"Characterising the environmental and social drivers of AMR across diverse settings is key to mitigating its current and future impacts. The humanities help us to understand complex social, behavioural and historical determinants of AMR in different settings and populations." - Assistant Professor Jackie Knee, LSHTM Department of Disease Control
Holistic and context-aware solutions are required in response to the technical and policy problems posed by antimicrobial resistance (AMR). However, there is little awareness of how to achieve this. Humanities and Environmental Sciences possess key technical and methodological skills in discursive, spatial, and ecological analysis of contextual dimensions of AMR.
Background
History, literary and critical studies, geography, and environmental sciences study the cultural, spatial, and temporal dimensions of human activity and interaction with their world. They investigate continuity and change in social and ecological relations, providing tools for understanding the intersections of politics, economics, epidemiology, and biology. Together, these disciplines help us to understand and assess the long history of social and technical interventions in human health, allowing us to outline recurrent patterns, evaluate their impact across space and time, and trace shifting behavioural and policy responses.
Environmental sciences foreground ecological consequences of human activity and help us to reimagine AMR within a network of human relations with animals, plants, pathogens, and terrains. Geography provides a critical and comparative lens on spatial dimensions of health and environmental policy, including inequalities. History investigates our changing techniques, emphases, and politics in human health at both the local and global scale. Literary and critical studies demonstrate how discourse on health is deeply interwoven with culture-bound and culturally specific interpretations and expectations.
The disciplines can also bridge science and policy. From the perspective of impact, these fields are centrally concerned with open dialogue with policy-makers in the interest of developing sensitive, responsive and fair policy apparatus in response to what is a deeply-rooted, widely distributed, and often poorly understood environmental, social and biological problem.
Areas of active research
The Humanities and Environmental Sciences pillar includes research from across a broad range of disciplines from history to environmental microbiology. LSHTM researchers and their collaborators are engaged in several active areas of research within this pillar.
- Water, sanitation, and hygiene (WASH) can help combat the spread of AMR in several ways, from reducing the transmission of enteric infections and reducing antibiotic use, to limiting the release of AMR microorganisms into the wider environment. For these reasons, the Lancet Commission on Water, Sanitation, Hygiene (WASH) & Health has identified AMR as key public health threat underscoring the urgent need to expand access to safe WASH globally.
- Researchers in the department of Infectious Disease Epidemiology are undertaking work on whether and how environmental hygiene practices in hospitals and other care facilities drive transmission of hospital-acquired infections (HAIs) and AMR, and what can be done to limit these risks.
- Researchers in the Anthropology of AMR research group at LSHTM study AMR using tools from the humanities and social sciences. Recent work in this group includes studying the history of antibiotics in several sub-Saharan African settings and how that shapes perceptions and use today.