"Social, economic and political science frameworks can help us understand the top down nature of policies, power of the actors involved, and lack of attention to unintended social and economic consequences resulting from policy enforcement, all of which can impede policy implementation." - Meenakshi Gautham, LSHTM Department of Global Health and Development
Major challanges for combatting antimicrobial resistance include reducing excessive antibiotic use while ensuring access for those who need them, dealing with the slow production of new antibiotics in a context of diminishing economic returns, and breaking through structural and policy barriers to reducing AMR.
Background
This pillar’s focus on social, economic and political sciences is of major significance in understanding and addressing these complex issues. Our work is increasing the evidence base around these issues and generating out of the box, novel solutions.
Health Economics concerns the valuation of resources, and the assessment of efficiency and equity in the analysis of behaviours and health systems, including the affordability of antimicrobials.
Anthropology and Sociology explores the relationships between humans, societies, and antimicrobials. AMR can be understood to operate on a global stage, co-constructed between the pharmaceutical and medical diagnostics industries, the scientific community and political-economic dynamics. To find alternative avenues for responding to AMR, it is necessary to unpick and reframe our scientific, political and public perceptions of the problem.
Health Policy Analysis and Political Sciences focus on understanding how factors such as the process, content and participating actors shape the development, decision-making and implementation of novel guidelines, policies, and legislation.
These disciplines work in concert to tackle challenges associated with AMR that confront our health, our health systems and our own assumptions about the scope and nature of the topic.
Areas of active research
Researchers in the Economic, Social and Political Sciences pillar address a wide range of research questions related to the role of antimicrobials in society, antimicrobial consumption and its drivers, the political economy of antibiotic use, and the design of antibiotic stewardship interventions, with a special focus on community settings in LMICs.
- Shunmay Leung, Head of the Department of Clinical Research at LSHTM, leads the Comparative Health Care Analysis and Cost-Effectiveness work package of the PERFORM study. This EU Horizon 2020 project aims to develop and validate new ‘-omics’ based diagnostic technologies to improve the management of acute febrile illness in children, and ultimately reduce unnecessary antimicrobial use.
- The Antimicrobials in Society (AMIS) research hub brings together social science research and researchers on AMR, and offers policymakers, scientists and funders new ways of conceptualising and acting on AMR. The hub is led by former co-Director of the AMR Centre, Clare Chandler.
- The UKRI funded project has generated evidence on antimicrobial consumption and its drivers in human and livestock health in community settings in India, leading to innovative co-design of interventions with multiple stakeholders in the AMR ecosystem.
- The School is home to the , led by Prof Nicholas Mays. The team, together with colleagues from the Royal Veterinary College, evaluated the implementation of the UK’s AMR Strategy 2013-2018 and will be undertaking an evaluation of the UK’s 2019-2024 National Action Plan.
- Our Health Systems researchers in the Department of Global Health and development are investigating the role of the private sector in AMR, with a special focus on antibiotics available through informal healthcare markets. This research spans informal providers and paravets in India (OASIS study/Dr. Meenakshi Gautham) community pharmacies and drug sellers in Indonesia (/ Prof. Virginia Wiseman), (Prof Sian Clarke and Dr. Eleanor Hutchinson) and Tanzania, (Dr. Mishal Khan) and (Prof. Catherine Goodman). has deepened existing understanding of the functioning of informal health markets, where informalities of antibiotics practices are co-produced by multiple actors including formal providers and supply chain stakeholders.
- We have set up a cross-disciplinary research network – the - with the aim of developing antibiotic stewardship interventions in agricultural community settings in Asia, Africa and S. America. This partnership focuses on the health of humans and animals in agricultural community settings and is especially concerned with the in backyard livestock. Given the complexity of these settings, our teams are developing and co-opting including pharmaceutical industry actors into intervention design.
Moving beyond the conservation of existing antimicrobials, our scientists are furthermore contributing to discussions on new business models for the discovery and development of antibiotics.