered in comparison to the benefits to the populations of hotspots compared to other populations. Where greater harms are borne by already disadvantaged populations, there is the potential for interventions against AMR to exacerbate existing social injustice. Stewardship, surveillance and innovation measures must be ethically evaluated through this lens."

Commenting on the relevance and timeliness of this publication, issue editor Tess Johnson said: “I've been interested in this area ever since the pandemic. It's amazing how much attention big, urgent threats get, but it's easy for us to forget about ongoing and multifaceted health issues, like drug resistance".

A review by Deepshika Batheja and Srishti Goel that explores how biological, sociocultural and behavioural factors contribute to the differential incidence of AMR in women, delving into the gendered implications that are often overlooked when it comes to the threat of AMR.

A paper, by Edna Mutua and contributors, that deals with the question of morality in AMR discourse as seen through data collected on antibiotic prescription, dispensing and use in human and livestock health in Tanzania.

An ethnographic study (with Clare Chandler as contributor) looking at the present and everyday realities of AMR for frail bedridden patients through the theoretical lenses of precarity and care.

A comment piece (with Sonia Lewycka and Rogier van Doorn as contributors) about access to diagnostics (CRP testing) in low-income and middle-income countries to prevent overuse of antimicrobials.

A study on Point-of-care tests (with Clare Chandler as contributor) that reveals social and temporal intersections between processes of technological innovation and health systems. 

This article (with Phaik Yeong Cheah and Tess Johnson as contributors) delves into the ethical tensions that might make it difficult to address or solve the complex issue of Antimicrobial resistance (AMR). The ethical analysis reveals multiple competing interests and unresolved ethical tensions, drawing from existing evidence and the experiences of the contributors living and working in low-income and middle-income countries. To be effective, AMR policies need to take all these tensions into account and find solutions that service those who are worst affected by AMR.

An article by Marina Joubert, Phaik Yeong Cheah and Sonia Lewycka, written for World AMR Awareness Week, on the threat of AMR and why the global response needs to be fair to all. It includes the call for a new approach to solutions that prioritise equity and sustainability and the importance of embedding public and community voices.

A comment piece written by the Just Transitions for AMR Working Group outlining the need for a just transition approach for antimicrobial resistance in order to prioritise justice, sustainability, inclusivity and equity in the planning for a future with AMR.