The impact of gender on exposure to pathogens has come under scrutiny in a recent review conducted by the World Health Organization (WHO). The findings shed light on how women may face a higher risk of encountering drug-resistant infections compared to men, particularly in regions where gendered divisions of labour prevail. This disparity highlights a crucial yet often overlooked aspect of the escalating threat posed by antimicrobial resistance (AMR).
According to the WHO-led global review, an alarming revelation emerged – more than 70% of countries do not acknowledge gender disparities in their national strategies to combat drug-resistant infections. This oversight raises concerns about the effectiveness of current approaches in addressing the evolving landscape of AMR. As part of efforts to enhance preparedness, the WHO recently expanded its list of most perilous drug-resistant bacteria, adding four pathogens deemed particularly hazardous to human health.
The criteria for inclusion in this list encompass factors such as the prevalence of infections caused by these bacteria, their lethality, and the feasibility of preventive measures like hand hygiene and vaccination. Among the newly added pathogens are three streptococcal bacteria associated with severe conditions such as pneumonia, as well as a highly resistant strain of tuberculosis. The distinctive challenges posed by these pathogens underscore the urgent need for comprehensive strategies to mitigate the spread of drug resistance.
A key revelation from the gender review is the heightened vulnerability of women, especially those in resource-constrained settings, to contracting drug-resistant infections. This susceptibility stems from various factors, including menstrual hygiene requirements and differential exposure to pathogens due to societal roles. The implications of these findings are profound, shaping the forthcoming WHO report that will focus on integrating gender considerations into global efforts to combat AMR.
Experts emphasise that gender plays a pivotal role in influencing patterns of infection exposure, healthcare-seeking behaviour, and treatment outcomes. The lack of explicit recognition of these dynamics in existing national action plans underscores the need for a more nuanced approach to address gender inequalities in the realm of infectious diseases. By acknowledging the impact of gender on health outcomes, policymakers can devise more targeted and effective interventions to combat AMR.
The WHO review draws on insights from 130 studies spanning over two decades, with a notable emphasis on research conducted in Africa and Southeast Asia. In resource-limited settings, factors such as inadequate access to clean water place women and girls at heightened risk of drug-resistant urinary tract infections. Additionally, women’s disproportionate responsibilities in household and caregiving roles expose them to a higher likelihood of encountering antibiotic-resistant pathogens in diverse settings.
Moreover, the overrepresentation of women in healthcare settings further amplifies their exposure to drug-resistant infections. As primary caregivers for their families, women often bear the responsibility of making healthcare decisions, including those related to vaccination and treatment. These dynamics underscore the need for a gender-sensitive approach in healthcare policymaking to address the multifaceted challenges posed by AMR.
The prevalence of sexual violence against women in certain regions also contributes to their heightened vulnerability to drug-resistant sexually transmitted infections. Cultural norms that limit women’s autonomy and access to healthcare exacerbate this risk, leading to suboptimal treatment-seeking behaviours and potentially facilitating the emergence of drug resistance. Addressing these structural inequities is essential to curbing the spread of antimicrobial resistance and safeguarding public health.
Despite the compelling evidence highlighting the gendered dimensions of AMR, data collection on sex and gender remains inadequate in many countries. This dearth of information hampers efforts to accurately assess the prevalence and impact of drug-resistant infections among different demographic groups. Bridging this knowledge gap is imperative for devising targeted interventions that address the specific needs and vulnerabilities of diverse populations.
Looking ahead, the WHO’s upcoming report presents a pivotal opportunity to galvanise global action on antimicrobial resistance with a renewed focus on gender considerations. By integrating gender-sensitive approaches into national strategies and healthcare policies, countries can enhance their resilience against the growing threat posed by drug-resistant infections. The forthcoming United Nations General Assembly meeting on antimicrobial resistance in September offers a platform for policymakers to make tangible commitments towards combatting AMR and fostering sustainable health systems worldwide.
The intersection of gender and antimicrobial resistance underscores the need for a comprehensive and inclusive approach to public health interventions. By recognising and addressing the unique challenges faced by women in combatting drug-resistant infections, policymakers can foster more equitable and effective strategies to safeguard population health for generations to come.
