Philippe Cullet (SOAS) & Oliver Cumming & Jacqueline Knee (LSHTM)

Water, Sanitation and Hygiene (WASH) has been one of the primary developmental issues for decades. Yet, the 2023 UN Secretary General report ‘Progress towards the Sustainable Development Goals’ paints a sobering picture of the progress towards ensuring access to water, sanitation and hygiene for all by 2030 (Goal 6). WASH is indeed at a turning point, as in the case of India where a major push towards building toilets and achieving universal access to basic sanitation by 2019 is now questioned in UN reports despite further improvements towards ensuring better septage and sewage management.  

One of the many dimensions of the limited progress with WASH is that new challenges keep emerging. One of them is anti-microbial resistance (AMR), which brings together WASH and health concerns. One of the important vectors of AMR is wastewater, which in many countries often finds its way directly into freshwater ecosystems. The burden of AMR is unequally distributed. It affects mostly countries with low human development and within countries, people at the bottom of the socio-economic scale. 

Effectively addressing the challenge of AMR requires a multi-disciplinary engagement. This project will use the lens of environmental justice to better understand how epidemiological studies can contribute to giving new bases to the law and policy response in the fields of water, sanitation and health. One of the specific points of entry will be inequality, which is now part of the framing of sustainable development, through Sustainable Development Goal (SDG) #10. SDG 10 offers a good starting point for doctoral enquiry as it covers both inequality between people and between countries, both of which need to be addressed separately and concurrently in the context of AMR. 

At the individual and community level, inequality is a threat to the realisation of the rights to health, sanitation and water. This project will build on epidemiological studies and AMR studies previously conducted at LSHTM in Mozambique and India. The Environmental Health Group at LSHTM has been working with the National Institute of Health of Mozambique for a decade in order to better understand health outcomes associated with exposure to poor WASH conditions. It will compare the regulatory response given in both countries, with lessons for both user and producer countries. One of the key links between the different concerns emerging here is the right to a clean environment, which provides an entry point into framing the environmental justice aspects of AMR. Both countries have recognised the right to a clean environment for a number of years but differ in many respects. In India the rights to environment, water and sanitation have been recognised since the 1990s but only through judicial intervention while Mozambique recognises only the right to environment but does in its 2004 Constitution. Both countries also have national action plans for antimicrobial resistance. Yet, despite these formal similarities, the situation on the ground is vastly different for reasons that include the much more significant contribution of India in terms of pharmaceuticals manufacturing, different socio-economic conditions and different antibiotic use, either for human health or in agriculture.  

Inequality concerning WASH and AMR is also a concern at the international level. This includes the global public health consequences of AMR in specific countries. It also includes questions around the contribution of drug manufacturing in the global South to AMR for drugs used in the global North. Questions of equity arise, as reflected in the discourse around differential treatment in the international law of sustainable development. In a context where the very idea of preferences for the global South is being questioned, this project will offer a targeted set of conceptual arguments confirming the absolute need for differentiation in a highly unequal world.  

This project will work from localised data on access to water and sanitation, and AMR and work towards providing a novel framing of environmental justice that can offer new bases for framing policy and law that is both more equitable and more environmental friendly. The project will use the rights to water, sanitation, health and environment as framing devices to link WASH and AMR at the level of individuals, communities and countries. The doctoral dissertation will have the potential to develop significant policy impact in the post-2030 period where a rethinking of the tenets of sustainable development will be required in view of the increasingly obvious limitations of the SDG framework in terms of both inequality and environmental sustainability.

Please note that this award covers up to Home/UK Fees only. International students are welcome to apply and contact us at scholarships@soas.ac.uk for further advice. 

Closing date for applications is: 12pm on 1 May 2024

Further details about the project may be obtained from: 

pcullet@soas.ac.uk – https://www.soas.ac.uk/about/philippe-cullet  

Further information about PhDs at SOAS is available from: 

Applicants interested in this award will need to ensure they submit an application for a PhD with the relevant project proposal as mentioned above.   

Further information about PhDs at SOAS university of London is available from: dsadmissions@soas.ac.uk  

There is a two-step procedure for applying.  

• Step one, apply for your PhD Programme and be sure to mention that you are applying for the Bloomsbury PhD Studentship 

Guidance for applying to a Research Programme and information on makes a complete application can be found here for How to Apply.  

• Step 2, apply for the scholarship by 12pm (UK local time) 1st May 2024. You can access the application by clicking the following link: Online Scholarship Application Form.  

How to Apply

Key References

Philippe Cullet & Lovleen Bhullar, ‘The Regulation of Planetary Health Challenges: A Co-Benefits Approach for AMR and WASH’, 52/3 Environmental Policy and Law  

(2022), p. 289-99. 

Just Transitions for AMR Working Group, ‘A Just Transition for Antimicrobial Resistance: Planning for an Equitable and Sustainable Future with Antimicrobial Resistance’, The Lancet (8 September 2023) https://doi.org/10.1016/S0140-6736(23)01687-2 

Usha Natarajan, ‘Environmental Justice in the Global South’, in Sumudu A. Atapattu, Carmen G. Gonzalez and Sara L. Seck (eds), The Cambridge Handbook of Environmental Justice and Sustainable Development (Cambridge: Cambridge University Press 2021). 

Erica R Fuhrmeister, Abigail P Harvey, Maya L Nadimpalli, Karin Gallandat, Argaw Ambelu, Benjamin F Arnold, Joe Brown, Oliver Cumming, Ashlee M Earl, Gagandeep Kang, Samuel Kariuki, Karen Levy, Chris E Pinto Jimenez 12, Jenna M Swarthout, Gabriel Trueba, Pablo Tsukayama, Colin J Worby, Amy J Pickering, ‘Evaluating the Relationship Between Community Water and Sanitation Access and the Global Burden of Antibiotic Resistance: An Ecological Study’, 4/8 Lancet Microbe e591-600 (2023) <https://doi.org/10.1016/S2666-5247(23)00137-4&gt;.