Antimicrobial resistance (AMR) is a potentially catastrophic global problem. Our use of antimicrobial drugs, including antibiotics, has escalated. These medicines are now a routine part of everyday life. For example, we use antibiotics not only to cure infections but in anticipation of infection for people, animals, and crops. We propose that the ways antibiotics are used is deeply embedded in the way our societies and economies work. It is important to understand the extent and nature of the way we have become intertwined with these medicines in order to understand the consequences of resistance and the best ways to reduce the threat of resistance.
Policy makers have agreed that to address AMR we must reduce our reliance on antibiotics. But how? The AMIS programme explores fresh approaches to the study of antimicrobials in society. Drawing on conceptual and methodological tools from anthropology, the AMIS research projects demonstrate the multiple roles that antimicrobials take in society today, and how they enable everyday life.
The AMIS programme aims to stimulate engagement with social research that presents different ways of conceiving, responding to, and framing global health issues, including AMR.
The AMIS Online Hub and Resource
The AMIS Hub www.antimicrobialsinsociety.org is an online resource that brings together research relevant to AMR from across different social science disciplines. Aimed at those designing and implementing AMR policy, as well as researchers from the life sciences, the AMIS Hub introduces readers to a wealth of relevant social research on AMR. The AMIS Hub materials include research summaries, blogs ‘from the field’, and reviews of existing and ongoing research and theory. We envision the Hub as a mechanism for policy-makers and life scientists to engage with social science research on AMR, to forge future collaborations and to inspire new ways to address AMR.
Our Research Themes
The AMIS programme asks fundamental questions about the role of antimicrobials in society. Four key thematic strands form the starting point for our perspective on antimicrobials and AMR:
Care: Antimicrobials often take the form of care in contemporary life. They are objects that ‘care’ for our sick and vulnerable. It is important to further our understanding of how antibiotic use is linked to institutional, ethical, and everyday forms of care.
Knowledge: How, where, and why do particular AMR policies get produced? By taking knowledge production as a starting point, we can consider the political, social and cultural aspects that shape AMR policy and how it circulates globally.
Pharmaceuticals and Markets: Our use of antimicrobials is shaped by the multitude of contexts within which they are prescribed, sold, and traded. It is important to explore both the nature and scale of markets that antimicrobials are traded in, and how these markets are shaped by specific histories and political economies.
Ecologies: AMR requires us to consider how human life is entangled with microbial life, animal life, and the environment. AMR poses tricky questions about human exceptionalism and pushes us to consider how we begin to study our interactions with our wider ecosystems.
Clare Chandler (AMIS Hub Principal Investigator)
Associate Professor in Medical Anthropology, London School of Hygiene and Tropical Medicine (LSHTM). Clare’s research focus has been on the use of antimicrobial medicines and diagnostics in global health. She directs the LSHTM Antimicrobial Resistance Centre and leads the Anthropology of AMR research group.
Coll Hutchison (AMIS Hub co-Investigator)
Coll is an anthropologist of science from LSHTM’s Department of Global Health and Development. His current research explores the roles of moralising metaphors, modern myths and scientific knowledge in the production of different antibiotics and AMR politics.
Laurie Denyer Willis (AMIS Hub Research Fellow)
Laurie is a medical anthropologist concerned with the urban and political ecologies of health and disease in post-colonial landscapes. Her research explores animal-human relations, religion, and shifting meanings of care.
Our research team in Thailand brings together leading medical anthropologists from Mahidol University and the Ministry of Public Health. Research will be based in Nakhon Pathom, near Bangkok, and will include the mapping of antibiotic use, and the networks that antibiotics travel within, including in farms, factories, laboratories, and during medical practice. The research will also follow antibiotics, microbes, and discourses to national and international arenas.
Komatra Chuengsatiansup (AMIS Hub co-Investigator)
Komatra has researched community health and social policy including community drug use, village health volunteers, and primary care in Thailand. As a medical anthropologist working in the Ministry of Public Health, his works are instrumental in integrating an anthropological perspective in health policy development and implementation.
Luechai Sringernyuang (AMIS Hub co-Investigator)
Mahidol University’s Health Social Science Department. He has extensive research experience in pharmaceutical use in Thailand, especially self-medication with modern pharmaceuticals in rural communities.
Uravadee Chanchamsang (Ministry of Public Health Thailand)
Uravadee is researcher at the Society and Health Institute. Her background is in Medicine and Medical Sociology. Uravadee wrote her master thesis on the medical socialization of Thai physicians. Currently, Uravadee is conducting research related to social factors affecting how Thai doctors prescribe antibiotics.
Sittichoke Chawraingern (Ministry of Public Health Thailand)
Sittichoke has a Master degree of Anthropology and wrote his thesis about patients with mental illness. Currently, Sittichoke works under the Culture and Health risk project.
Panoopat Poompruek (Silpakorn University)
Panoopat is a medical sociologist and pharmacist who works as a faculty member at Department of Community Pharmacy, Silpakorn University. Panoopat has research experience in ethnographic studies on the phenomenon of medicine use by kathoeis (transgender women) to modify their bodies.
Our research team in Uganda is based at the Infectious Disease Research Collaboration (IDRC). The research will involve three study sites, seeking to understand how antimicrobials shape and enable ways of life within health care facilities across Tororo, among urban workers in Kampala, and in different scales of chicken and pig farms in peri-urban Wakiso and rural Tororo.
Susan Nayiga (AMIS Hub co-Investigator)
Susan is a social scientist with the IDRC in Uganda. Her current research is on understanding the consequences of tackling antimicrobial resistance in Uganda. She is interested in understanding how the imperative to restrict antibiotics impacts care.
Sarah Staedke (AMIS Hub co-Investigator)
Professor of Malaria & Global Health, LSHTM and IDRC, Kampala, Uganda. Sarah is a clinical epidemiologist based in Uganda where she has conducted research since 1999. Her research is focused on methods to improve quality of care and fever case management, and novel approaches to prevent and control malaria.
Christine Nabirye (Infectious Diseases Research Collaboration)
Christine is a medical sociologist and pharmacist at the IDRC in Uganda. She has substantial experience in qualitative research informed by medical anthropology, with a special interest in researching health care delivery in low resource settings.
Our research team in Thailand brings together leading medical anthropologists from Mahidol University and the Ministry of Public Health. Research is based in Nakhon Pathom, near Bangkok, and includes the mapping of antibiotic use, and the networks that antibiotics travel within, including in farms, factories, laboratories, and during medical practice. The research follows antibiotics, microbes, and discourses to national and international arenas.
The AMIS Thailand project team consists of:
Our research in Uganda is aimed at better understanding the roles of antimicrobials in society and everyday life. We will identify how antimicrobials shape and enable ways of life within health care facilities, among urban workers, and in animal farming. By addressing how people actually use antimicrobials, including antibiotics, and the wide-reaching reasons for reliance on these drugs, we will provide a detailed account that can be used by policy makers working on Antimicrobial Resistance (AMR) in Uganda today.
Using established social science methods, we provide fresh approaches to the study of antimicrobials in Ugandan society, to demonstrate how antibiotics are linked to social, economic, and political systems. Our research will focus on antibiotics but will also include antimalarials, antiretrovirals and antifungals. Project sites include Kampala, Wakiso, and Tororo.
How will social science contribute to the AMR research agenda in Uganda?
Social science research can assist in articulating the roles of antibiotics in everyday life in Uganda - for both people and animals- and in mapping their relationships to wider imperatives and infrastructures. is will help to reveal the wide effects that AMR may pose, as well as to inform potential consequences of policies to roll-back antimicrobial availability. With this knowledge, Ugandan policy makers can design policy tailored to our context in order to reduce the threat of AMR in our country.
Our research will focus on people engaged with health workers and patients in Tororo district, with day-wage urban workers (factory workers, vendors, hawkers) in Nakawa Division, Kampala district, and in diff erent scales of farming (piggery and poultry) in peri-urban Wakiso and rural Tororo district. It will also include detailed historical and archival research on Ugandan AMR policy guidelines, legal frameworks and regulations, both locally and globally, that will assist policy makers in charting future policy directions.
The AMIS Uganda project team consists of:
The AMIS Hub is an online resource, curated by anthropologists at the LSHTM, that brings together research relevant to AMR from across different social science disciplines. Aimed at those designing and implementing AMR policy, as well as funders and researchers from the life sciences, the AMIS Hub introduces readers to a wealth of relevant social research on AMR. The AMIS Hub materials include research summaries, blogs ‘from the field’, and reviews of existing and ongoing research and theory. We envision the Hub as a mechanism for policy-makers and life scientists to engage with social science research on AMR, to forge future collaborations and to inspire new ways to address AMR.
The AMIS Programme also includes two empirical research projects in Thailand and Uganda. Drawing on novel research tools from anthropology, the mapping of antibiotic roles in society, and collaborations with our diverse stakeholders across these countries, the AMIS projects in Thailand and Uganda seek to open the field of AMR research beyond its traditional boundaries
For the latest social science on AMR sign up to our newsletter.