Fleming Initiative publishes two key milestones in advancing global antimicrobial resistance education

The Fleming Initiative today published two key outputs aimed at accelerating global action on antimicrobial resistance (AMR) education:

1. A global consensus framework that sets out recommendations for what every child and adolescent aged 5 to 18 should know about AMR, and how AMR can be integrated into both community- and school-based educational initiatives worldwide.

2. A first-of-its-kind global review of AMR education initiatives, which highlights a critical gap in evidence for behaviour change and health outcomes that the new framework aims to address.

AMR occurs when microbes such as bacteria and fungi adapt and become resistant to the drugs we use to treat them – meaning common infections and minor injuries can become life-threatening. 

The causes of antimicrobial resistance are often rooted in individual and collective behaviours that lead to the misuse and overuse of antibiotics and other antimicrobial drugs.

Helping people to understand antimicrobial resistance and to use antimicrobial drugs appropriately will be key to preventing AMR becoming a global humanitarian crisis that could result in at least 8 million lives lost yearly by 2050.

Children and adolescents engaging with AMR educational game at the Great Exhibition Road Festival, 2025;

photo by Eleanor Bentall

Vision for AMR education and global collaboration

The recommendations set out in the consensus document are the culmination of the Fleming Initiative convening over 70 experts in AMR, AMR education and AMR engagement from across the globe. This in turn has kicked started a network of experts that will continue to collaborate, with the launch of the AMR Education Collaborative which aims to facilitate the implementation of the key principles within the consensus document.

The document has been supported by all four members of the Quadripartite Joint Secretariat on AMR.

Dr Yvan Hutin, Director, Antimicrobial Resistance of World Health Organization (WHO) said:

“Embedding AMR education in schools is not optional – it is essential for achieving global targets and securing a future free from untreatable infections."

Jacqueline Álvarez, Chief, Chemicals and Health Branch of the United Nations Environment Programme (UNEP), said:

“UNEP is proud to support this global consensus, which places environmental stewardship at the heart of AMR education and equips learners everywhere to become agents of change.”

Thanawat Tiensin, Chief Veterinarian of the Food and Agriculture Organization of the United Nations (FAO), said:

“FAO welcomes this timely consensus document as a critical step in empowering children and adolescents to become the next generation of AMR champions across agrifood systems and beyond.” 

Dr Javier Yugueros Marcos, Head of the Veterinary Products & Drug Resistance Department of the World Organisation for Animal Health (WOAH), said:

“Educating children... [to become] champions of a healthier and sustainable tomorrow, where the effectiveness of antimicrobials is preserved for humans, animals and plants, all across the One Health spectrum.”

Professor Alison Holmes, Director of the Fleming Initiative, said:

“Informed children and adolescents helped shape the climate movement and they can do the same for antimicrobial resistance. Through education, children and adolescents can be empowered to champion infection prevention, help their families and communities reduce the spread of infections, and use antimicrobials responsibly. Achieving global consensus on how to best integrate AMR into education provides a pathway to scale educational initiatives worldwide and, ultimately, save lives.”

The global consensus document establishes a global framework for AMR education which can be tailored and contextualised to different regions and countries to meet their distinctive needs and priorities.

Several key overarching themes are outlined as priorities for educators across the globe to include in their educational material and initiatives, including:

1. AMR education must include general infection prevention and control, as well as the specifics of AMR

2. AMR education should go beyond science and be woven into other subjects including the arts, health, history and human geography

3. AMR education should be incorporated into existing activities and curricula where possible, reducing additional burden on educational systems

4. AMR education should be framed in a positive manner, emphasizing that action and behaviour change can lead to positive outcomes and benefits

These overarching themes would not only ensure global coherence in the information and messaging around AMR which children and adolescents receive, but would also help facilitate a consistent and holistic approach to AMR education, one in which children and adolescents are active collaborators in their learning. The AMR Education Collaborative is working with global partners to facilitate implementation and embed these principles in interventions in India with support from the Indian Institute of Technology Kharagpurand and in Nigeria in collaboration with One Health and Development Initiative.

Children participating in AMR-related public workshop hosted by Fleming Initiative, 2025; photo by Helena Dolby

Addressing the evidence gap in AMR education and behaviour change

A recent review led by researchers from the Fleming Initiative, University College London and University of Edinburgh underscores why this consensus framework is urgently needed. Analysing 119 AMR education initiatives across 44 countries, the study found that while 44 programmes reported improved knowledge of AMR following evaluation, none measured real-world behaviour change or improvements in AMR-related health outcomes.

Importantly, this is the first review to include an open global call for submissions, improving equity by capturing initiatives that are often not represented in academic literature. The findings align with the United Nations General Assembly’s recommendations on global collaboration and resource sharing for AMR education, and point to future opportunities for innovation – including participatory, co-developed approaches with teachers and students to strengthen real-world impact.

Professor Alison Holmes added:

“This study provides a clear view of current gaps in AMR education. While many programs improve knowledge, few have measured behaviour change or better health outcomes. It highlights the need to expand evaluations to focus on real-world impact and to gather more evidence on effective interventions.”

"I want a future where antibiotics are understood & trusted (education and support)." A message left by the audience at the Paddington Station Installation delivered by Fleming Initiative in partnership with GSK, 2024; photo by Helena Dolby

Working together to do more

AMR is a deeply complex crisis that must be tackled from all angles to find solutions, but this cannot happen if work on AMR is siloed by sector, research field, or border. 

The Fleming Initiative has prioritised convening stakeholder groups globally across five priority areas, including Education, to build connections, share knowledge, and generate outputs such as global consensus documents and strategic plans that will help catalyse new solutions to AMR.

By bringing together expert voices on Diagnostics, Education, Global Fellowships, Surveillance, and National Action Plans, the Fleming Initiative aims to drive the emergence of powerful new ideas.

The AMR Education Collaborative will follow up on the consensus document with a detailed implementation roadmap, outlining key partners and pathways towards impact regionally, nationally and globally.