Antimicrobial resistance is often described in technical terms: surveillance, prescribing data, stewardship frameworks, diagnostics, innovation pipelines and One Health systems. All of these are essential. But one of the clearest lessons I have learned through my work in antimicrobial resistance is that evidence alone does not create action.

That message became especially clear to me when I was honoured to be featured on the iconic Piccadilly Lights in London as part of The Fleming Initiative’s global “Thank You Antibiotics” campaign, in partnership with Imperial College London. The message was simple, visible and powerful:

“The whole world relies on antibiotics.”

In one of the busiest and most recognisable public spaces in the world, antimicrobial resistance was not confined to an academic conference, a policy meeting or a specialist clinical discussion. It was placed in front of the public: commuters, tourists, families, students, healthcare workers and people who may never have heard the term “antimicrobial resistance” before.

That matters.

Antibiotics are often invisible when they work. They protect surgery, cancer treatment, transplantation, childbirth, neonatal care, dentistry, intensive care and the management of common infections. They are part of the hidden infrastructure of modern medicine. Yet because they are so familiar, their fragility is easy to underestimate.

The Fleming Initiative’s campaign captured something that technical reports sometimes struggle to communicate: antibiotics are not only medicines; they are a shared public good. Their future depends not only on scientists, clinicians and policymakers, but also on public understanding, responsible use and collective action.

Public awareness is not optional

For many years, AMR communication has focused on facts: the scale of resistance, the risk of inappropriate antibiotic use, and the need for stewardship. These facts are vital. But facts alone do not always change behaviour.

Public engagement requires emotion, relevance and visibility. People need to understand not only that AMR exists, but why it matters to them, their families and their future healthcare. A billboard in Piccadilly Circus cannot solve AMR. But it can make the issue visible. It can start a conversation. It can move AMR from the specialist world into everyday public life.

This is why public engagement must be treated as a core part of AMR strategy, not an optional communications activity at the end of a project. If we want people to use antibiotics responsibly, trust delayed prescribing, accept diagnostic testing, understand why antibiotics are not needed for viral infections, and support One Health action, they need to be invited into the conversation.

From public awareness to policy action

The same principle applies to policy. In May 2026, I convened and led a Parliamentary Roundtable on Antimicrobial Resistance at the House of Commons in Westminster, bringing together parliamentarians, public health leaders, researchers, professional bodies, patient advocates and healthcare professionals.

The discussion reinforced a message that is becoming increasingly difficult to ignore: the AMR challenge is no longer only about generating more evidence. The UK and the global health community already have strong evidence, frameworks and policy commitments. The urgent question is how to implement them at scale.

The policy brief developed after the roundtable called for five practical priorities: embedding antimicrobial stewardship as routine professional practice; operationalising One Health; investing in diagnostics, interoperable data and responsible AI; sustaining antimicrobial innovation; and establishing a standing research–policy–practice interface to keep evidence, delivery and accountability connected.

This final point is crucial. Too often, research, policy and practice operate in parallel rather than as a continuous system. Evidence is produced, policy is written, and implementation is assumed. AMR teaches us that this is not enough. We need structures that keep policymakers, researchers, clinicians, patients and the public in sustained dialogue.

AMR needs both science and imagination

The Piccadilly Lights campaign and the Parliamentary Roundtable may appear very different. One is a public-facing awareness campaign in the heart of London. The other is a policy discussion inside Westminster. But for me, they are part of the same mission.

AMR requires science, but also imagination. It requires surveillance, but also storytelling. It requires innovation, but also public trust. It requires policy, but also implementation.

This is especially important because antimicrobial resistance is not a future abstract threat. It is already affecting patients, healthcare systems and communities. Resistant infections can mean longer hospital stays, more complex treatment, higher costs and avoidable suffering. The burden is also unequal, with low- and middle-income countries carrying a disproportionate share of global impact.

A purely technical response will not be enough. We need to build public understanding from schools to universities, from hospitals to communities, and from local prescribing decisions to global One Health policy.

Thank you antibiotics — but also protect them

The phrase “Thank You Antibiotics” is powerful because it invites gratitude. But gratitude should lead to responsibility.

If the whole world relies on antibiotics, then the whole world has a role in protecting them. Clinicians can prescribe responsibly. Pharmacists can support stewardship and patient education. Researchers can generate implementation-focused evidence. Policymakers can create accountability and invest in diagnostics and surveillance. Educators can embed AMR in curricula. The public can use antibiotics only when needed and follow professional advice.

No single campaign, roundtable or policy brief will solve AMR. But each can help build the ecosystem of awareness, trust and action that AMR urgently requires.

For me, seeing the AMR message displayed on Piccadilly Lights was more than a personal honour. It was a reminder that antimicrobial resistance must be taken out of the margins and placed where people can see it, discuss it and act on it.

The next phase of AMR is not only discovery. It is delivery.

And delivery will depend on whether we can connect science, policy and public imagination before the medicines we rely on lose their power.

Learn more about the Fleming Initiative here.