Understanding the Socio-economic and Environmental Determinants of Antimicrobial Resistance

Journal article

Abstract Antimicrobial resistance (AMR) is a major global public health threat which disproportionately affects low- and middle-income countries. It intersects with other public health issues including climate change and its impact is compounded by existing socio-economic inequities. In the South Asian setting, persistent gender and caste-based discrimination create differences in infection susceptibility, health-seeking behaviours, accessibility and affordability to essential antibiotics, and quality health care and appropriate diagnosis by healthcare providers, resulting in disparities in healthcare access and outcomes. We report on the deliberations from a cross-disciplinary workshop held in Bengaluru, India, focusing on the Indian context of AMR and its intersections with gender, caste, and climate change—contexts that often apply to the rest of South Asia. The two-day workshop brought together healthcare professionals, public health experts, gender experts, climate experts, researchers, activists, and community members to explore institutional and community-level issues in AMR, gender, caste, and climate change. We also present a conceptual framework to understand how caste-based discrimination influences antibiotic use and AMR in India and other South Asian countries. Finally, we discuss the key recommendations highlighted by the experts to address the gender and caste blind spots in existing data collection methods, surveillance, and policy measures related to AMR.

Authors: Bhagawati, R; Banerji, A; Charani, E; Malghan, D; Lewycka, S

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Cambridge University Press
• Journal: Public Humanities
• Volume: 2
• Article number: e107
• Publication date: 2026-08-12
• DOI: 10.1017/pub.2025.10101
• EISSN: 2977-0173
• ISSN: 2977-0173
• Language: English
• Keywords: Caste; Context (archaeology); Public health; Antibiotic resistance; Global health; Resistance (ecology); Health care; Public policy