These are the kinds of role-play led conversations we, at Superheroes against Superbugs (SaS), had with students of pharmacy at a college in Ropar, Punjab. The movie that was our muse is well-celebrated across generations in the region. This setting helped the young people connect with the context in a light-hearted but intimate manner. Once in a relatable setting, we put them at the helm of making the right decisions in their future professional careers as pharmacists to fight antimicrobial resistance (AMR).

AMR is a situation where the antimicrobial drugs such as antibiotics aren’t as effective in stopping microbial infections. This happens when microbial populations in proximity to antimicrobial drugs evolve to resist the action of the same drugs. Such microbes are also called superbugs. 

Millions of people die due to AMR globally each year, and experts estimate these numbers will look extremely grim in the next two decades.

Experts have also identified different ways to slow the microbes’ evolution into superbugs. In a nutshell, it will need less frequent usage of antimicrobial drugs. That will require various stakeholders – antimicrobial manufacturing industries, medical doctors, pharmacists, animal and plant farmers, the general public – to all contribute to the judicious use of these drugs and policymakers to regulate their usage. At SaS, so far, we have focused most of our conversations on the overuse and misuse of antibiotics among three categories of people – future medical doctors, future pharmacists and consumers of antibiotics.

Antibiotics are one of the most widely used and misused antimicrobial drugs. These drugs kill bacteria. However, they are hailed as miracle drugs and assumed to cure any infection such as the ones caused by viruses. In a place like India where not everyone has the luxury to wait for an infection to subside or to access healthcare, the practice of self-medicating with antibiotics is very common. Pharmacists are hand-in-glove in this practice. Medical doctors can also feel pressured to prescribe antibiotics as they fear losing their patients to other practitioners who offer what the patients want.

We have interacted with young students of medicine, pharmacy, and those in schools and colleges, ages 15 – 23 — to inform them of the AMR crisis and help them find their individual roles in curbing the problem. We mostly engage through workshops in the schools and colleges they study in. We work with carefully selected subject experts to inspire the young people to take action against the problem. However, simply listening to talks from experts often don’t suffice to gather and hold the attention of young people in a topic they are uninitiated in. So, we infuse it with various formats of storytelling and art; these help place AMR in the cultural context of each group.

In addition to the example mentioned right at the beginning of this article, we have designed role plays and case studies for medical students to think through the various kinds of scenarios they might need to solve in their careers as doctors. We have designed an escape room keeping in mind the essence of urgency that doctors generally have to function under. It is intended to inspire doctors to practice evidence-based medicine against infectious diseases, such as by accessing the modern diagnostic tools to confirm the cause of diseases and collaborating with microbiologists in their hospitals to keep track of the antibiotic-resistance patterns in the patients visiting them. We invite medical doctors to highlight the importance of having open conversations with patients on when and how to use antibiotics.

Similarly, for pharmacy students, we have emphasised the unique role they play for people who might access pharmacists without going to doctors. The pharmacists need to realise their responsibility of playing a similar role as that of a doctor in explaining the usage protocols of antibiotics.

We worked with high school and college students largely probing their antibiotic usage patterns, informing them of the gravity of the problem and enabling them with tools of storytelling to contextualise AMR in their lives. This is important because most people don’t know AMR as a health concern. It is not one disease but a deterrent to treatment of many infectious diseases. Our medical reports do not show AMR as a cause of disease or death. It remains in the background often limited to the knowledge of the medical practitioner.

We trained these students to make comics depicting their understanding of the problem and their imagination of how they can fight it. Many of the school students we worked with made simple black and white comics divided into four panels telling a simple story of AMR. These comics, called the grassroots comics made it evident for all of us that AMR plays out differently for a high-income urban community with easy access to antibiotics, in a low-income community with problems of hygiene, in an agrarian setting where farmers overuse antibiotics or in a riverside town where their river gets routinely polluted. The makers of these comics shared these stories with their peers who were not a part of our workshops directly.

Others had the opportunity of co-designing their comics with artists and translating them for wall murals in Hyderabad and New Delhi. These murals became a reminder of AMR for people in these cities. Some even made songs and plays on AMR and used them in their schools and colleges to inform others of the problems of antibiotic misuse and AMR.

And, that’s what we want – we want young people to connect with the problem of AMR deeply enough to identify the changes they can bring about in their lives and communities to fight the problem. 

We acknowledge that we can engage with only a relatively small number of young people closely. So, it is only when they become our partners to take the cause ahead, we can hope to bring about changes.