Antimicrobial resistance, equity and justice in low- and middle-income countries: an intersectional critical interpretive synthesis
Global inequities in the burden of antimicrobial resistance (AMR), between and within populations, are heavily influenced by the social and structural determinants of health. Yet, AMR action has had limited attention to equity, and social approaches to AMR haven't routinely gone beyond an exploration of knowledge and awareness around ABU. This represents a missed opportunity to design equitable interventions and policy across One Health. We report the results of a critical interpretive synthesis of the social and structural drivers of AMR in Low- and Middle-Income Countries and present a conceptual framework of these drivers, linking to the Sustainable Development Goals (SDGs). We emphasise the limitations of a biomedical dominance in AMR research, highlighting the value of wider bodies of evidence for understanding the drivers of AMR to support equity and justice. We argue AMR interventions need action across the SDGs to target the root causes and address significant gaps in evidence.
Authors
- Mustapha Immurana (ORCID: https://orcid.org/0000-0001-5711-7566)
- Owen Nyamwanza (ORCID: https://orcid.org/0000-0003-0577-4702)
- Webster M. Mavhu (ORCID: https://orcid.org/0000-0003-1881-4398)
- S. N. M. Okioma
- Russell Dacombe (ORCID: https://orcid.org/0000-0002-6705-1537)
- Sushil Baral (ORCID: https://orcid.org/0000-0002-3425-6915)
- Rosie Steege (ORCID: https://orcid.org/0000-0003-2120-649X)
- Kate Hawkins (ORCID: https://orcid.org/0000-0003-2915-1921)
- Katy Davis (ORCID: https://orcid.org/0000-0001-6936-4222)
- Syeda Tahmina Ahmed (ORCID: https://orcid.org/0000-0003-3796-333X)
- Anne Ngũnjiri (ORCID: https://orcid.org/0000-0001-6893-9047)
- Ralalicia Limato (ORCID: https://orcid.org/0000-0002-5306-3254)
- Margaret Gyapong (ORCID: https://orcid.org/0000-0002-4818-3497)
- Abriti Arjyal (ORCID: https://orcid.org/0000-0002-3624-5726)
- Mavis Pearl Kwabla (ORCID: https://orcid.org/0000-0002-1435-0795)
- Ayuska Parajuli (ORCID: https://orcid.org/0000-0002-3631-2335)
- Fidelis E. Y. Anumu (ORCID: https://orcid.org/0000-0003-2798-7872)
- Lilian Otiso (ORCID: https://orcid.org/0000-0003-0164-154X)
- Meenakshi Monga (ORCID: https://orcid.org/0000-0002-0614-8706)
- Syed Masud Ahmed (ORCID: https://orcid.org/0000-0001-5032-7181)
- Sally Theobald (ORCID: https://orcid.org/0000-0002-9053-211X)
- Sneha Paul
- Bachera Aktar (ORCID: https://orcid.org/0000-0003-0242-1792)
- Sabina Faiz Rashid (ORCID: https://orcid.org/0000-0003-0916-2631)
- Jane Thiomi
- Beatrice Egid
Institutions
- Liverpool School of Tropical Medicine (GB)
- University of Health and Allied Sciences (GH)
- LVCT Health (KE)
- Centre for Sexual Health and HIV AIDS Research (ZW)
- BRAC University (BD)
- University of Brighton (GB)
Publication Details
- Journal
- Nature Communications
- Published
- 2025-10-13
- DOI
- https://doi.org/10.1038/s41467-025-64137-z
- Citations
- 6
- Primary Topic
- Antibiotic Use and Resistance
- Type
- article
- Field-Weighted Citation Impact
- 7.57
Funders
- Department of Health and Social Care