Equity, data and the surveillance gap in antimicrobial resistance: A call for inclusive action

Antimicrobial resistance (AMR) is a growing global health concern that spans human, animal, and environmental health, making it a quintessential One Health issue. Global AMR surveillance systems such as the World Health Organisation’s (WHO) Global Antimicrobial Resistance and Use Surveillance System (GLASS) have created important opportunities for countries to collect and report AMR data systematically across sectors and settings. These systems also include the capacity to capture variables such as sex, age, and infection origin (community-acquired or healthcare-associated). This can facilitate the use of equity indicators and provide a foundation for more inclusive and responsive AMR analysis. This commentary highlights the value of building on these existing systems by expanding the routine collection and analysis of both basic and advanced equity-related variables and indicators using the human health sector as an entry point. Incorporating variables such as location of residence, education level, occupation, socio-economic status, disability, and ethnicity enables an intersectional analysis. This can enhance understanding of who is most affected by AMR and why, and inform effective responses. Recognising that AMR surveillance data often comes from health facilities, we also explore the benefits of complementing it with community-level and community-led approaches to better reflect diverse realities and patterns of AMR across populations and contexts. By integrating equity considerations into AMR data systems, countries and global stakeholders can strengthen the design, implementation, and targeting of interventions. These steps support more responsive health systems and contribute to AMR solutions that are not only scientifically sound but also socially inclusive. Embedding equity in AMR surveillance is a vital step toward achieving the full promise of One Health – ensuring that responses are informed, effective, and reflective of the diverse communities they are meant to serve. One Health impact statement Antimicrobial resistance (AMR) is a quintessential One Health issue, shaped by the interconnected health of humans, animals, and the environment. This commentary highlights how equity-centred human health surveillance can enhance AMR responses by improving our understanding of who is most affected and why. We discuss human health surveillance as an entry point as it aligns with the expertise of the authorship group, who bring reflections from working across the Fleming Fund’s ( 2025 ) global portfolio under Gender and Equity within Antimicrobial Resistance (GEAR up) (GEAR up, 2024 ). GEAR up is a regional grant funded by the Fleming Fund that seeks to catalyse action on equity within AMR through mainstreaming gender and equity within routine AMR systems and structures. Aligned with One Health as a concept, strengthening the routine collection and use of disaggregated data – such as sex, age, and socio-economic status – can improve the design of inclusive, targeted interventions across sectors. The commentary draws on transdisciplinary collaboration involving public health experts, social scientists, implementers, and policy makers from multiple countries. Social science perspectives augment and improve our understanding of AMR beyond purely biomedical terms, improving understanding of how social and cultural nuances influence perceptions towards, and responses to it. By integrating social science perspectives alongside epidemiological and microbiological expertise, this approach detects often-overlooked inequities and promotes context-sensitive action. It also underscores the importance of combining academic and pragmatic knowledge systems to co-produce insights that are directly relevant to communities and decision makers. Ultimately, this work supports more effective and inclusive surveillance systems, contributing to improved health outcomes, stronger accountability, and more equitable global AMR responses.