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Green Templeton College | Oxford

Haenssgen 2
Dr Haenssgen presents at the Aid and International Development Forum 2018 Asia Summit, UN Convention Centre, Bangkok (Photo credit: Nutcha Charoenboon)

Green Templeton College Associate Fellow Doctor Marco J Haenssgen (Centre for Tropical Medicine and Global Health and CABDyN Complexity Centre) and his team have recently completed survey research in Thailand and Laos to inform policy responses to the growing global health problem of drug resistance. Threatening to evolve into the leading cause of death with a toll of ten million lives annually by 2050 if left unchecked, drug resistance is a top priority on global health agendas. Dr Haenssgen’s work took place to inform policy responses from a social science perspective, building on his background in development studies.

Following the completion of 5,900 interviews with rural respondents, Dr Haenssgen and his team have been presenting their preliminary research findings at the Aid and International Development Forum 2018 Asia Summit in Bangkok (pictured), the Development Studies Association 2018 Annual Conference in Manchester, the 2018 International Health Conference in Oxford, and the ESRC Research Methods Festival 2018 in Bath.

Dr Haenssgen’s research documents the complexity of human behaviour and people’s understanding of antibiotics, and the role of marginalisation and poverty as underlying drivers. The unconventional blend of development studies and global health research helps to challenge stereotypes and assumptions that are pervasive in current policy responses to influence the behaviour of the general population and reduce unnecessary antibiotic use. Dr Haenssgen’s work shows that, while attitudes and knowledge did contribute to problematic behaviours, only few people adhered to the stereotype of the person who considers antibiotics as 'miracle drugs'. He explains, 'We see a more general dependence on pharmaceuticals as a form of good care, which corresponds to current anthropological research in this field. We could argue that problematic antibiotic use among the general population is therefore only a symptom of deeper-rooted problems, like poverty, stress, and health system deficiencies.'

The implications of this work are that often-propagated global awareness campaigns to improve antibiotic use among the general population are likely going to be insufficient to improve the behaviour of the general population fundamentally. Research team member Nutcha (Ern) Charoenboon has provided further insights into this point with an in-depth examination of three villages in Thailand. After a half-day activity that shared information about antibiotics and drug resistance with villagers, Ms Charoenboon found that participants were better informed, yet some felt so confident that they started selling antibiotics to fellow residents. 'We need to consider all possible interpretations and side-effects when we think about "educating the general public," and that requires the medical and the social fields to work together,' she concludes.

Dr Haenssgen and his team argue that the social dimension of antibiotic mis-use and drug resistance requires solutions beyond conventional health policy responses like education and awareness raising. Such solutions could include social protection, labour regulation, or access to credit, but the identification of the most effective strategies will require more social science research on antimicrobial resistance. According to Dr Haenssgen, development studies research therefore has an important role to play in understanding the problem and informing new policy responses to the global superbug crisis because the current emphasis on global awareness campaigns 'will at best make a small difference for patient behaviour, and, at worst, it will waste precious time and distract us from structural causes of antibiotic use.'

The survey research project 'Antibiotics and Activity Spaces' is led by GTC Associate Fellow Dr Marco J Haenssgen in collaboration with GTC Governing Body Fellow Prof Felix Reed-Tsochas and GTC student Mr Jeffrey Lienert. More information can be found at the RCUK Gateway to Research, in the project’s research protocol published in the BMJ Global Health, and at Antimicrobials in Society. For updates on Dr Haenssgen’s work, follow @HaenssgenJ on Twitter.