How gender and social inequities shape climate-AMR vulnerabilities: A rapid realist synthesis and conceptual framework development for livestock and aquaculture systems

Context

Climate change and antimicrobial resistance (AMR) increasingly interact in ways that do not affect all people equally. In livestock and aquaculture systems in low- and middle-income countries (LMICs), climate stressors such as heat waves, floods, and droughts can increase disease risks and disrupt livelihoods, often leading to greater reliance on antimicrobials. However, who is most exposed to these risks, and how they respond, is strongly shaped by gender roles, access to resources, decision-making power, and other social determinants of health. 

Despite growing recognition of equity and gender issues in AMR and climate policy, these factors are rarely integrated in a meaningful way. Most policies and interventions acknowledge inequality but do not explain why certain groups, such as women smallholder farmers, informal workers, or landless producers, face higher AMR risks under climate stress. As a result, interventions may unintentionally reinforce existing inequities or fail to reach those most vulnerable. There is a critical need for practical frameworks that make these hidden pathways visible and usable for policy and programme design.

Problem

Many AMR and climate change interventions assume that people respond to climate stress in similar ways. In reality, social positions, such as gender, income, land ownership, and access to services, strongly shape how farmers and producers experience climate shocks and make decisions about antimicrobial use. 

While studies show that women and marginalised groups often face higher risks, we still do not understand the mechanisms behind these differences. Current evidence describes what inequalities exist, but not how or why they translate into higher antimicrobial use or AMR under climate stress. Without this understanding, policies and programmes struggle to design solutions that actually work for vulnerable populations. 

This gap leads to ineffective or even harmful interventions. For example, promoting climate-smart technologies without considering who controls resources or credit can exclude women farmers and push them toward crisis-driven antimicrobial use instead. There is currently no clear, evidence-based framework that explains these pathways or guides equitable intervention design in livestock and aquaculture systems. 

Project overview

This project will develop and validate a practical, evidence-based framework that explains how gender and social inequities shape AMR risks under climate change in LMIC livestock and aquaculture systems. 

Using a rapid realist synthesis approach, the project will combine evidence from literature, expert knowledge, and lived experiences to understand what works, for whom, under what conditions, and why. It will analyse how specific contexts (such as climate stressors or policy environments) trigger social and economic mechanisms that influence antimicrobial use and AMR outcomes. 

The project will include expert interviews, community dialogues, and observation of real-world implementation by supporting an ICARS project in the Philippines. Findings will be tested and refined through stakeholder co-creation and expert validation processes. The final output will be a clear conceptual framework, supported by policy-relevant recommendations, that can be used by researchers, policymakers, and implementers to design more equitable and effective climate-AMR interventions. 

Solutions and outcomes

The project will produce a validated conceptual framework that makes visible the hidden social mechanisms linking climate change, gender and social inequities, and AMR. This framework will help explain why certain groups face higher risks and where interventions can be most effective. 

Key outcomes include clearer guidance on how to integrate gender and equity considerations into AMR and climate initiatives, identification of practical intervention points, and improved alignment between policy goals and on-the-ground realities. The framework will support more inclusive programme design, helping ensure that climate-smart and AMR interventions reach those most affected rather than reinforcing existing inequalities. 

By translating complex social dynamics into actionable insights, the project will strengthen One Health approaches and support LMICs in designing climate-resilient, socially equitable AMR strategies. Ultimately, it aims to move the field beyond acknowledging inequities toward systematically addressing them.