March 28, 2024
On March 18 and 19, One Health Trust hosted a workshop funded by the World Health Organization and the British Academy in Bangalore, India. The workshop highlighted the urgent need to address antimicrobial resistance (AMR), which occurs when germs (including bacteria, viruses, fungi, and parasites) adapt to resist treatment, leading to increased illness severity and mortality.
The event was organized by OHT’s Dr. Deepshikha Batheja in collaboration with Dr. Esmita Charani from the University of Cape Town and Dr. Tasha Koch of Eh!woza. The first day of the workshop focused on how social and economic inequities related to gender and caste in India can affect the emergence and spread of drug-resistant infections. Day two addressed the intersection of gender inequity and climate change as it relates to AMR.
Human activities, particularly the misuse and overuse of antibiotics, accelerate the emergence and spread of infections resistant to medicines. Factors like inadequate hygiene and limited healthcare access exacerbate AMR spread, disproportionately affecting vulnerable groups such as women and lower castes.
India, with some of the highest rates of drug-resistant infections in the world, serves as a poignant case study. Women are disproportionately affected due to biological factors such as urinary tract infections, childbirth, and menstruation. Gender inequities and sociocultural biases also increase the risk of AMR among girls/women. They make them more prone to infections and reduce their access to quality healthcare, including essential antibiotics, immunization, and diagnosis.
Women’s low levels of education, nutrition, access to clean water, sanitation, and the nature of paid (frontline healthcare and sanitation) and unpaid work (caregiving responsibilities) also puts women at risk of these dangerous germs. Climate change further compounds these challenges by altering ecosystems and exacerbating unsanitary conditions. Caste discrimination hinders healthcare access and can relegate certain caste groups to jobs that expose them to unsanitary and harmful conditions, increasing the likelihood of a drug-resistant infection.
To help stakeholders address the disproportionate impact of AMR on marginalized communities, the diverse cohort of researchers at the workshop worked together to strategize the integration of gender, caste, and climate considerations into healthcare, environmental, economic, and labor policies.
Dr. Batheja said, “Gender inequities, when combined with other power hierarchies, such as caste, can cause differences in vulnerability to drug-resistant infections among different genders and social groups. Climate change further amplifies existing gender-based inequities in health, antimicrobial usage, and drug resistance. The workshop on gender and AMR (and its intersection with caste and climate change in India) is the first step to explore the linkages between these complex issues and is a call-to-action to build evidence on sociocultural drivers of resistance worldwide and to inform sound public health policy which can mitigate the spread of AMR.”
The workshop participants provided diverse perspectives on and potential solutions to control the spread of these difficult-to-treat infections. From ensuring women are included in clinical trials to establish inclusive prescribing guidelines for new antibiotic treatments, to improving access to drinking water and menstruation products, and promoting education to reduce stigma around gynecological issues and sexually transmitted diseases, the experts showed the need for work across disciplines and sectors to solve major health problems.
