Antimicrobial resistance: the urgency of tracking attention

Misha Kidambi

One of the objectives of the global action plan on antimicrobial resistance is “to improve awareness and understanding of antimicrobial resistance through effective communication, education and training.” Tools like Altmetric will be vital in tracking the attention research in the area gets across different information platforms.

What was discovered first, antimicrobials or antimicrobial resistance? The answer is not as obvious as expected. The first report of antimicrobial resistance ostensibly pre-dates penicillin discovery. Antimicrobial resistance (AMR) develops when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness, and even death. The increasing prevalence of AMR globally has been so alarming that AMR is recognized as one of the top 10 global public health threats facing humanity. 

In 2015, the World Health Organization adopted the Global Action Plan and established the World Antimicrobial Resistance Awareness Week (earlier known as the World Antibiotic Resistance Awareness Week) from 18-24 November.  The World Antimicrobial Resistance Awareness Week, or WAAW, is a global campaign that aims to raise awareness and understanding of AMR and promote best practices among One Health stakeholders to reduce the emergence and spread of drug-resistant infections. The WHO website states that the theme for WAAW 2023 is “Preventing antimicrobial resistance together“. 

Despite the alarming global health threat posed by AMR, the February 2023 editorial in The Lancet Microbe stated that antimicrobial resistance (AMR) is thought to be “largely unknown to the general public”, at least in the USA. To get a quick overview of when and who is having conversations about AMR, we ran a search for publications that included “Antimicrobial Resistance” in the title in Altmetric Explorer. The results (Fig. 1) showed that while the phrase Antimicrobial Resistance had only negligible mentions before 2012, the conversation around the theme has steadily been picking up attention, especially in the News and X, formerly Twitter, categories. This rise is evident starting in 2015 when the GAP was adopted.

Fig. 1: The conversation around the theme has steadily been picking up attention since 2012.

Zooming in on the X and the News categories for the same period (Fig. 2)  shows a slight dip in mentions in 2020, possibly coinciding with the COVID-19 pandemic. But the attention picks up again in 2021, and there is a sharp rise seen in 2022.

A look at the Altmetric Attention Scores of publications that included “Antibiotic Resistance” in the title shows that a study published in The Lancet titled Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis garnered an attention score of 11101, putting it in the top 5% of all research outputs scored by Altmetric (see Fig. 3)

Fig. 3

This study presents the first global estimates of the burden of bacterial AMR covering an extensive set of pathogens and pathogen–drug combinations using consistent methods for both counterfactual scenarios. The need to have such global approaches to research that give a holistic picture of global challenges, in this particular case AMR, is being addressed in Digital Science’s campaign titled Fragmentation: a divided research world? In the article Waves of attention: patterns and themes of international antimicrobial resistance reports, 1945–2020, published in BMJ Global Health, authors Overton et. al. write, “Attention regarding AMR at the international policy level has increased consistently since the late 1990s. This increase in policy push coincides with a planetary framing of AMR threats that have to be dealt with at the international level.” 

The same authors, however, also caution that, despite the ongoing escalation of the AMR problem, the number of international reports started to decline after 2017/2018. This decline, coupled with recent reductions in international funding and support from significant national donors, suggests that attention to AMR at the international level may have reached a turning point even before the onset of the COVID-19 pandemic according to them. Given that the WHO has stated that “the clinical pipeline of new antimicrobials is dry” and that in 2019, it “identified 32 antibiotics in clinical development that address the WHO list of priority pathogens, of which only six were classified as innovative,” continued efforts to carry out AMR research in a globally coordinated manner, and ensuring that the impact in real-word settings are systematically tracked remains a burning issue.

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