25th August 2020

As MP Julian Sturdy recently noted in his cross-party letter to the UK Prime Minister, antimicrobial resistance is not only a problem that is potentially exacerbated by COVID-19 – it has the potential to be an even bigger threat than coronavirus. Yet this public health emergency remains stubbornly under the radar compared to other diseases. Could something as simple as renaming it resolve the issue?

It is no coincidence that antimicrobial resistance has been called a “silent tsunami”. There is no question that drug-resistant infections pose an existential threat to humanity, yet the problem fails to attract the international attention it so urgently requires. Few physicians and even fewer lay people have a full understanding of what antimicrobial resistance means, and the media continue to sideline the topic, even when reporting on related health threats such as sepsis.

So where does the communication about antimicrobial resistance fall short? How can we instil an appropriate sense of urgency, encourage increased medical research and inspire better stewardship of existing drugs?

The UK Wellcome Trust report Re-branding Resistance suggests that antimicrobial resistance has a framing issue. The report outlines five principles for the language and concepts which should be used when sharing information about antimicrobial resistance. One problem is the inconsistent use of terminology, with various alternative terms such as “Superbugs” and “AMR” used synonymously.

In my recent article for JAC-Antimicrobial Resistance, I extend this argument and outline several linguistic properties that compromise the impact of “antimicrobial resistance” in media communications. The term is long and abstract, difficult to pronounce, lacks intuitive meaning and fails to express the extent of the threat to human medicine. It also falls short with regard to specificity. For example, antimicrobial resistance is frequently confused with the related but narrower issue of antibiotic resistance. Even worse, the abbreviation “AMR” is highly ambiguous because it can also refer to “Anisotropic magnetoresistance”, “Automatic meter reading” or an Arabic male name, to list but a few.

In light of these linguistic handicaps, I propose a strategic name change. Creating a new term will be essential to re-branding the problem and help increase international awareness and willingness to take action. As previously seen in the context of HIV/Aidsor more recently during the COVID-19 pandemic the renaming of health threats can be possible if implemented at the international level with the authority of a globally respected organisation such as WHO.

In the process of creating a new name to replace “antimicrobial resistance”, it will be essential to draw on relevant findings from the fields of psycholinguistics and marketing, which provide essential insights for the creation of functional names that stick. These include early psychology literature pertaining to the concept of “word attensity”, recent cognitive research on “processing fluency” in the context of word recognition, and relevant marketing literature examining the components of successful branding strategies such as memorability and uniqueness.

Only the strategic choice of a single term which:

  1. is short and easy to pronounce,
  2. makes intuitive sense, and
  3. has unique meaning

is likely to bring about overdue change in the global discussion of antimicrobial resistance.

Eva M Krockow, Assist. Prof of Psychology + Health & Wellbeing Research Lead, Department of Neuroscience, Psychology and Behaviour at the University of Leicester @EM_Krockow

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