Ways to talk about AMR / Powerful new insights into messages that do (and do NOT) work

Dear All:

Verbatim comments from interviews with 12,000 people in Germany, India, Japan, Kenya, the UK, the USA and Thailand:

• India: “[Antimicrobial resistance] is quite normal, no big thing, like malaria. It’s on a personal level, if you take antibiotics, your resistance will be on [the] lower side. If you are fit, your body resistance is more.”
• Germany: “Air pollution is something that is more global for everybody and, with antibiotic resistance, there are just a certain number of people that are affected.”
• US: “I think antibiotic resistance is an issue, but I think we have at least ten, twenty years before it becomes, like, a huge enough problem, that affects a lot of people.”
• Kenya: It doesn’t affect everybody.”

Oh no, Mr. Bill! We are all familiar with the difficulty of communicating the complexity of AMR, but these quotes are pretty depressing.

But, perhaps this is not a surprise given the complexity of these ideas and the diversity of messages that have been used. Consider this UK media map in which each node in the network represents one UK news item during a 12-month period, with the nodes grouped by key topic. It’s great to see that there were a lot of stories, but the lay public is confused by the more than 20 different headline topics (some of which are pretty technical):

To address this problem, Wellcome Trust have undertaken an enormous research project with the aim of finding better ways for all of us to talk. You can find the full report here (the map just above is from page 12 of the report), but a brief orientation may help you digest the materials more easily.

The key finding is that there are universal themes that resonate across countries. Five key principles for communicators when talking to the public about antimicrobial resistance were identified:

1. Frame antimicrobial resistance as undermining modern medicine
2. Explain the fundamentals succinctly
3. Emphasize that this is a universal issue; it affects everyone, including you
4. Focus on the here and now
5. Encourage immediate action

Based on these universal themes, the report (jump to page 30 of the full report for this material) suggests this headline narrative will quickly interest listeners in all countries:

• Common infections and injuries that were once easily treatable are becoming more dangerous and killing once again. This is because of drug-resistant infections which are undermining modern medicine.

Follow this quick message, the most effective next step is this 5-part story that step-wise applies the 5 key principles noted above:

• Infections become drug-resistant when the bacteria that cause them adapt and change over time, developing the ability to resist the drugs designed to kill them.
• The result is that many drugs – like antibiotics – are becoming less effective at treating illnesses. Our overuse of antibiotics in both humans and animals is speeding up this process.
• Without working antibiotics, routine surgery like hip replacements, common illnesses like diarrhoea, and minor injuries from accidents, even including cuts, can become life-threatening.
• People are already dying from drug-resistant infections, and as more drugs stop working, more lives will be put in danger. Drug-resistant infections can affect anyone; we are all at risk of infections from drug-resistant bacteria.
• We can solve this problem. By taking action now to develop new drugs, and to make sure the drugs we already have stay effective, we can protect ourselves, our families and our communities.

This is an impressive piece of work … many thanks to Team Wellcome for making it happen. I encourage everybody to read the report and start using these messages consistently.

Finally, I know that Team Wellcome would be pleased to answer questions or to hear ideas for tools that would be useful to you. The team can be reached at DrugResistantInfections@wellcome.ac.uk.

All best wishes, –jr

John H. Rex, MD | Chief Medical Officer, F2G Ltd. | Expert-in-Residence, Wellcome Trust. Follow me on Twitter: @JohnRex_NewAbx. See past newsletters and subscribe for the future: https://13.43.35.2/blog/

Upcoming meetings of interest to the AMR community:

• 4 Nov 2019 (FDA, White Oak): Public hearing on FDA’s proposed rules for “Use of Fecal Microbiota for Transplantation to Treat Clostridioides (Clostridium) difficile.” Go here for the online FR notice and here for the .pdf version.
• 7 Nov 2019 (webinar, 17:00-18:30 CEST): REVIVE webinar entitled “Converting Gram-positive-only compounds into broad-spectrum antibiotics.” Go here to register.
• 12-19 Nov 2019 (cyberspace): CARB-X Funding Round 4 is open for Expressions of Interest (EOIs). Go here for details. This round is limited to new classes and/or new targets in early development phases (hit-to-lead through Phase 1) targeting a specific list of Gram-negative pathogens (see link, but in brief is Carbapenem-resistant Abau, Pae, E’bacteriaceae as well as FQ-R Salmonella, Shigella, and Neisseria.
• 14-15 Nov 2019 (Hamilton, Ontario): “Fueling the Fight Against Antimicrobial Resistance”, a 2-day Gairdner Foundation-sponsored symposium in collaboration with the Michael G. DeGroote Institute for Infectious Disease Research and the David Braley Centre for Antibiotic Discovery at McMaster University. Go here for details.
• 18-19 Nov 2019 (FDA, White Oak Campus): FDA-IDSA-NIAID-Pew-sponsored workshop: “Enhancing the Clinical Trial Enterprise for Antibacterial Drug Development in the United States.” Mark your calendar now, details to follow.
• 19 Nov 2019 (London): BSAC seminar entitled “Into clinical practice: Meeting the challenges of Gram-negative infection management”. A one-day conference on treatments for Gram-negative infections. Go here for details.
• [NEW] 26 Nov 2019 (webinar, 9:30-11:00 CET): REVIVE webinar entitled “Innovation in point-of-care diagnostics for sepsis and bloodstream infections.” Go here to register.
• 28-29 Nov 2019 (Birmingham, UK): BSAC workshop entitled “ARM (Antibiotic Resistance & Mechanisms)”. This meeting is a research forum for UK-based researchers at all levels, including PhD students and technicians. Go here for details.
• [NEW] 5 Dec 2019 (Monthey, Switzerland): The BioArk technology park is holding a one-day workshop on AMR. Entitled “The Ark Life Sciences Series #1”, you can get more details here.
• 16-18 Dec 2019 (Bangkok, Thailand): 3rd International Symposium on Alternatives to Antibiotics in Animal Production. Go here for details: https://www.ars.usda.gov/alternativestoantibiotics/
• 21 Jan 2020 (London): BSAC’s 2nd Antimicrobial Chemotherapy Conference – An ABC for everyone involved in developing new antimicrobials. Go here for details.
• 20 Feb 2020 (London, UK): Westminster Health Forum conference entitled “Antimicrobial resistance – coordinating a global response and progress on the UK strategy.” Go here for details.
• 26-27 Feb 2020 (Washington, DC): US PACCARB public meeting. Go here for details.
• 1-6 Mar 2020 (Il Ciocco, Tuscany, Italy): GRC on Antibacterial Discovery and Development: “Now is the time to re-boot antibiotic R&D before it’s too little, too late.” Go here for details.
• 12-13 Mar 2020 (Basel, I’m told): BEAM-, Novo REPAIR-, CARB-X-, DZIF-, ND4BB-, ENABLE-supported (among a long list!) Conference on Novel Antimicrobials and AMR Diagnostics. Final location is TBD, details will appear here, and you should mark your calendar now. 
• 16-17 Mar 2020 (London): BSAC Spring Conference entitled: “Bridging the gap between science, policy and effective antimicrobial use.” Go here for details. 
• 18-21 Apr 2020 (Paris): Annual ECCMID meeting (#30)
• 25-30 May 2020 (Rotterdam), Annual ESPID meeting (European Society for Pediatric ID, #38)
• 10-13 Apr 2021 (Vienna): Annual ECCMID meeting (#31)
• 1-4 Sep 2020 (Dublin): Annual ASM-ESCMID Conference on Antibiotic Development #5! Mark your calendar now and go here for details.
• 9-10 Sep 2020 (Washington, DC): US PACCARB public meeting. Go here for details.