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

Project status
Ongoing
Departments
International

Summary

Antimicrobial resistance (AMR) is a significant global concern, with 10 million annual deaths and US $100 trillion projected cost to the global economy by 2050 if no action is taken.

Like climate change, AMR is a multi-sectoral, borderless problem that disproportionately affects the poorest, and requires collective action and coordinated efforts. Urgent, system-wide change is needed to avoid a future where antimicrobials do not work, and common infections become life-threatening. Current efforts focus on solutions developed in high-income settings, which neglect structural challenges, particularly for poor communities where the disease burden is highest.

We aim to develop a framework for Just Transitions toward equitable and sustainable solutions to mitigate AMR. Our proposal outlines strategies to engage diverse groups of stakeholders to devise fair policies and regulatory tools, and has the potential to transform approaches to tackling AMR. Synergies with Just Transitions for agriculture and climate will have wider planetary health benefits.

Further information

On this page, as you scroll down, you can find sections providing details regarding our project:

  • Latest
  • Press releases
  • Events
  • Publications
  • Researchers

Follow @JT4AMR for updates from the programme.For further information, contact the Press Office on [email protected] / 020 7969 5273 / 07500 010 432.

Latest

Interview with Phaik Yeong Cheah on the ethical challenges underlying AMR

5 February 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.

Formal submission to the UN Committee on Economic, Social and Cultural Rights (CESCR)

9 January 2025

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).

Interview with Sonia Lewycka on One Health interventions

30 September 2024

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.

Responsive dialogues on experiences with AMR in South Africa

30 August 2024

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.

Workshop in Bangalore on AMR, gender inequity, caste, and climate change

28 March 2024

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.

Events

Roundtable Meeting on AMR in the Community

15 January 2025, British Academy, London

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.

Publications

Tracing epistemic injustice in global antimicrobial resistance research

March 2025, Trends in Microbiology. Phaik Yeong Cheah, Sonia Lewycka, Jantina de Vries.

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.

Special Issue on Antimicrobial Resistance and Social Justice

December 2024, Monash Bioethics Review. Issue editor, Tess Johnson.

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".

Understanding gender inequities in antimicrobial resistance: role of biology, behaviour and gender norms

January 20, 2025, BMJ Global Health

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.

Antibiotic prescription, dispensing and use in humans and livestock in East Africa: does morality have a role to play?

October 17, 2024, Monash Bioethics Review

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.

Microbes and marginalisation: ‘Facing’ antimicrobial resistance in bedridden patients in a peri-urban area of Thailand

October 5, 2024, SSM - Qualitative Research in Health

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.

C-reactive protein testing in primary care for acute respiratory infections: a cost-effective strategy to mitigate antimicrobial r

September 18, 2024, The Lancet Global Health

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.

The social lives of point-of-care tests in low- and middle-income countries: a meta-ethnography

June 22, 2024, Health Policy and Planning

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. 

Interventions to address antimicrobial resistance: an ethical analysis of key tensions and how they apply in LMICs

3 April, 2024, BMJ Global Health

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.

Antimicrobial resistance is a silent killer that leads to five million deaths a year. Solutions must include the poor

November 17, 2023, The Conversation

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 just transition for antimicrobial resistance: planning for an equitable and sustainable future with antimicrobial resistance

September 08, 2023, The Lancet

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.

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