Antibiotics and activity spaces : an exploratory study of behaviour, marginalisation, and knowledge diffusion

Antimicrobial resistance (AMR) is a top global health challenge, threatening to become the leading cause of death globally by 2050. Policies to tackle AMR recognise that human behaviour and medicine use are important, but the global health policy tools are insufficient. Not only are education and awareness campaigns insufficient to change behaviours fundamentally, but they might also delay more effective action to address structural factors of medicine use, like poverty, stress, hardship, and health system deficiencies. Considering the urgency of AMR action, this is a dangerous and costly omission. Our research calls for reimaging global health policy as development policy, recognising that AMR is only one among several symptom of deeper-rooted social problems. Antibiotics and Activity Spaces is a survey of 5,885 villagers in Chiang Rai (Thailand) and Salavan (Lao PDR) to better understand (1) how people access healthcare and what actually counts as “problematic” antibiotic use, (2) whether antibiotic-related information from educational activities spreads or simply evaporates in village community networks, and (3) whether there are simple “early warning” indicators (e.g. specific symptoms) to detect whether people are likely to have “problematic” antibiotic use. The surveys are currently being implemented by 10-member survey teams in each country and expected to be finished in April 2018. This project is funded by the Antimicrobial Resistance Cross Council Initiative supported by the seven research councils in partnership with the Department of Health and Department for Environment Food & Rural Affairs (grant ref. ES/P00511X/1, administered by the UK Economic and Social Research Council)