Antimicrobial resistance (AMR) is a critical public health threat globally, but its burden is not distributed equally and is heavily influenced by the social determinants of health. Improved public health outcomes are possible using an intersectional equity lens in disease prevention and control, but these have had limited use in AMR.

Data on the burden of AMR disaggregated by various social stratifiers are still limited across contexts.  This represents a critical missed opportunity to better tailor AMR interventions to improve programmatic effectiveness and sustainability and avoid further entrenching intersectional gender inequities. Gender mainstreaming can strengthen the capacities of organisations and communities to take action to address social inequities but must include critical interpretation of disease surveillance data and an intersectional lens.  

GEAR up seeks to catalyse action on gender and equity within AMR through supporting Fleming Fund country grantees to mainstream gender and equity within routine AMR systems and structures. We aim to increase awareness, and contribute to the knowledge, on structural inequities driving and shaping the AMR response. We also seek to facilitate South-South exchange through building a global community of practice to guide and inspire further action and global knowledge sharing. 

Objective 1: Mainstream gender and equity considerations into existing surveillance structures  

• Action: Encourage the collection of AMR surveillance data that is disaggregated by sex, age, location and, where feasible, other social stratifiers such as ethnicity, sexuality, socioeconomic status and refugee status 

• Action: Support analysis of existing disaggregated datasets in Fleming Fund countries 

Objective 2: Inform National Action Plans on equity and AMR 

• Action: raise awareness around equity and gender dimensions of AMR  

• Action: Review existing national plans or AMR strategies and incorporate equity considerations and policies or actions that strive for equity 

Objective 3: Promote further research to strengthen the evidence base on the intersections between gender and AMR 

• Action: Conduct and support empirical research in Fleming Fund countries, including qualitative research  

• Action: Develop specific case studies, tools and resources 

Objective 4: Inspire action on AMR through South-South exchange 

• Action: Build a community of practice around equity and AMR  

GEAR up is funded by the Fleming Fund. The Department of Health and Social Care (DHSC)’s Fleming Fund is a UK aid programme supporting up to 25 countries across Africa and Asia to tackle antimicrobial resistance (AMR), a leading contributor to deaths from infectious diseases worldwide.

The Fleming Fund invests in strengthening AMR surveillance systems through a portfolio of country grants, regional grants, and fellowships managed by Mott MacDonald, and global projects managed by DHSC.