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The key drivers of AMR – outer context

A video explaining how AMR occurs and what factors drive the development of AMR.
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Because you’re on this course, I expect you know quite a bit already about antimicrobial resistance. However, I wouldn’t mind just going over a few things that I always think are really important to consider. So I think we need to acknowledge that antimicrobial resistance is actually a natural phenomenon. It is part of what microbes do. It’s part of their evolution. It’s Darwinian. However, we also need to recognise that any exposure to antimicrobials will select and drive antimicrobial resistance, and that’s whether the exposure is intentional or unintentional, at an individual level or at a societal level. We also all know about the major problem that public health and the delivery of health care faces now because of the challenge of antimicrobial resistance.
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And this is a particular problem in low and middle income countries. But we also have to remember that we must make sure that we preserve access to effective antibiotics for now, and for the future. So whilst we must try and minimise exposure, we also must not compromise the access to antibiotics and the treatment of infection. So this is a complex issue, and there is no single magic bullet. We all need to work together on this to preserve the effectiveness of antimicrobials now, for our generation, and in the future. Now, I think we need to consider several things here it’s going to take a long time before we get new agents that will work.
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So it’s up to us to think about how we can preserve the antimicrobials that we have, and how can we use these more intelligently. This means that the issue is beyond what we can do in laboratories in terms of looking at target molecules, and drug development, and molecular bacteriology. It means that, as individuals and society, we need to think about what actions can we take to improve how we use antimicrobials.
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And that is why we need to think about how we can use social sciences research and apply it to this field to change behaviours, to understand context, to understand systems, and think about what needs to change to make effective change in how we use antimicrobials, and to minimise the threat of antimicrobial resistance to us, to our patients, and for future generations. And this is why it’s absolutely critical that we have an understanding of the role of social sciences in this domain.
In this introductory video Professor Alison Holmes summarises the key points in relation to antimicrobial resistance.
The emergence of AMR is a natural evolutionary response to antibiotic exposure. At a societal level, complex and interlinking drivers are increasing the prevalence of resistant bacteria, predominantly arising from use in humans and agriculture and the presence of antibiotics in the environment.
Before we consider how social science research can provide insights into the contextual drivers of antimicrobial resistance and help identify targeted solutions, we need to recognise that the first step is in the prevention of infection and spread of AMR by ensuring effective sanitation, vaccination, hygiene and infection prevention measures. Additionally gaining insight into the mechanisms of AMR, long-term persistence, and successful transmission, is fundamental to the development of novel targets for both diagnostic tests and therapeutic agents with integration of these into sustainable AMS strategies. Gaps in understanding and areas for innovation are clear, yet progress towards these goals is still urgently needed, with a careful awareness of any potential impact on access to effective antimicrobial treatment.
There is no single solution and multiple, synergistic, overlapping and complementing approaches will be needed, with a strong overarching shared goal to ensure and sustain access to effective antibiotic therapies. This is why social science research has a critical role in the battle to tackle AMR; it provides understanding around and has an impact on behaviours of individuals (patients, the public, or healthcare professionals), populations, and policy makers.
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Tackling Antimicrobial Resistance: A Social Science Approach

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