Antimicrobial resistance – a context for learning

Modern antibiotic medicines came into use in the middle of the 20th century. They enabled doctors to treat serious – and sometimes fatal – bacterial infections like strep throat and pneumonia. Prior to antibiotics, even simple cuts and grazes could be dangerous.

Penicillin was approved for clinical use in humans in 1943. In 1944, resistance to penicillin was identified in the bacteria Staphylococcus aureus. In 1945, Alexander Fleming (who discovered penicillin) warned that too small doses would educate microbes to resist penicillin rather than clear up the infection and that a host of “penicillin-fast organisms” could be passed to other individuals until they reach someone who penicillin cannot save.

Fast forward a few decades – the World Health Organization considers antimicrobial resistance (AMR) to be one of the top 10 global public health threats facing humanity.

Tackling infectious disease and AMR requires kotahitanga – unity, togetherness – across human, animal, plant, and environmental health, bringing everyone in Aotearoa New Zealand along on the journey.

Antimicrobial resistance – a wicked problem

Wicked problems are problems that are incredibly complicated and difficult to solve. Often, wicked problems involve social, environmental, economic or political issues or combinations of each of these.

People often consider antimicrobial resistance to be a human issue due to concerns about its effects on human health. However, it is the interconnectedness of humans, animals and ecosystems that makes antimicrobial resistance a wicked problem. For example, tetracyclines – a common antibiotic used in human and animal health – are often not fully metabolised by the body. On average, more than 75% of tetracyclines consumed by humans and livestock are released into the environment in an active form, usually via effluents. Environmental concentrations of tetracyclines have been found to trigger antimicrobial resistance in some parts of the world.

Antimicrobial resistance is a global problem. Addressing the threat it poses requires action by governments, healthcare providers, veterinarians, horticulturists and livestock and poultry producers – as well as individuals.

Enhancing health and science literacy

The New Zealand Government is acting to help reduce the risks posed by antimicrobial resistance. The Prime Minister’s Chief Science Adviser published the Infectious disease and antimicrobial resistance report. One recommendation is directed at educators:

Investigate ways of engaging rangatahi and tamariki in AMR and infectious disease conversations through hui and workshops, resources, and curricula at primary, intermediate, and secondary level.

Raising health and science literacy by learning about antibiotics and antimicrobial resistance can follow multiple pathways. Underlying science concepts include:

• the immune system – cells, tissues and organs that work together to protect an organism

• adaptation and evolution – how microorganisms change to develop resistance

• vaccination – using an organism’s own immune system to protect it.

Ākonga can build agency by learning about infectious disease and AMR and the links between individual action and community impact:

• At primary and intermediate level, this may involve learning about microbes, the role of preventative techniques (for example, personal hygiene and vaccinations) and how our immune system protects us from disease.

• At secondary level, ākonga build on this knowledge and consider the interconnections between humans, animals, plants and the wider environment and the impacts this has on encouraging or slowing disease and antimicrobial resistance.

Interactive planning pathways

The planning map below provides a gateway to collections of articles, multimedia and student activities grouped by common themes or contexts. By using a combination of these resources, teachers can combine conceptual understanding and capabilities development into relevant learning experiences.

Connections across multiple learning areas – mātaiaho

Learning about antimicrobial resistance spans multiple learning areas, including:

• science – exploring Living World concepts (life processes and evolution) and the science capabilities (using evidence and engaging with science)

• mātauranga – using rongoā to fight infection and exploring holistic practices

• health – taking individual and collective action for the care of one’s self and others

• social sciences – exploring societal issues within Aotearoa and the world

• sustainability – participating to create change/cultivate the wellbeing of our people and planet.

Each learning area supports ākonga to get involved and take positive action, which can help them feel empowered and avoid becoming overwhelmed by the seriousness of this wicked problem.