It is World AMR Awareness Week 2024 this week. Much has been said about AMR over the past 10 years since Jim O’Neil chaired the seminal Review on Antimicrobial Resistance between 2014 and 2017. The O’Neill review raised the profile of AMR as a global disruptor. Importantly, this review highlighted concrete actions that could be taken by everybody in society to make sure that the effects of resistance to antibiotics are minimised and controlled as far as possible.
Exciting and groundbreaking advances have been made in how AMR can be managed, particularly around the science and technical aspects of new antimicrobial treatments. But the everyday reality of AMR has not improved for large numbers of people the world over. The art of bringing about behaviour change that sticks – at all levels of society – has not yet been used with wide success. Herein lies an immediate challenge to be solved if we are to manage AMR effectively.
The real-life face of AMR
We had the privilege of attending and presenting some of our work at the 33rd International Congress of Antimicrobial Chemotherapy (ICC 2024) in Istanbul recently. The conference was an invaluable opportunity to hear from science and healthcare professionals from the fields of infectious diseases and clinical microbiology who work face-to-face with individuals and communities who are struggling to overcome drug-resistant infections.
This conference was a stark reminder of the face of AMR for vast numbers of people worldwide: hospitals without any running water; clinics without doctors or medication, leading to patients with infectious diseases waiting all day in queues only to be sent home at the end of the day without having seen a doctor; malnutrition as a result of being in a conflict zone; and closer to home, being refused a course of antibiotics when one is warranted, leading to worsening of symptoms and spread of disease more broadly in the community.
The biggest takeaway from this conference for us was the elephant in the AMR room – that managing a complex, multifaceted global challenge has both technical and human factors and that both of these need to be managed. Managing this conundrum is both science and art. The scientific and technical aspects have received the bulk of attention over the past decade and we have a number of old and new ways of managing microbes in our environment. Significantly less attention has been paid to how best to bring about mindset- and behaviour change that sticks because it results in win-win situations.
Bringing about change that sticks
Recognising each other’s humanity is a good starting point. In the absence of a safe and stable environment, adequate and safe nutrition, water and warmth, nobody is in a position to think or do things in ways other than in survival mode, even if they want to. This is not rocket science. It is basic human psychology.
A first step in bringing about change that sticks is therefore to create conditions that are safe, secure and in which people can start to thrive rather than just survive. This is where the art of managing AMR comes in: establishing trust and credibility, building relationships, working in partnership with individuals and their communities to meet shared goals of improved living conditions. It goes without saying that a tailored, creative, case-by-case process of working out how to put fundamental infrastructure and daily necessities in place is needed so that individuals and communities can implement what science has shown works to minimise AMR.
Taking the road less travelled
As humans, we are at an important juncture in our global AMR journey. We have a chance now to take the road that is as yet less travelled by opting to walk in partnership with individuals, communities and regions to jointly bolster their ability to withstand AMR. As an art, this involves a bit of risk. Or we can carry on as normal and hope for the best. At Biophys, we opt for the taking the road less travelled.
