Antimicrobial Resistance: Is the Glass Half Full or Empty?

Abstract

In public health, a major challenge is finding ways to influence the transition from technical discussions or expressions of concern to the implementation of effective political and social action. Certain phenomena, such as disasters or outbreaks, require no such transitioning. However, many other issues such as HIV/AIDS are not well understood or appreciated initially beyond technical levels until a period of socialization has fostered broader engagement. Other examples are tobacco control and climate change. Antimicrobial resistance (AMR) is another very significant danger that may, or may not, be effectively addressed depending on whether current efforts to broadly socialize the issue go far enough. AMR is a global phenomenon in which a wide range of microorganisms are becoming more resistant genetically to the available medicines used to inhibit or kill them. The implications are profound because the ability to fight infection is a fundamental requirement for both modern health and agricultural practices. While antibiotic resistance, which refers specifically to resistance among bacteria, has been known since the advent of antibiotics, concern over its implications has largely been restricted to health practitioners and scientists until recently. Today, a wider audience is becoming more aware of AMR due, in significant part, to concerted efforts to achieve greater social and political engagement. For example, by raising awareness through entities such as the World Health Assembly, the United Nations General Assembly, the World Economic Forum, and country grouping such as the G7, G20 and G77. In addition, expressions of concern among food consumers and (social) media in some countries have, more generally, fostered action. Nonetheless, it remains uncertain as to whether the issue has been sufficiently socialized to ensure sustained and effective long-term practices by key groups such as the general public, agriculture, food and pharmaceutical related industries, the health sector and governments. Evidence of progress will be reflected in the adoption of certain policies and changed practices, partnerships and incentives. What is certain, is that more actions appear to be needed, including the collection of critical evidence if complementary and synergistic policies and practices are to be established across sectors.