Study title

The AMIS Project Uganda is an anthropological research project aimed at better understanding the use of antimicrobials in Ugandan society. The study used a mixed-methods approach to investigate the roles and context of antimicrobials in daily life in Tororo, Wakiso and Kampala districts from the perspective of health care providers, farmers and day wage urban workers. The data collection includes field-note and contact summaries, in-depth interview transcripts, key informant interview transcripts, medicines surveys, oral histories, and participant feedback dialogues.Our use of antibiotics has escalated. We are often most aware of antibiotic use when we treat infections - for people, and animals. However, their use is more widespread. We use them routinely to reduce risks of infection amongst people with vulnerable immune systems, in farming livestock, to manage infection and to promote growth and even in crop farming. This widespread use is linked to a rise in antibiotic resistance (AMR). The amount of antibiotic chemicals in circulation is held responsible for driving selection pressure amongst bacteria such that some infections become untreatable with previously effective drugs. This can have dramatic consequences for both health and economics. And yet, scientists have emphasised the lack of evidence for using antibiotics in many scenarios. For example, it is estimated that at least 50% of human antibiotic usage has no clinical benefit. Policy makers are agreed that we must reduce our reliance on these medicines. But how? Efforts to change end user behaviour are often called for but thus far have not had the widespread impacts required to curb the emergence and spread of resistance. In this research, we propose that antibiotics are embedded within our socioeconomic infrastructure in such a deep way that attempts simply to change behaviour of patients, physicians of farmers are peripheral to our underlying dependency on their use. We suggest that by...