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Anti-Microbials in Society (AMIS) Hub

Fresh approaches to the study of antimicrobials in society.

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About us

The AMIS programme ran from 2017 to 2021, with the aim to promote and produced high-quality research on antimicrobials in society by building on social and interdisciplinary research for innovative and insightful solutions to antimicrobial resistance.

Visit our AMIS Hub website - www.antimicrobialsinsociety.org – an online resource connecting you with relevant research, people and projects on AMR from a societal perspective.

Who we are

The AMIS team was comprised of a team of researchers in the UK, Thailand, and Uganda undertaking research into the nature of our reliance on antimicrobials in animal, human and plant life.

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About
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AMIS Uganda

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. Through this project we proposed 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 explored fresh approaches to the study of antimicrobials in society. Drawing on conceptual and methodological tools from anthropology, the AMIS research projects demonstrated the multiple roles that antimicrobials take in society today, and how they enable everyday life. 

The AMIS programme aimed to stimulate engagement with social research that presents different ways of conceiving, responding to, and framing global health issues, including AMR.

 

Who we are
Profiles
London-based
AMIS Hub Principal Investigator

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

Coll Hutchison

Research Fellow
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.

ANNA
PERRIS

Research Assistant

Alice
Tompson

Research Degree Student
Thailand-Based

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 Profile Pic

Komatra Chuengsatiansup

Ministry of Public Health Thailand
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

Luechai Sringernyuang

Mahidol University, Thailand
AMIS Hub co-Investigator

Luechai Sringernyuang is an Associate Professor in medical anthropologist, Director of Health Social Science International Programme and Dean of the Faculty of Social Science and Humanities at Mahidol University, Thailand. He has extensive research experience in pharmaceutical use in Thailand, especially self-medication with modern pharmaceuticals in rural communities.

Phakha Whanpuch Profile

Phakha Whanpuch

Mahidol University

Phakha's research interest in AMR is to better understand the role of antimicrobials in daily life in Thai society, including with health care providers, farmers, day wage urban workers, scientists and policy-makers.

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.

Ministry of Public Health Thailand

Thitima is an anthropologist at the Society and Health Institute. Thitima conducts ethnographic research focusing on antimicrobial use in tangerine plantations.

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.

Ministry of Public Health Thailand

Wirun's research focuses on the use of the “bio-social interaction framework” - linking in-depth biological studies and social analysis - to understand the global and local problems of antimicrobial resistance. 

Uganda-based

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

Susan Nayiga

Infectious Disease Research Collaboration
AMIS 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.

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.

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.

Mentors
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AMIS Mentors

The AMIS programme is guided by a group of researchers, which span the humanities, biological, clinical, and social sciences, to give advice and support.

History:

Sociology:

Anthropology:

Geography:

Clinical:

Microbiological:

Pharmacological:

Veterinary:

Policy:

Economics:

  • Professor Richard Smith, Exeter
  • Professor Kara Hanson, LSHTM

Previous AMIS Contributors 

Laurie Denyer Willis 
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.

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.

 

Thailand
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AMIS Thailand
AMIS Thailand

Our research team in Thailand brought 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 arenas.

The AMIS Thailand: Ministry of Public Health project team consists of:

The AMIS Thailand: Mahidol University project team consists of:

Our research teams in Thailand have compiled two short films as part of the dissemination of key findings from their research. To view the films please visit the AMIS Youtube channel. 

Uganda
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AMIS Uganda
AMIS Uganda

The research in Uganda was aimed to better understand the roles of antimicrobials in society and everyday life. We aimed to identify how antimicrobials shape and enable ways of life within health care facilities, among urban workers, and in animal farming. By researching how people actually use antimicrobials, including antibiotics, and the wide-reaching reasons for reliance on these drugs, to provide a detailed account that can be used by policy makers working on Antimicrobial Resistance (AMR) in Uganda today.

Using established social science methods, the team in Uganda 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 focused on antibiotics but also included antimalarials, antiretrovirals and antifungals. Project sites include Kampala, Wakiso, and Tororo.

How does 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. This has helped reveal the wider effects that AMR pose, as well as informed 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 Uganda.

Our research has focused on health workers and patients in Tororo district, with day-wage urban workers (factory workers, vendors, hawkers) in Nakawa Division, Kampala district, and in different scales of farming (piggery and poultry) in peri-urban Wakiso and rural Tororo district. It has also included 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:

Ugandan Short Films

These short films show the AMIS Uganda research activities aimed at understanding the roles that antibiotics play in everyday life and the context within which antibiotics are used in rural Tororo, peri-urban Wakiso and urban Kampala.

The Antimicrobials in Society (AMIS) Project Uganda: A film about anthropological approaches to the study of antibiotic use for humans and animals in households and farms in rural, urban, and peri-urban settings in Uganda, East Africa.

Antibiotics as Hygiene: A film about antibiotic use in an urban informal settlement in Uganda 

No medicine, no life: A film about everyday life and use of medicines to relieve pain and enable productivity in rural households in Tororo district, Eastern Uganda 

Antibiotics as Protection: A film about antibiotic use in pig and poultry production in Wakiso district, Uganda

 

Online Hub
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The AMIS Hub is an online resource that has brought together research relevant to AMR from across different social science disciplines, throughout the AMIS project. 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, commentaries, reviews of existing and ongoing research and theory and highlights relevant events. We envisioned 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.

Outputs
AMIS Publications
Use of antibiotics to treat humans and animals in Uganda: a cross-sectional survey of households and farmers in rural, urban and peri-urban settings
Susan Nayiga, Miriam Kayendeke, Christine Nabirye, Laurie Denyer Willis, Clare Chandler, Sarah G Staedke
2020
JAC- Antimicrobial Resistance
Social, cultural and economic aspects of antimicrobial resistance
Timo Minssen,Kevin Outterson, Susan Rogers Van Katwyk, Pedro Henrique D Batista, Clare I R Chandler, Francesco Ciabuschi, Stephan Harbarth, Aaron S Kesselheim, Ramanan Laxminarayan, Kathleen Liddell, Michael T Osterholm, Lance Pricel & Steven J Hoffman
2020
World Health Organization
Hunger will kill us before coronavirus does!
Susan Nayiga, Christine Nabirye, Miriam Kayendeke, Sarah G Staedke
2020
Social Science in Humanitarian Action Platform
Tuberculosis in the borderlands: migrants, microbes and more-than-human borders
Komatra Chuengsatiansup & Wirun Limsawart
2019
Palgrave Commun
The ‘Drug Bag’ method: lessons from anthropological studies of antibiotic use in Africa and South-East Asia
Justin Dixon, Eleanor MacPherson, Salome Manyau, Susan Nayiga, Yuzana Khine Zaw, Miriam Kayendeke, Christine Nabirye, Laurie Denyer Willis,Coll de Lima & Clare Chandler
2019
Global Health Action
The modern era must end: antibiotic resistance helps us rethink medicine and farming
Coll de Lima Hutchison, Gwen Knight, Richard Stabler, Clare Chandler
2018
BMJ
Anthropology’s contribution to AMR control
Laurie Denyer-Willis and Clare Chandler
2018
Addressing Antimicrobial Resistance through Social Theory: An Anthropologically Oriented Report
Clare I R Chandler, Eleanor Hutchinson & Coll Hutchison
LSHTM: Research Online
Antimicrobial Resistance & Anthropology
Chandler, C.I.R., and Hutchinson, C.
University of Bristol
Setting the standard: multidisciplinary hallmarks for structural, equitable and tracked antibiotic policy
Claas Kirchhelle, Paul Atkinson, Alex Broom, Komatra Chuengsatiansup, Jorge Pinto Ferreira, Nicolas Fortané, Isabel Frost, Christoph Gradmann, Stephen Hinchliffe, Steven J Hoffman, Javier Lezaun, Susan Nayiga, Kevin Outterson, Scott H Podolsky, Stephanie Raymond, Adam P Roberts, Andrew C Singer, Anthony D So, Luechai Sringernyuang, Elizabeth Tayler, Susan Rogers Van Katwyk, Clare I R Chandler
2020
BMJ Global Health 2020;5:e003091.