On 8 July 2025, the Just Transitions for AMR Working Group organised a 75-minute panel discussion at the Oxford Global Health and Bioethics International Conference held at the University of Oxford, UK. The aim of the panel was to gather feedback on the strengths and limitations of our approach, identify any gaps, and explore areas for further work. The panel was chaired by Phaik Yeong Cheah (Mahidol Oxford Tropical Medicine Research Unit, Thailand), who introduced the topic. This was followed by a series of six five-minute presentations by members of the working group.

Sonia Lewycka (Oxford University Clinical Research Unit, Vietnam) explained the origins and development of the Just Transitions approach and its application in the context of antimicrobial resistance (AMR). Sonia described how we are adapting the “just transitions” concept, which is used in climate change mitigation, to promote fair and equitable policy shifts toward sustainable, low-carbon economies. She highlighted parallels between climate change and AMR: both are “super-wicked” problems, both disproportionately impact disadvantaged populations, and both require collective action.

Tess Johnson (Ethox Centre) discussed various conceptions of justice being considered by the group in relation to AMR, and noted forms of justice often overlooked by traditional Just Transitions frameworks, such as epistemic justice and ubuntujustice.

Deepshika Batheja (Indian School of Business and One Health Trust, India) illustrated how AMR affects different populations unequally, including disparities between men and women and among different caste groups in India.

Duy Minh Vu (Oxford University Clinical Research Unit, Vietnam) shared insights from a project in Vietnam in which his team engaged primary care doctors, healthcare stakeholders, and community members to explore their views on AMR.

Edna Mutua (KEMRI-Wellcome Trust, Kenya) presented an overview of policies surrounding AMR containment in low- and middle-income countries and illustrated gaps in governance mechanisms – most of which are adapted from the Global Action Plan and implemented in a top-down manner.

Finally, Sheila Varadan (University of Leiden, the Netherlands) drew connections between Just Transitions for AMR and climate justice, summarised key points from the panel, and highlighted important gaps in the current Just Transitions framework.

The session concluded with a Q&A segment. Participants raised questions about the practical implementation of the framework and whether different approaches should be considered for different microbes and pathogens.

‘Bugs and drugs’ were featured on the menu at the 2025 Summer Showcase of the British Academy, with four members of the ‘Just Transitions for Antimicrobial Resistance’ (AMR) working group leading a science café on 21 June. Nearly 30 members of the public gathered for an open conversation about antibiotics, ethics, and the future of healthcare.

“I found the discussion fascinating, especially the debate about equity in healthcare,” said computer scientist Anthony Kesterton. “I never realised how interconnected the use of antibiotics is to so many aspects of our lives.” (Anthony also captured the featured photo of the British Academy during the event.)

Discussion points ranged from antibiotic use in farming, the influence of ‘big pharma’ in encouraging overuse and the role of ‘good’ versus ‘bad’ bugs. “It was interesting to hear people’s views on the connections between antibiotic drugs and our modern lives and systems, and what drug resistance means for our relationships with microbes. This included the ‘should we have more dirt in childhood?’ debate, and how porous boundaries should be, such as nurses and surgeons wearing scrubs to cafes near to their hospitals”, Professor Clare Chandler remarked.

Professor Caesar Atuire highlighted some of the key tensions between public health ideals and global economic pressures, such as the desire to farm less intensively and how it contrasts with growing demands on food production. He also highlighted the ethical challenges of donating near-expired drugs to developing countries.

For Professor Sonia Lewycka, who leads the ‘Just Transitions for AMR’ project, one conversation stood out: Some people spoke about using as little medicine as possible, while others described using medicines regularly to stay well. “The first perspective made me think of the Hippocratic belief in the natural ability of the body to heal itself, while the second perspective reminded me of conversations about traditional medicine in Vietnam, where, based on Confucian principles, medicines are used to keep the body in balance.” This conversation provided me with some good ideas about how to explore the use of antibiotics in Vietnam further, she added.

“I found the event useful as a way to reflect on my communication of some of my work,” Dr Tess Johnson remarked. “Sometimes, particularly as an ethicist, you get wrapped up in the details of an argument or the specifics of a case, and it’s hard to take a step back and see the big picture of what you’re trying to do. An event like this is a valuable reality check about people’s concerns and the ethical issues they care about. I am reminded of why we’re undertaking this research and where my priorities should lie.”

Johnson brought along a World Health Organisation (WHO) poster showing a hand reaching into a bowl of sweets mixed with antibiotics. While some attendees saw the image as a call for greater access to antibiotics, others viewed it as a warning against their misuse. The differing interpretations sparked reflection among the facilitators. “This example illustrates why it’s essential to pre-test health communication materials with your audience,” added Professor Marina Joubert. “People may read a message very differently from what the scientists or designers intended.”

From 21–22 May 2025, three members of the BA-funded Just Transitions for AMR Working Group (Professor Sonia Lewycka; Dr Sheila Varadan and Dr Tess Johnson) participated in a two-day interdisciplinary workshop titled “AMR and Transitional Justice: What Can We Learn from the Climate Transition?” Hosted by the University of Graz, the event was part of the Austrian Science Fund (FWF) project: A Political Conception of Transitional Justiceand supported by Climate Change Graz.

The workshop brought together scholars and practitioners to explore how insights from climate justice can inform approaches to justice in transitions, particularly in the context of antimicrobial resistance (AMR). By examining the parallels between AMR and climate change, participants considered how justice frameworks might support more equitable and inclusive transitions.

The Just Transitions for AMR Working Group was invited to share its expertise on how the just transitions framework can address the trade-offs and unequal burdens associated with AMR and related interventions.

Professor Sonia Lewycka presented on epistemic injustice in AMR research, highlighting how certain groups are unfairly marginalised in the production, dissemination, and application of AMR knowledge.

Dr Sheila Varadan discussed the dual nature of just transitions in AMR, emphasising both the potential to promote sustainability and equity, and the challenges posed by competing priorities, power imbalances, and global inequalities in AMR governance.

Dr Tess Johnson examined the ethical justifications presented for coercive antimicrobial stewardship measures. She argued in favour of more structured analysis of potential justifications and their theoretical and empirical foundations before justifications like ‘this measure will promote solidarity’ or ‘this measure holds those responsible for antimicrobial resistance accountable’ are presented to publics by policymakers.

Participants left the workshop with a deeper and more nuanced understanding of justice, drawing on transitional justice concepts from the climate change field. These perspectives offer valuable tools for addressing the complex challenges of just transitions in AMR. A key theme that emerged was the importance of language – particularly the term epistemic injustice – in shaping how injustice is identified and addressed. This reflection is expected to influence future research and writing in the field.

The workshop not only enriched the intellectual foundation of the Just Transitions for AMR initiative but also opened new avenues for collaboration and partnership. It provided a productive space for reimagining how we understand and respond to the global challenge of AMR.

Public communication and engagement around antimicrobial resistance (AMR) was on the agenda at the 2025 Public Communication of Science and Technology (PCST) Conference, held from 24–27 May in Aberdeen, Scotland. A panel titled “Breaking Barriers: Refocusing Public Communication about AMR” brought together international experts to explore innovative strategies for addressing this global health challenge.

Convened by Marina Joubert (Stellenbosch University, South Africa), a member of the ‘Just Transitions for AMR’ working group, the panel featured diverse perspectives on the complexities of AMR communication.

Marina Joubert opened the session with findings from a scoping review that identified key challenges and potential solutions in AMR communication. Brigitte Gschmeidler (Life Sciences in Dialogue, Austria) emphasised the importance of regional context in shaping effective AMR messaging. Mary Chambers (Oxford University, Vietnam) explored how decolonising science communication can address the “super-wicked” nature of AMR in Southeast Asia. Paul Flowers (University of Strathclyde, UK) discussed strategies for fostering meaningful public engagement on AMR.

Katharine Richter (University of Adelaide, Australia) showcased how public events like Pint of Science, Soapbox Science, and National Science Week are used to connect Australian audiences with AMR research. Bruno Pinto (Agência Nacional para a Cultura Científica e Tecnológica, Portugal) concluded the session with a creative look at how comics can serve as powerful tools for AMR communication.

The panel sparked lively discussion, guided by four thought-provoking questions:

1. How can we overcome the ‘language’ and ‘image’ problem of ‘antimicrobial resistance’?

2. When should culture and local knowledge be embraced in science communication—and when might they pose challenges?

3. What evidence base can we build for effective public engagement on AMR?

4. Can storytelling enhance our ability to communicate AMR?

Stay Connected: To stay informed about future events or research related to AMR communication, contact Marina Joubert at marinajoubert@sun.ac.za

Gender and other socio-economic disparities significantly contribute to the impact of antimicrobial resistance (AMR), affecting both healthcare access and the success of strategies to combat antimicrobial resistance (AMR). Despite this, current National Action Plans (NAPs) often fail to consider gender and equity concerns.

To bridge this gap, Dr Deepshikha Batheja (from the Indian School of Business and One Health Trust) convened a meeting of experts on ‘gender and AMR’, hosted at the British Academy in London on 15 January 2025, with a focus on how equity concerns can be effectively incorporated into AMR research and policy.

The programme for the day included insightful contributions from a distinguished panel of speakers, including UK parliamentarian Baroness Natalie Bennett, WHO experts Anand Balachandran and Zlatina Dobreva, along with researchers Professor Sonia Lewycka, Dr Deepshikha Batheja, Dr Rosie Steege, Victoria Saint, Susan Nayiga, and Srishti Goel.

The group discussions, chaired by Dr Edna Mutua, focused on actionable strategies for researchers, policymakers, funders, and healthcare providers to ensure gender-responsive, inclusive, and equitable AMR mitigation efforts across high-income and low- and middle-income countries. This meeting served as a crucial step toward embedding gender and equity considerations in AMR policies, reinforcing the need for inclusive, community-driven, and people-centered approaches to tackling this global challenge.

Held on 15 January 2025 in London, Deepshikha Batheja convened a roundtable meeting titled “AMR in the Community: Mainstreaming Gender and Equity in National Action Plans and AMR Governance.” The meeting was organised in collaboration with the Max Institute of Healthcare Management at the Indian School of Business and One Health Trust, The British Academy, and the World Health Organization (WHO), and was funded by a Knowledge Translation Grant from The British Academy.

Biological factors contribute to higher antibiotic use among women, and these are further compounded by socio-cultural barriers and systemic discrimination that limit women’s access to quality healthcare and health information. These intersecting inequities increase disease burden and the risk of antimicrobial misuse. Despite this, AMR governance frameworks and National Action Plans (NAPs) often overlook equity considerations and the cultural dimensions shaping health behaviours.

The primary aim of the meeting was to convene experts to examine how antimicrobial resistance (AMR) intersects with gender and other socioeconomic factors. Building on WHO’s People-Centered Approach (PCA), the roundtable focused on policies for integrating social justice into AMR research, surveillance, and interventions, as well as on strengthening collaboration among stakeholders to address AMR from a broader, more inclusive perspective. The meeting built on discussions from a gender and AMR workshop held in Bangalore in 2024, with the shared goal of advancing inclusive frameworks for AMR governance and improving global health policy.

Baroness Natalie Bennett, UK Parliamentarian, delivered the keynote address. Additional speakers included:

Dr Sonia Lewycka (Oxford University Clinical Research Unit), who outlined the origins and evolution of the Just Transitions approach and its relevance to AMR.

Anand Balachandran (World Health Organization), who presented work on advancing equity through a people-centred approach to addressing AMR.

Dr Rosie Steege (Liverpool School of Tropical Medicine), who discussed GEAR UP’s work in catalysing action on gender and equity in AMR.

Victoria Saint (Bielefeld University), who spoke on strengthening evidence, research, and action to address the equity dimensions of AMR.

Zlatina Dobreva (World Health Organization), who presented WHO recommendations for addressing gender inequality in National Action Plans.

Dr Deepshikha Batheja (Indian School of Business and One Health Trust) and Srishti Goel (One Health Trust), who shared quantitative evidence on unequal AMR impacts across populations, including gender-based disparities.

The meeting concluded with a facilitated group discussion chaired by Dr Edna Mutua (KEMRI–Wellcome Trust), focusing on inclusive governance and research approaches to addressing AMR, with particular attention to gender, income, race, and other intersecting vulnerabilities.

Output from the meeting: Batheja, D., Saint, V., Dobreva, Z., Goel, S., Lewycka, S., Mutua, E., … & Balachandran, A. (2025). “Integrating gender and equity commitments in the revised global action plan on antimicrobial resistance.” The Lancet.