Why we need to change the way we talk about antibiotic resistance

In 2010, India woke up to a scientific storm. A research paper published in The Lancet Infectious Diseases described a new enzyme that could make bacteria resistant to nearly all antibiotics, including our last-resort drugs. This enzyme was named New Delhi Metallo-beta-lactamase, or NDM. Overnight, the gene’s name became a political issue. The Indian government argued it unfairly tarnished the nation’s reputation, while the British researchers defended it as a standard naming practice. The media seized the story, politicians took positions, and for a short time, antimicrobial resistance became front-page news.

The messaging problem

This controversy, and the unbiased opinions of many who stated that AMR could push our country into a catastrophic health crisis if not urgently tackled, created a momentum that later paved the way for initiatives such as the Chennai Declaration, which I was privileged to coordinate. Those were years when strong, even frightening, predictions worked. They jolted decision-makers. They made headlines. They opened doors. But what worked in 2010 no longer works today.

For over a decade, we have repeated the same dire forecasts: 10 million deaths every year by 2050, one hundred trillion dollars lost to the global economy, a looming collapse of healthcare. These numbers, taken from the landmark report by British economist Lord Jim O’Neill, once carried weight. They reframed AMR as not just a medical problem, but also an economic and political one. Governments took notice. The G7 and G20 put AMR on their agenda. For a time, the message worked.

But repetition dulls impact. Psychologists call this habituation: the more you hear something, the less you respond. Psychologist Paul Slovic, who has studied how humans perceive risk, calls it psychic numbing: the bigger the numbers, the less we feel. A single patient’s suffering moves us; 10 million deaths become an abstraction. As journalist Paul Brodeur wrote, “Statistics are human beings with the tears wiped off.” In talking about AMR only in statistics and distant futures, we have wiped off the tears and lost the human connection.

Today, the media is tired of AMR stories. Policymakers are distracted by other crises. Even doctors are weary of hearing the same warnings at conferences. Among the public, AMR barely registers. This is not because resistance is less dangerous than before. If anything, the problem is worse. The real crisis is that our words no longer move people. AMR has become, above all, a communication crisis.

Making it personal

If the language of catastrophe no longer works, what can? I believe the answer lies in making the story personal. Instead of talking only about the future collapse of healthcare systems, we must talk about the present impact on individual bodies. The focus must shift from statistics to biology.

The human body is not just human. It is microbial. Trillions of bacteria, viruses, and fungi live in and on us, shaping our health in ways we are only beginning to understand. This community, called the microbiome, helps digest food, produces vitamins, trains immunity, and protects our skin. It even communicates with our brain, influencing mood and cognition.

Antibiotics, while life-saving, are not neutral. Even a single dose can disrupt the microbiome for months. In some cases, the balance never fully recovers. The consequences ripple through what scientists call the “axes” of communication between the gut and the rest of the body. Disturbances in the gut microbiome affect the brain, worsening anxiety or depression. They affect the lungs, increasing the risk of asthma and severe respiratory infections. They alter metabolism, raising the likelihood of obesity and diabetes. They influence the skin, aggravating conditions like eczema or acne. They reshape the immune system, making allergies and autoimmune diseases more common. These are not distant predictions for 2050. These are impacts on us, on our children, today.

The good bugs

For too long, we have told only the story of the bad bugs—the resistant pathogens that kill. But there is another story we must tell: the story of the good bugs. And one of the most surprising, even delightful, examples of their role comes from something as ordinary as perfume.

Why does the same perfume smell different on different people? Perfumers usually say it is because of differences in skin chemistry, in pH or moisture or oiliness. But research is showing another dimension: the microbes on our skin. Bacteria on the skin produce enzymes that interact with fragrance molecules. These enzymes break some molecules down, amplify others, and sometimes even create new scents. That is why a floral perfume may smell fresh on one person but heavy on another. Or why a woody note lingers on one wrist but fades quickly on another. It is not only the perfume; it is the partnership between fragrance molecules and bacterial enzymes on the skin.

This is a reminder that microbes are not only about disease. They are about individuality, diversity, and beauty. They shape our daily experiences in invisible ways. Bugs are not just enemies. They are part of who we are.

So if we can tell such positive, fascinating stories about microbes, why can’t we do the same for AMR? Instead of only warning that antibiotics cause resistance in society, we can say: antibiotics can harm your microbiome. Protect your good bugs—they protect you. This is not a softer message. It is a more effective one, because it connects to people’s own lives. It replaces dread with responsibility. It offers hope.

Shifting the story

This is the shift we need. From resistance in hospitals to resilience in the body. From global catastrophe to personal consciousness. From fear to fragrance. From the language of war to the language of wisdom.

The good, the bad, and the ugly bugs all live with us. The question is: how will we tell their story? If we continue with pessimism alone, people will turn away. If we change our language, if we bring in positivity, biology, and human connection, we can keep AMR on the agenda—not as an abstract threat, but as a living, urgent, and solvable challenge.

(Dr Abdul Ghafur is senior consultant, infectious diseases, Apollo Hospitals, Chennai and coordinator, Chennai Declaration on AMR. [email protected])

Published – October 10, 2025 06:00 am IST