AMR.Solutions

The language of AMR: The power of metaphor

Dear All,

Acronyms and jargon fill our daily scientific lives but can be impenetrable to newcomers. A great example is the title of the 20 Feb 2020 newsletter: “Language Matters: CRE vs. CPE; SDD vs. I; and MDR, XDR, PDR, UDR vs. DTR.” Total gobbledygook unless you’ve worked in the area for a while!

On the other hand, we’ve gotten a lot of mileage out of the idea that “Antibiotics are the Fire Extinguishers of Medicine,” a simple metaphor that takes one naturally into STEDI attributes of antibiotics as well as the related STRIDES values of diagnostics (newsletters from 14 Apr 2020 and 18 June 2025, respectively … and with apologies for the acronyms).

But, does that metaphor translate universally? And, it’s a very specific and focused message about what an antibiotic does. However, it neither explains the idea of AMR nor gives guidance on the best use of antibiotics.

So, now let’s go to the paper that provoked this newsletter. You may recall the 13 June 2024 newsletter (“The (confusing!) language of AMR: ChatGPT tries to help!”) in which we learned of the work of the oustanding work of Eva Krockow (Associate Professor of Psychology, University of Leicester). When I heard her speak in 2024, she shared her initial work on the language of AMR. Please do go (re)read that newsletter for discussions both of why AMR is a terrible acronym (but we’re stuck with it) and why translating “antibiotic stewardship” may require > 10 words in some languages!

Since then, she has gone on to do a deep study of the idea of finding metaphors that would be good tools for communicating the concepts related to AMR. Here are the papers you need to follow the next parts of the discussion:

  • Krockow EM, Jones M, Mkumbuzi S, Mendelson M, Tarrant C, Froud R, et al. Developing public health risk messages about antibiotic resistance using metaphors: an international co-design and e-Delphi consensus study. Scientific Reports. 2026;16(1):9788. DOI:10.1038/s41598-026-40577-5.
  • Krockow EM, Jones M, Tarrant C, Mendelson M, & Flusberg SJ. Risk communication about antimicrobial resistance: a content analysis of metaphor use in global public discourse. Journal of Risk Research, 2024;27(12): 1605-1622. DOI: 10.1080/13669877.2025.2485044
  • Thibodeau PH and Boroditsky L. Metaphors We Think With: The Role of Metaphor in Reasoning. PLoS ONE 6(2): e16782. DOI:10.1371/journal.pone.0016782.


The premise of the project was that metaphors are powerful ways to quickly and clearly explain new concepts. Linking a new idea to a known concept can be very vivid: vaccines strengthen your body’s defenses against infection in the same way working out strengthens your muscles. 

To leverage this insight, Krockow et al. conducted an international project in which they first generated 190 possible metaphors in workshops conducted in South Africa and the UK. These metaphors were then tested in a 3-round Delphi process with a diverse 37-person panel of AMR communication experts from 27 countries. The project sought metaphors for 9 different types of messages:

  1. The microbial world is diverse
  2. Bacteria can develop resistance, meaning that antibiotics lose effectiveness
  3. Antibiotics work only against bacterial infections
  4. It’s the bacteria that develop resistance
  5. Antibiotics should never be shared with other patients
  6. You should complete your course of antibiotics as prescribed
  7. Patients need to follow their doctor’s advice
  8. Antibiotics aren’t always required for minor infections
  9. Infection prevention helps to avoid antibiotic use

The process selected 38 metaphors for global use. You’ll want to peruse the entire table in the publication, but here’s an example from each category:

  1. The world of germs is a garden full of diverse insects – some helpful, a few dangerous.
  2. Weeds resist weed killer—bacteria resist antibiotics
  3. Using antibiotics for viruses is using the wrong key to unlock a door
  4. Just like a bad apple spoils the whole bushel, a few resistant bacteria can affect the wider population—changing the balance and spreading resistance to others.
  5. Sharing leftover antibiotics is using your house key for someone else’s door.
  6. An unfinished course of antibiotics is a fire half-out. Sparks remain, ready to flare up again even stronger.
  7. Ignoring medical advice is baking without a recipe.
  8. Using antibiotics for minor infections is using a sledgehammer to kill a fly.
  9. We can save our antibiotics by avoiding infection just like we avoid emergency services by maintaining our car.

Consistently favored themes included nature/gardening (diverse insects, weeds), tools/engineering (lock-and-key, car maintenance, petrol vs. diesel), and fire-fighting. The ideas of war, soldiers, and fighting were also often considered but were not favored due to the way these themes can reduce to binary good/evil concepts that assign blame. 

It was also interesting that some ideas were easier than others to express in metaphor. The concept that antibiotics aren’t needed for viral infections generated 7 metaphors whereas the idea that it’s the bacteria that become resistant (rather than the host) only generated 2 metaphors — and neither is (to my eye, anyway) very punchy.

What a fascinating project! As the paper concludes, “Drawing from domains like nature, gardening, tools, engineering, and firefighting these metaphors avoid alarmist war imagery and instead use relatable, everyday symbolism that resonates across cultures and regions.”

And there’s still more to be done: the work could be extended to other languages, other domains (animal health), and related disciplines (diagnostics, in particular).

So, do take a look at the paper and its ideas. I’m also told a metaphor communication toolkit is coming … and I’ll be sure to share that when it is released. Until then, many thanks to Krockow et al. for their excellent work!

All best wishes, –jr

John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Operating Partner, Advent Life Sciences. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future: https://amr.solutions/blog/. All opinions are my own.

John’s Top Recurring Meetings
Virtual meetings are easy to attend, but regular attendance at annual in-person events is the key to building your network and gaining deeper insight. My personal favorites for such in-person meetings are below. Of particular value for developers, the small meeting format of BEAM’s AMR Conference (March) and GAMRIC (September-October; formerly, the ESCMID-ASM conference series) creates excellent global networking. IDWeek (October) and ECCMID (April) are much larger meetings but also provide opportunities for networking with a substantial, focused audience via their Pipeline sessions. Hope to see you there!

  • 17-21 April 2026 (Munich, Germany): ESCMID Global 2026, the annual meeting of the European Society for Clinical Microbiology and Infectious Diseases. You can go here to register and view the preliminary program; the abstract submission window for 2026 will run 15 October to 26 Nov 2025. For those who would like a substantial opportunity to present a product to a large audience (see also adjacent note about IDWeek), I know that the meeting schedule will again include Pipeline Monday.
  • [PRELIMINARY PROGRAM; TRAVEL GRANTS; ABSTRACT DEADLINE is Fri 10 Apr at noon CET] 22-24 Sep 2026 (Lisbon, Portugal): The 2nd GAMRIC, the Global AMR Innovators Conference (London, UK). Formerly the ESCMID-ASM (or ASM-ESCMID depending on location) Joint Conference on Drug Development for AMR, 2026 will be the 11th year for this series that is now under the joint sponsorship of CARB-X, ESCMID, BEAM Alliance, GARDP, LifeArc, Boston University, and AMR.Solutions. The ongoing series employs the successful format of prior meetings with a single-track meeting and substantial networking time. The 2025 meeting was a sell-out success! A written summary of the 2025 meeting is here and the videos from the sessions are now available here. Registration for the 2026 meeting is now open and you can view the preliminary program here. Abstract submissions are open through Fri 10 Apr at noon CET; note as well that travel grants are available for attendees with accepted abstracts. A late-breaker window be announced for July.
  • 21-24 Oct 2026 (Washington, DC, USA): IDWeek 2026, the annual meeting of the Infectious Diseases Society of America. Details are not yet available but I would expect the program to continue to provide a substantial opportunity to present a product to a large audience (see also adjacent note about ESCMID) as well as opportunities to present at an IDWeek Pipeline Session.
  • 23-24 Mar 2027 (Basel, Switzerland): The 10th AMR Conference (3-4 Mar 2026) is now over and offered a rich program that included a 10-year retrospective (we’ve done a lot!), regulatory updates, discussions of how to pursue development in China, and much more … in addition to being a superb opportunity for networking! I am told the session videos will soon be available on the conference website. Mark your calendars for next year’s 11th AMR Conference!

  Upcoming meetings of interest to the AMR community:

  • 17-21 April 2026 (Munich, Germany): ESCMID Global 2026, the annual meeting of the European Society for Clinical Microbiology and Infectious Diseases. See Recurring Meetings list, above.
  • [NEW] 28 Apr 2026 (9:30-11:00 CET, virtual): REVIVE (GARDP)-sponsored webinar: “Natural product-inspired antibiotics: Successes and future prospects.” Go here for details and to register.
  • 4-8 June 2026 (Washington, DC): ASM Microbe, the annual meeting of the American Society for Microbiology. The meeting format is evolving and next year will combine 3 meetings (ASM Health, ASM Applied and Environmental Microbiology, and ASM Mechanism Discovery) into one event. Go here for details.
  • 11-12 Jun 2026 (Washington, DC): The Second Annual Unite for Sepsis Symposium, presented by the Sepsis Alliance. The event seeks to accelerate progress in sepsis research and care. Go here for details and to register.
  • 22-24 Sep 2026 GAMRIC (Lisbon, Portugal), the Global AMR Innovators Conference (London, UK; formerly the ESCMID-ASM Joint Conference on Drug Development for AMR). See list of Top Recurring meetings, above..
  • 10-18 Oct 2026 (Annecy, France, residential in-person program): ICARe (Interdisciplinary Course on Antibiotics and Resistance) … and 2026 will be the 10th year for this program. Patrice Courvalin orchestrates content with the support of an all-star scientific committee and faculty. The resulting soup-to-nuts training covers all aspects of antimicrobials, is very intense, and routinely gets rave reviews! Registration for 2026 will be during March 16–July 3, 2026. You can go here for more details and you should put a reminder in your calendar register on / after 16 March.
  • 21-24 Oct 2026 (Washington, DC, USA): IDWeek 2026. See list of Top Recurring meetings, above.
  • 10-13 November 2026 (Madrid, Spain): The International Society for Infectious Diseases (ISID) has announced its 21st International Congress on Infectious Diseases (ICID). Register and view the preliminary program here (Early bird closes 30 July 2026); abstract deadline is 28 April 2026.
  • 23-24 Mar 2027 (Basel, Switzerland): The 11th AMR Conference sponsored by the BEAM Alliance. See list of Top Recurring meetings, above.
  • ??? Mar 2028 (yes, that’s 2028, with location TBD): The 2028 Gordon Research Conference (GRC, https://www.grc.org/) entitled “Antibacterials of Tomorrow to Combat the Global Threat of Antimicrobial Resistance” and its related Gordon Research Seminar (GRS) for young doctoral and post-doctoral researchers will be sometime in March 2028. The organizers hope to coordinate dates and location with the 2028 BEAM-AMR meeting. Details to follow — mark your calendar!

Self-paced courses, online training materials, and other reference materials:

Current funding opportunities

  • CARB-X have announced a funding round that will be open 8-22 April 2026 (there will also be a round during 4Q 2026). There are 4 funding themes as below. Informational webinars have been announced for 9 and 10 April 2026.
    • Direct-acting therapeutics for infections caused by Gram-negative bacteria
    • Novel Chemistry for AMR Challenge – target-based therapeutics.
    • Non-vaccine approaches to prevent neonatal sepsis
    • Diagnostics for neonatal sepsis
  • The Horizon Europe Work Programme 2026-2027 includes at least 3 calls of interest within its Cluster 1 — see the list below.  The application window starts 10 Feb 2026 and closes on 16 Apr 2026. See also the 12 Dec 2025 newsletter about the call. Note as well that there calls for agents to prevent and/or treat viral infections.
    • HORIZON-HLTH-2027-01-DISEASE-08: Development of innovative antimicrobials against pathogens resistant to antimicrobials
    • HORIZON-HLTH-2027-02-IND-02: Portable point-of-care diagnostics
    • HORIZON-HLTH-2026-01-DISEASE-03:Advancing research on the prevention, diagnosis, and management of post-infection long-term conditions. 
  • ENABLE-2 has continuously open calls for both its Hit-to-Lead program as well as its Hit Identification/Validation incubator. Applicants must be academics and non-profits in Europe due to restrictions from the funders. Applications are evaluated in cycles … see the website for details on current timing for reviews. 
  • BARDA’s long-running BAA (Broad Agency Announcement) for medical countermeasures (MCMs) for chemical, biological, radiological, and nuclear (CBRN) threats, pandemic influenza, and emerging infectious diseases is now BAA-23-100-SOL-00004 and offers support for both antibacterial and antifungal agents (as well as antivirals, antitoxins, diagnostics, and more). Note especially these Areas of Interest: Area 3.1 (MDR Bacteria and Biothreat Pathogens), Area 3.2 (MDR Fungal Infections), and Area 7.2 (Antibiotic Resistance Diagnostics for Priority Bacterial Pathogens). Although prior BAAs used a rolling cycle of 4 deadlines/year, the updated BAA released 26 Sep 2023 has a 5-year application period that ends 25 Sep 2028 and is open to applicants regardless of location: BARDA seeks the best science from anywhere in the world! See also this newsletter for further comments on the BAA and its areas of interest.
  • HERA Invest was launched August 2023 with €100 million to support innovative EU-based SMEs in the early and late phases of clinical trials. Part of the InvestEU program supporting sustainable investment, innovation, and job creation in Europe, HERA Invest is open for application to companies developing medical countermeasures that address one of the following cross-border health threats: (i) Pathogens with pandemic or epidemic potential, (ii) Chemical, biological, radiological and nuclear (CBRN) threats originating from accidental or deliberate release, and (iii) Antimicrobial resistance (AMR). Non-dilutive venture loans covering up to 50% of investment costs are available. A closing date is not posted insofar as I can see — applications are accepted on a rolling basis; go here for more details.
  • The AMR Action Fund is open on an ongoing basis to proposals for funding of Phase 2 / Phase 3 antibacterial therapeutics. Per its charter, the fund prioritizes investment in treatments that address a pathogen prioritized by the WHO, the CDC and/or other public health entities that: (i) are novel (e.g., absence of known cross-resistance, novel targets, new chemical classes, or new mechanisms of action); and/or (ii) have significant differentiated clinical utility (e.g., differentiated innovation that provides clinical value versus standard of care to prescribers and patients, such as safety/tolerability, oral formulation, different spectrum of activity); and (iii) reduce patient mortality. It is also expected that such agents would have the potential to strongly address the likely requirements for delinked Pull incentives such as the UK (NHS England) subscription pilot and the PASTEUR Act in the US. Submit queries to contact@amractionfund.com.
  • INCATE (Incubator for Antibacterial Therapies in Europe) is an early-stage funding vehicle supporting innovation vs. drug-resistant bacterial infections. The fund provides advice, community, and non-dilutive funding (€10k in Stage I and up to €250k in Stage II) to support early-stage ventures in creating the evidence and building the team needed to get next-level funding. Details and contacts on their website (https://www.incate.net/).
  • These things aren’t sources of funds but would help you develop funding applications
    • The Global AMR R&D Hub’s dynamic dashboard (link) summarizes the global clinical development pipeline, incentives for AMR R&D, and investors/investments in AMR R&D. See also the 7 Feb 2026 newsletter (“The global funding pipeline, 2017-2023: A review”) about an excellent deep dive by the Hub team into patterns of funding over time.
    • Antimicrobial Resistance Research and Innovation in Australia is an actively updated summary that covers Australia’s AMR research and patent landscape. It is provided via collaboration between The Lens (an ambitious project seeking to discover, analyse, and map global innovation knowledge) and CSIRO (Commonwealth Scientific and Industrial Research Organisation, an Australian Government agency responsible for scientific research). Lots to explore here!
    • Diagnostic developers would find valuable guidance in this 6-part series on in vitro diagnostic (IVD) development. Sponsored by CARB-X, C-CAMP, and FIND, it pulls together real-life insights into a succinct set of tutorials.
  • In addition to the lists provided by the Global AMR R&D Hub, you might also be interested in my most current lists of R&D incentives (link) and priority pathogens (link).
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