Lessons and Insights from the 2023 Annual Conference

“[We] estimated that unless action is taken, the burden of deaths from AMR could balloon to 10 million lives each year by 2050” (O’Neill, 2016) 

“There were an estimated 4·95 million […] deaths associated with bacterial AMR in 2019” (The Lancet, 2022)

Imagine a future where antibiotics no longer work. Surgical procedures ranging from routine hip replacements to childbirth, or treatments such as cancer chemotherapy, would become incredibly risky – potentially fatal to attempt. The quotes above are well-known in the antimicrobial resistance (AMR) research sphere. They act as a warning for the future, painting an image of one which is wrought with many great costs – not only the economic burden of AMR, but more importantly the countless lives we would lose.

But what if we could take action to avert this bleak future? This hope is why I chose to start a PhD in the field of AMR.

The recent national AMR Conference continued to fuel this spark for my research. The conference led by the University of Bristol and funded by the Medical Research Foundation in early August, is a highlight of the national multi-disciplinary PhD training programme. There were plenty of eye-opening discussions, ranging from recent advances in AMR research, to the wider responsibility of scientists, the government, and the public to overcome such a multi-faceted global issue. Here are some of the ideas I took with me from the conference.

1) Collaborating in science is key.

• Interdisciplinary research allows expertise from multiple fields to come together, tackling complex modern issues from multiple angles. That’s why it’s so important to have events such as these conferences, which allow exchange of scientific ideas and provide means for collaboration.
• Open-source drug discovery: to maximise open innovation and collaboration in research, this approach suggests that secrecy be abandoned. The idea is that all data and experiments are readily available in a repository, for others to comment on during – not just after – the project. The projects would not be owned by singular lab groups, and suggestions and discussions are encouraged. I think it would be interesting to see how well this framework holds in future.

2) AMR is much bigger than just the microbiological/bacterial research that I’ve been exposed to.

Of course, it’s so important to learn more about how antimicrobials work on microbes to develop new therapeutics – this is the area that I’m researching for my PhD! However, to solve such a global issue in a concerted way, it’s important to recognise that we have to collectively reduce the impact of AMR while fighting it. How?

• By improving antimicrobial stewardship: educating the public about AMR and regulating distribution of antimicrobials to no more than what is appropriate, to reduce rate of resistance acquisition.
• Recognising the One Health policy: human health is intertwined with the fate of animal health and the ecosystem. Indeed, around 60 per cent of human infections are estimated to have come from animals, with these outbreaks being spurred on by human actions (such as urbanisation, climate change, intensive farming). Therefore, it is important to tackle AMR alongside protecting animals and ecosystems.

3) Wider responsibilities of scientists and researchers in public engagement.

Disseminating our scientific research to the public is incredibly important, both to increase transparency of research to the public, who fund it, and to increase trust in the scientific community. This concept was fleshed out in an insightful panel discussion which discussed the complex issue of increasing visibility on AMR.

• Importance of language surrounding AMR: to increase the visibility and tangibility of AMR for the public, we need to reframe and standardise the way we talk about AMR. For example, terms such as ‘antimicrobial resistance’, ‘drug-resistant infections’, ‘superbugs’, ‘antibiotic resistance’ are used interchangeably by practitioners, but it can be difficult for the public to quickly recognise this as one issue.
• Importance of policy-making: in order to deliver actionable changes, it is crucial to engage not only the public but also local and national government. These are the changes which have the potential to impact social behaviour most directly.

4) Optimistically, there has been lots of exciting advances in AMR research!

I’m not sure what I’m allowed to share from other people’s works, but I’ve learned such a wide range of new ideas and recent AMR updates. Here are some (very general) areas of interest:

• the recent advances and rise of fungicide use in agriculture, as well as its regulation;
• new methods of understanding the links between DNA sequences and AMR phenotypes;
• increased understanding of biofilm formation and how to circumvent them;
• developments in water purification/ sewage treatments to reduce leaching of antimicrobials into open rivers; and
• improving quantification and regulation of antimicrobial supply and usage, both in hospitals and in farms.

So what can I, as a researcher, do about AMR? (…aside from doing more research)

An interesting suggestion came up in a panel discussion: for every article/publication you publish, post an accessible summary for non-academics/those with no expertise in your field.

I think this is a brilliant idea! After all, I think the research that we do is much more impactful when it reaches the people for whom we do it. If within your means, use your platform to educate! This is something I’ll try to hold myself more accountable for as well.

What can I, as the public, do about AMR?

1. Only take antibiotics when appropriate and complete the full course!
2. Time to do some reading! If you have a few minutes, start by checking out: https://www.who.int/news-room/fact-sheets/detail/antibiotic-resistance

Now imagine a future where antimicrobial resistance is well-controlled. One where we took responsibility and action at all levels, ranging from the global level all the way down to the individual level. To echo the words from The Review on Antimicrobial Resistance by O’Neill (2016), “AMR has been seen as simply a health issue for far too long. It is also an economic and financial issue. We need all of these groups to come together to tackle it.”

Overall, I have hope that we can eventually reduce the impact of AMR on our livelihoods, but we all have to play our own roles to make this future at all possible.