Integrating gender and equity to better tackle Antimicrobial Resistance
Antimicrobial resistance (AMR) happens when bacteria, viruses, or other germs stop responding to the medicines like antibiotics that are meant to inhibit or kill them. AMR is increasing worldwide, making infections harder or even impossible to treat and posing a serious threat to public health.
An estimated 1.14 million people lost their lives in 2021 as a direct result of AMR, and it contributed to an estimated 4.71 million deaths in that year. Coordinated efforts to tackle AMR have expanded, with a Global Action Plan (GAP) since 2015 and national action plans (NAPs) on AMR in 178 countries as of September 2024. While this marks real progress, these global and national action plans overlook equity, gender, context and culture plus the specific challenges faced by populations in situations of vulnerability and marginalisation.
There is growing evidence on the crucial role of gender and other social and structural drivers for AMR, which can exacerbate inequities and undermine the effectiveness of efforts to tackle AMR. Addressing inequities in exposure, prevention and access to health care and treatment (antimicrobials, diagnostics and vaccines) and improving equitable access to research and development are key to achieving commitments to prevent and manage AMR.
The World Health Organization (WHO) is working to strengthen the focus on dimensions of gender, equity, and disability inclusion. WHO guidance on addressing gender inequalities in AMR proposes 20 recommendations for policy-makers to consider in their national action plans. Sarah Simpson has been working with Victoria Saint and WHO in developing guidance that presents evidence on equity dimensions of AMR, and outlines recommendations to strengthen knowledge and action to address inequities in country NAPs. The guidance (in development) also aligns with the 2024 Political Declaration of the High-Level Meeting on Antimicrobial Resistance, which recognises equity as a cross-cutting principle.
During 2025-2026 the GAP will be revised providing an opportunity to strengthen equity and gender considerations. Sarah and Victoria co-authored with global colleagues a commentary published in the Lancet, which provides specific evidence and suggestions to integrate gender and equity in the GAP.
Sarah Simpson is a Senior Technical Advisor at the Nossal Institute for Global Health. Sarah’s research focus’ on the practical integration of equity, gender and wider determinants into public health and health systems for greater inclusion and improved health outcomes for all.
Victoria Saint, Research Associate and Doctoral Candidate School of Public Health Bielefeld University, Germany is a global and public health practitioner, analyst and researcher who’s doctoral research focuses on the equity, gender and social determinants of health dimensions of AMR.