In understanding the conditions for human health and wellbeing, microbial relationships emerge as both benefitting and impairing health and wellbeing, while global burdens of antimicrobial resistance (AMR) are primarily borne by the global south. Found everywhere in our lives microbes are especially important in our health care systems and the food supply chain; from farm to table (Ma et al; 2021). While AMR has long been identified as a health issue, it has only recently acquired global political momentum. Following the highlighting of AMR by the UN (2015) and WHO (2015) as an emerging sustainable health challenge connecting human, animal and environmental health (One Health). Furthermore, health and AMR are interconnected with ecological, economic and social sustainability challenges (Ward, Kristiansen, & Sørensen, 2019; Veenker & Paans, 2016), including a need for research on AMR-education (Mölstad et al., 2017; Pavydė et al., 2015; Wernli et al.,2017). Food security represents such a nexus, being an enduring sustainability challenge in Southern Africa. Food availability, accessibility and affordability disproportionately affected the health of communities in the global south, emphasising the importance of health education that engages One Health as a focus for social justice and health equity (Pithara 2019: Ruger, 2010).

This paper answers the special call on envisioning the role of health and wellbeing education in advancing social justice and health equity, by (re)envisioning antimicrobial resistance[1] through two co-creation research workshops. As antimicrobial resistance, impacts and links all three spheres of One Health (human, animal and environmental health) exploring it becomes crucial as part of health education for Sustainable Health(y) Futures. Considering all three spheres of One Health, the reported workshops crucially resulted in the generation of bio-social innovations for health education. This took the form of novel health practices that included the (re)envisioning of how to address resistance in the health-care system, food production and consumption as well as built and natural environments.

Furthermore, the paper responds to the overarching theme of ECER 2023 by reporting on a co-creation research workshops on how diversity in ways of knowing health and well-being intersects with diverse health-related values. The paper explores how a diversity of value-knowledges(s) emerge and transact as part of engagements between lecturers/researchers and students in a Zimbabwean university setting. As such, the focus is on ways of doing knowledge together, developing joint epistemological practices and generating shared ways of coming to know health as part of (re)envisioning resistance. (Re)envisioning thus becomes an emerging process of working together for sustainable health(y) futures, where the future is not set but the subject of engagement from a diversity of value-knowledges. Through the results of the workshops, the paper surfaces embedded understandings of how to develop practices and conduct health education that engages with social justice and health equity through developing contextually relevancy to a society like Zimbabwe, where the health care system is under severe stress. These results can find purchase outside the Global South as healthcare systems around the world are struggling to respond to increased demand (Papanicolas 2019).

The paper aims to explore knowledge co-creation regarding the intersections of health, food and antimicrobial resistance (AMR) as a basis for health education practices that integrate human, animal and environmental health as biosocial innovations.

Three research questions are formulated:

• How do participants articulate the intersections of health, food and antimicrobial resistance (AMR)?
• How do the intersections, as articulated by workshop participants, create opportunities for developing health education practices that integrate human, animal and environmental health?
• What forms of biosocial innovation do the health education practices engender for (re)envisioning resistance for sustainable health(y) futures? 

[1] The emergence and spread of resistance among microbes to medicines,

The paper draws on two co-creation research workshops conducted in collaboration with researchers at the Department of Women´s and Children´s Health, Faculty of Medicine, Uppsala University; Department of Science Technology and Design Education, Faculty of Education, Midlands State University; Swedish School of Sport and Health Sciences; The Midlands University Research and Innovation Center; Department of Nutrition, Dietetics and Food Sciences, University of Zimbabwe and UNESCO, Harare Office. Through this collaboration, the research workshop was able to connect the articulation arena of health policy and the implementation arena of health practice through the case of health, food sustainability and AMR, linking local to global sustainability challenges. Participants for the two workshops will involve 20 health education practitioners (lecturers and researchers) and 40 students from Midlands State University and the University of Zimbabwe (Cornwall & Jewkes, 1995; Spinuzzi, 2005). The selection of participants is based on a holistic understanding, encompassing participants from a range of departments and academic disciplines all sharing an interest in the intersections of health, food, food security, sustainability and AMR. The workshops operationalise participant research workshop methods (Bergold & Thomas, 2012; Spinuzzi, 2005; Unger, 2012) centring on participants´ experiential encounters from being part of physical, social and institutional environments. To this end, the workshop explores the co-creation of knowledge to (re)envision resistance for sustainable health(y) futures, thus addressing the challenges of implementing global and national policies on health, food, sustainability and AMR. Consequently, the workshops sit at the intersection of health, food and AMR as wicked sustainability challenges, exploring how these challenges are articulated in the local situations and contextual practices of Zimbabwean rural and urban health education. Through the co-creation of knowledge, biosocial innovations are generated that integrate all spheres of One Health in response to the needs of society and communities where food, health, sustainability and antimicrobial resistance (AMR) intersect. With the workshops as joint processes of knowledge construction, collaborative learning becomes key to develop health information, communication and education that integrates the health of humans, animals and environments (Bell et al. 2004; Bergold and Thomas 2012). As such, research method has the dual-purposes: (1) to enable participants to develop knowledge and capacity related to the intersections between health, food, lifestyle choices and AMR (2) to enable researchers to generate empirical data about intersections between health, food, lifestyle choices and AMR (Darsø & Høyrup, 2012; Darsø, 2001; Rossi, & Sein, 2003; Ørngreen & Levinsen, 2017).

The paper illustrates how co-creation goes beyond top-down implementation of SDGs to encompass contextual considerations. AMR, as a wicked case for the co-creation workshop, enabled envisioning Sustainable Healthy Futures where the resistance is not isolated from the efforts of food security, food safety and salutogenic health, especially in the Global South (Founou et al. 2021; Mensah 2014). Antimicrobials become crucial in promoting meat production, bringing the tension of access-excess regarding food and antimicrobials to the fore (Jaffee et al. 2019). Retroviral drugs developed and distributed for HIV/AIDS treatment are repurposed as agricultural growth promoters (Ndoboli et al. 2021). Efforts to provide access to food drive excess antimicrobial use, with the risk of limiting access to effective human retroviral treatment. Contributions are made regarding ways of doing knowledge together, developing joint epistemological practices and generating shared ways of coming to know health as (re)envisioning resistance. Insights are offered regarding how health educational practitioners and students, based on their practices and experiences, articulate the relationships between health, food, dietary choices, lifestyle, sustainability and AMR. Furthermore, the paper outlines how knowledge co-created through research workshops can form the basis for health practices as biosocial innovations that holistically engage with human, animal and environmental health. As such, insights are offered regarding the conditions for knowledge co-creation and biosocial innovation that move beyond established approaches to health, food and antimicrobial resistance (AMR) for (re)envisioning sustainable health(y)futures. Such (re)envisioning encompasses embracing the epistemological and experiential diversity of sometimes complementary and sometimes contradictory value-knowledges as part of shared explorations of “what to do?” in contextually situated health education. From these results, the paper also encompasses method development in bridging the implementation gap between knowing and doing as part of how research workshops can be used for participants to explore value-knowledges in response to health-related sustainability challenges.

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