AMR education for school students, as antimicrobial resistance (AMR) is a public health challenge across the globe, is increasingly recognised as a critical strategy to address this growing threat, particularly in lower-middle-income countries (LMICs). In an LMIC like India, where there is unregulated access to antimicrobials in the community, and patients can choose their healthcare provider, education and awareness on responsible use of antibiotics need to start from the community level, especially that target a change in behaviour of the general public in order to sustain mitigation of AMR in the country.

Improving awareness and understanding of AMR has been recognised as a strategic priority in India’s National Action Plan (NAP) on AMR 2017 and 2025 (NAP-AMR 2.0), with a special focus on providing such education to school and college students. School students are the future adults of the country, and if we are able to instill a responsible use of antibiotics in them, it will lead to better healthcare decision-making. They are also curious to learn, and this enthusiasm can be tapped into when developing educational content for them. Rather than providing education via didactic lectures alone, the use of animated videos, storytelling, games etc, can also be explored to make the session more interesting for the students.

Organisations such as React Asia Pacific and Superheroes against superbugs have developed and implemented various educational workshops for this population. The key focus of these workshops is providing education on AMR in fun and creative ways, including games and focus group discussions. The students who attend such workshops also have the potential to become change leaders and spread the education among their peers and family. There are also various educational institutions in India that have published about such interventions among school students. The majority of these interventions use a pre- and post-test to assess the impact of their educational sessions. Whilst such tests provide an insight into the immediate impact of these interventions, it is important to also follow up with the students to assess if they are able to create any long-term change in their behaviours and/or those of their family members. The facilitators can go back to the students a while after the workshop and collect feedback. If the students report any challenge in implementing the lessons learnt, it can be considered as an opportunity for the facilitators to refine their approach toward content delivery to create more lasting impact. Efforts could also be taken to engage with the parents of the students gradually so that the awareness trickles down to even older generations.

Another key consideration should be that, rather than merely considering the students as study subjects, they are considered as stakeholders and are given opportunities to share their knowledge and experience. Efforts should be taken to understand their knowledge and its source before providing them with new information. When initiating such interventions, it would also be better to start from high school students (aged 13 and above) since they already have a basic understanding of the human body and microbiology.

AMR is a silent pandemic, and it is essential that we invest in creating sustainable mitigation strategies. Developing such interventions from the student level enables creating lasting behaviour change and creating future citizens who are aware of using antimicrobials rationally and responsibly.

Written by ISID Emerging Leader, Vrinda Nampoothiri