“We need to trust science, not condemn it, in order to survive”

Dr Tina Joshi's commentary follows her recent visit to the UN General Assembly meeting on antimicrobial resistance
Tina Joshi
For years we’ve known that drug-resistant infections – also known as antimicrobial resistance (AMR) – are a big threat to human health. By 2050, as many people could die from them as cancer; with the highest rates among over-70s and young children (read article).

What is (or isn’t) being done

To help tackle the issue of AMR, there have been national task forces, international movements and countless research papers from across disciplines. I’ve also recently returned from the United Nations General Assembly (UNGA) for the High-Level Meeting (HLM) on AMR, where 193 world leaders committed to taking action and reducing deaths, with each one asserting that they’re taking this issue seriously.
So why are drug-resistant infections a growing problem?
The more antimicrobials we use, the more the microorganisms will find a way to survive, so we need to reduce antimicrobial consumption across the environment, humans, agriculture and animals. In addition, we need understanding and action from everyone. AMR needs all of us, across countries and all walks of life, to do our bit – and it won’t happen if we don’t listen to science.
Infection prevention and control is the cornerstone of preventing transmission—the best infection is no infection at all. Handwashing is vital, and we must work together to ensure that workers from all disciplines comply with infection control and prevention processes, including effective handwashing and disinfection. Handwashing is also one of the easiest things we can all do to reduce transmission of microbes.
Petri dish with mould and bacteria
Self-disseminating vaccines
Vaccinations and diagnostics all help to prevent unnecessary drug use too by helping antimicrobial stewardship, but we also need global measures to be put in place to improve water and sanitation and hygiene (WASH) in low to middle income countries, and to increase surveillance of antimicrobial resistance.
This will give us the necessary data to understand the scale of the problem and how many people across the globe are affected by drug resistant infections. This data and evidence will help galvanise a response from the countries that signed the UN Political declaration on AMR.

The problem today

But there’s a growing discourse worldwide that scientific facts like the above aren’t ‘truth’. Influential figures might think science is scary, controlling, or a way of trying to make others feel inferior, and using wide-reaching public platforms to share their messages mean more people mistrust it too.
What’s more, consumer behaviour is influenced by algorithms – ‘we saw you liked y so we’re sending you z’. If someone accesses anti-science content once, they’ll likely start seeing more of it. It’s like bouncing around in an echo chamber and there’s no way of accessing what’s real.
What we do know is that science is the closest thing we have to truth. Washing hands will prevent infection spread. Most medieval diseases are gone because of vaccines. Not overusing antibiotics will help to limit AMR.
A black woman's hands are pictured as she holds her phone. Her face isn't in the photo, which is zoomed in to her hands as she appears to type on the phone.
A huge part of tackling AMR is encouraging patient, public and clinician awareness of the fact that microbes can evolve to become resistant to antimicrobial drugs. The message needs to hit home that we are neither developing enough antimicrobial drugs or diagnostics, nor are we funding drug development to reach our patients.
We can do more by spreading the message, increasing education and becoming AMR advocates.

Helping to slow it down

AMR is happening now, but we can help to slow it down. Microbiology is at the core of AMR, and the Microbiology Society’s ‘Knock out AMR’ campaign puts microbiologists at the forefront of developing innovative solutions to the problem. I attended the UNGA meeting in New York as a member of the Society, and it became clear there’s more we need to do to communicate the importance of AMR.
Microbes will continue to evolve, and microbiologists have an extremely important part to play in solving the AMR puzzle through scientific research, clinical research and understanding pathogen behaviour.
We need to trust science, not condemn it, in order to survive. We all need to ensure we’re listening to the right people and pulling in the right direction, together.
Read Dr Joshi’s latest papers:
  • Knocking Out Antimicrobial Resistance Editorial: Reflections on the United Nations General Assembly High Level Meeting on Antimicrobial Resistance (doi: 10.1099/jmm.0.001937)
  • Unless we confront antimicrobial resistance now, we risk the consequences of a post-antibiotic society (doi: 10.1136/bmj.q2104)

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