Education and Behaviour Change - The Fleming Initiative's Stance

Antimicrobial resistance (AMR) is driven to a large degree by human behaviour, from how we prevent infection to the ways we use medication. As such, a big part of the solution needs to be guided by behaviour change, and this can be underpinned by making sure that people understand what AMR is, how their behaviour contributes, and what they can do to be part of the solution. This is especially true for young people who have huge scope to make positive contributions throughout their lives, influence the people around them and grow into the leaders of the future.  

At the Fleming Initiative, we see education as a key component of tackling the AMR crisis. As such, we are working hard to understand what educational initiatives already exist and how AMR education fits into existing school curriculums. We are also seeking to understand the key components of AMR education internationally so that we can provide guidance for future interventions internationally and working with young people to develop educational tools that fit their needs and expectations. 

A first step is understanding what is already happening and what works in AMR education. We have recently completed a systematic review of AMR education programmes in primary and secondary school-aged people and will continue to update this so that these resources remain available. We’ve learned that while AMR education programmes are not uncommon, they often lack input from young people, fail to scale up to make a larger impact and, though they often improve knowledge, there is little evidence on long-lasting behaviour change. 

Because schools are generally the venue for delivering AMR education, we wanted to understand how the curriculum in schools helps to facilitate this. We found that in England, the only subject where AMR-related topics are expressly taught is biology. However, given the focus of exams (GCSEs), there is scope to integrate AMR education into a number of subjects including history, geography, food sciences and citizenship. 

So how should AMR education in the future look? To answer that question, we have convened an expert collaborative of 70+ international experts of medicine, pedagogy and behaviour change and we will be publishing our findings early next year. This forthcoming consensus document suggests that AMR education should be underpinned by age-appropriate knowledge of AMR, is embedded within local contexts, integrated across subjects and emphasises what people can do to make a difference. We will continue to work with our expert collaborative on the best ways to implement the consensus document internationally, how best to evaluate educational interventions, and what resources teachers and parents need. 

Finally, we would be remiss not to apply this learning directly to the development of AMR education. We are currently working with secondary school students in England to co-design an initiative that fits their preferred ways of learning, gives them the knowledge they need, and spurs on action. Whatever ideas we manage to come up with together, we will be designing and developing this educational tool next year, rolling it out to schools across the country, and evaluating its effectiveness.  Then in the future, we would look to repeat this co-design with students in other countries. 

Behaviour change is about more than education, and we are investigating other ways that we can influence people's behaviour, including by using social media, or by changing the way we talk about AMR and the way antibiotics are packaged. But education remains a cornerstone of our behaviour change strategy to reduce the impact that people have on AMR. We hope that our efforts to understand where AMR education is now, our support for future development and research and our own intervention development activities will help lead to an informed and active population in the future.