Enhancing Access to Antimicrobial Resistance Diagnostics for the Marginalised

Background

Antimicrobial resistance (AMR) is a growing threat in low- and middle-income countries, yet access to reliable diagnostics remains deeply unequal. Marginalised populations, particularly in rural, tribal, and remote settings, are least likely to reach laboratories capable of culture and susceptibility testing, leaving treatment to empirical and often inappropriate antibiotic use. This work, conducted under the EquityAMR initiative in India, examines the AMR diagnostic access gap for marginalised communities and the role point-of-care technologies could play in closing it.

Approach

The study combined two complementary strands of empirical work across two contrasting Indian states. A laboratory capacity assessment was carried out across 14 health institutions, appraising testing capacity, quality control, equipment, and data management. Alongside this, a spatial analysis characterised the geographic distribution of diagnostic services to map inequities in access. Arun Mitra contributed the spatial analysis and data-science component of the work.

What we found

• Spatial analysis revealed pronounced urban-rural and hilly-plains disparities in the availability of diagnostic services, leaving remote and marginalised populations underserved.
• Laboratory assessments across the 14 institutions exposed consistent gaps in testing capacity, quality control, equipment, and data management.
• Point-of-care testing (POCT) emerged as a key opportunity to extend AMR diagnostics closer to underserved populations and bridge these structural gaps.

Outputs & impact

The findings were published in the Journal of Global Antimicrobial Resistance (September 2025; available online 9 July 2025; DOI 10.1016/j.jgar.2025.06.023; PubMed 40645328). The paper informs policy on AMR stewardship and equitable diagnostics, highlighting how decentralised, point-of-care approaches can strengthen surveillance and rational antibiotic use for marginalised communities.