Antibiotic resistance is rising globally – between 2000 and 2015, antibiotic consumption in humans increased 65% when expressed in defined daily doses. Antimicrobials are also used in livestock production to maintain health and productivity. These practices contribute to the spread of drug-resistant pathogens in both humans and livestock, posing a significant public health threat.

Researchers from the Anthropology of Antimicrobial Resistance team at the LSHTM work in countries across Africa and Asia, including Ghana, Uganda, Malawi, Zimbabwe, China, Myanmar, and Thailand, to understand how antibiotics are used in society. The following video highlights three case studies from this global research.

In Malawi, antibiotics are frequently out of stock at public clinics and people have trouble accessing antibiotics, except cotrimoxazole, which is intended for people living with HIV. To capture the type of antibiotics people are using at home, LSHTM researchers developed a ‘drug bag’ method, asking people to tell us about the antibiotics they use.

Drug bag Malawi

In Zimbabwe, in a context of political instability, antibiotics are used to fill gaps in fractured health systems. Researchers investigating antibiotic use in urban Harare found that people living in cramped and unsanitary living conditions were using antibiotics to cope with systemic challenges and keep them well enough to work.

Zimbabwe Drug Image

In Uganda, antibiotics are used to protect animals and farmers from diseases and mitigate the risks of economic losses. The video shows a striking scene of a chicken being spoon-fed colistin, (a last line antibiotic used to treat pneumonia in humans) as a prophylactic to prevent disease.

Chicken Antibiotics

These examples demonstrate that to reduce our reliance on antibiotics globally, we need to fix the structural challenges they are used to address. The Anthropology of AMR team question whether a narrow focus on changing individual behaviour is appropriate, and consider how interventions can address wider problems, with downstream effects on antibiotic use, and reduction in AMR.

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