AMR in LMICs: Social Determinants, Surveillance, and Context-Specific Evidence

The World Health Organization recently delineated 40 global research priorities for AMR (Bertagnolio et al., 2024), highlighting the need for evidence relevant to low-resource settings (LMICs). The 2024 UN General Assembly established ambitious targets to substantially reduce AMR mortality by 2030. Despite these commitments, substantial data gaps remain on the true incidence and socioeconomic burden of resistant infections in LMICs, particularly where decentralized laboratory capacity is limited. Public health responses are often adapted from high-income settings, with limited adjustment for differences in infrastructure, health system organization, and clinical context. Closing these gaps will require evidence that explicitly examines the intersection of WHO priority pathogens with social determinants, healthcare access, and clinical vulnerability in LMIC populations.In LMICs, AMR containment is constrained by limited granular epidemiological data. While clinical stewardship remains important, many of the drivers of AMR in these settings operate outside hospital walls. Social inequities, inadequate sanitation infrastructure, population displacement, and fragmented health systems shape the selection and transmission of drug-resistant pathogens. Conventional passive surveillance often underrepresents the burden among socioeconomically vulnerable populations, contributing to persistent data voids.This Research Topic aims to strengthen the evidence base on the social and structural determinants of AMR in LMICs, and on context-appropriate surveillance approaches suited to resource-limited settings. By connecting microbiological and structural public health perspectives, the collection seeks to assemble disaggregated evidence that can inform locally relevant responses aligned with the 2030 AMR targets.We invite original research, systematic reviews, methodological studies, and policy analyses focused on AMR in LMICs. Submissions should address one or more of the following themes, with explicit attention to LMIC contexts:• Social and structural drivers in LMICs: the influence of socioeconomic deprivation, migration, WASH infrastructure, and health expenditure on the prevalence and transmission of WHO priority bacterial and fungal pathogens in low- and middle-income settings.• Context-appropriate surveillance in LMICs: the use and evaluation of cost-effective approaches, including geographic information systems (GIS) for spatial mapping of AMR hotspots and genomic epidemiology for tracking critical threat pathogens (e.g., the ESKAPE group) within resource-constrained networks.• Granular burden estimates from LMIC populations: epidemiological data disaggregated by sex, age, and socioeconomic status, with particular attention to neonates, displaced communities, and rural populations in LMICs.• Public health program evaluations in LMIC settings: assessments of the AMR-related consequences of broad public health interventions implemented in LMICs, such as mass drug administration campaigns or the syndromic management of sexually transmitted infections. Topic editors: Quan K Nguyen, Andrew W. Taylor-Robinson, Jeffrey Mayne Source: https://www.frontiersin.org/research-topics/80455/amr-in-lmics-social-determinants-surveillance-and-context-specific-evidence