Gender inequality worsening rise in drug-resistant infections, Experts warn

Women’s unequal access to healthcare and exposure to violence is driving the rise of drug-resistant infections, threatening efforts to curb antimicrobial resistance globally experts have warned.

They noted that these inequalities worsened by social norms, stigma are making women more vulnerable to infections and inappropriate antibiotic use, driving antimicrobial resistance (AMR)

Speaking at a virtual briefing on AMR under gender lens, Soumya Swaminathan, former Chief Scientist of the World Health Organization (WHO), warned that violence against women significantly increases the risk of drug-resistant infections. “Women are at a very high risk of intimate partner violence or domestic violence—physical or sexual. This could lead to more infections. And because of their position within the household and the community, they are less likely to seek timely and adequate care for these injuries or infections, which could lead to drug-resistant infections,” she said.

Swaminathan, also Chairperson of the MS Swaminathan Research Foundation, highlighted that women may take partial courses of antibiotics, receive wrong doses, or delay seeking treatment for sexually transmitted infections, urinary tract infections, reproductive tract infections, or pelvic inflammatory disease.

Swaminathan added that unplanned pregnancies and unsafe abortions can also heighten their risk of AMR.

Swaminathan noted that rural women farmers with livestock and limited financial autonomy face higher risks of neglecting infections or taking inappropriate treatment.

Swaminathan urged the inclusion of gender-based violence indicators and gender-sensitive stewardship measures in National Action Plans on AMR. Bhakti Chavan, a survivor of extensively drug-resistant TB and member of WHO’s AMR Task Force, said stigma further compounds the problem, adding that women diagnosed with TB or HIV/AIDS often hide their illness due to fear of social judgment.

“They delay testing, avoid clinics, take medicine secretly, or stop treatment early to prevent family members or neighbours from finding out,” she explained.

Experts also highlighted power imbalances and social norms as drivers of AMR. Esmita Charani, Associate Professor at the University of Cape Town, said women frequently have the least power in healthcare settings and often prioritise the care of family members over themselves.

Experts warned that without addressing gender disparities, social norms, and power imbalances, global efforts to curb AMR and achieve the Sustainable Development Goals could falter.