Gender and social inequities influence antibiotic use, exposure, and access to resources. Addressing these factors enhances the effectiveness and inclusivity of AMR strategies, ensuring that vulnerable and marginalised groups receive equitable protection and support.
Antimicrobial resistance (AMR) is a global health threat that intersects significantly with gender and equity issues. While research on gender and AMR has historically focused on biological susceptibility, a substantial gap remains in understanding the broader social and structural dynamics. Â
Interventions often engage different populations based on social norms and cultures (e.g. considering caretaking roles women often have in many cultures), but may not be designed and implemented with the needs of different populations in mind. The impact of AMR often falls disproportionately on already vulnerable or marginalised populations, making it essential that interventions understand the most affected populations and are tailored to deliver more equitable results. This highlights the need for a wider equity approach to AMR intervention and implementation research, where gender and other sociocultural drivers are fully integrated. Â
Intentionally integrating gender and equity dimensions into AMR research design and implementation across sectors, supported by dedicated funding opportunities, will help build the evidence base on how research projects and public programmes can better integrate and address gender disparities in AMR across the One Health spectrum. This is critical to developing contextually relevant, equitable solutions with sustainable impact.Â
Considering gender and equity is relevant across all one health sectors, yet AMR research to date has been largely biomedical, with limited social investigation including on gender and its interplay with factors that drive AMR in different settings such as healthcare, community or farm settings. Applying a gender and equity lens is essential not only to promote equity in project outcomes, but also to enhance the effectiveness, accessibility, and sustainability of AMR solutions.Â
ICARS is contributing to this agenda by funding projects that apply a gender and equity lens, helping to generate practical evidence for more inclusive and sustainable AMR solutions. In 2024, ICARS, the International Development Research Centre (IDRC), and the UK Department of Health and Social Care’s Global AMR Innovation Fund (GAMRIF) launched a two-year project with a Gender and Equity stream, to conduct a deeper exploration into the critical but under-researched intersections between AMR, gender and equity.Â
In household and community settings, gender and sociocultural inequities can restrict individuals’ ability to seek care and use antibiotics appropriately. An ICARS–funded project in Lao PDR is applying a gender and equity lens to promote compliance with Good Pharmacy Practices in private pharmacies, which are often the first point of contact with the health system for patients, particularly in rural areas. The pharmacy profession in Lao PDR has a higher proportion of women than men, therefore applying a gender and equity lens may strengthen interventions for pharmacists as well as their engagement with the communities they serve.Â
AMR exposure and vulnerability differ by gender and social status due to occupational roles, living conditions, and environmental factors. For example, women account for 70% of the global healthcare workforce and are therefore disproportionately exposed to drug-resistant infections in those settings. In Ghana, an ICARS-funded project is tailoring interventions to different types of health practitioners from four hospitals operating in different socio-economic contexts, to understand the behavioural, cultural and institutional factors influencing antibiotic use and infection, prevention and control (IPC), to inform public health policies and programmes.Â
Gendered social roles and socioeconomic status shape access to education, training, and resources related to AMR. In Zimbabwe, an ICARS-funded project aimed at reducing antibiotic use in poultry farming has established farmer field schools for small- to medium-scale farmers to improve biosecurity, animal husbandry practice, poultry health and profitability for local chicken producers. By strengthening poultry management skills, increasing profitability, and ensuring equitable access to training, the project supports women’s financial independence and enhances household resilience, advancing both gender equality and sustainable livelihoods.Â
Further, the Responsive Dialogue approach, developed by Wellcome to support public engagement and community leadership, offers a framework for gathering diverse views from the public to generate interventions that address the real-life challenges. ICARS has worked with Wellcome and Eden University to expand the original toolkit by developing practical guidelines for facilitating ‘Conversation Events’ in low- and middle-income settings. In Zambia, this approach was used in a project that broke down myths and misconceptions about urinary tract infections (UTI) and UTI management among community members.
Explore related ICARS-supported projects and research initiatives:
