In 2010, India woke up to a scientific storm. A research paper published in The Lancet Infectious Diseases described a new enzyme that could make bacteria resistant to nearly all antibiotics, including our last-resort drugs. This enzyme was named New Delhi Metallo-beta-lactamase, or NDM. Overnight, the gene’s name became a political issue. The Indian government argued it unfairly tarnished the nation’s reputation, while the British researchers defended it as a standard naming practice. The media seized the story, politicians took positions, and for a short time, antimicrobial resistance became front-page news.

The messaging problem

This controversy, and the unbiased opinions of many who stated that AMR could push our country into a catastrophic health crisis if not urgently tackled, created a momentum that later paved the way for initiatives such as the Chennai Declaration, which I was privileged to coordinate. Those were years when strong, even frightening, predictions worked. They jolted decision-makers. They made headlines. They opened doors. But what worked in 2010 no longer works today.

For over a decade, we have repeated the same dire forecasts: 10 million deaths every year by 2050, one hundred trillion dollars lost to the global economy, a looming collapse of healthcare. These numbers, taken from the landmark report by British economist Lord Jim O’Neill, once carried weight. They reframed AMR as not just a medical problem, but also an economic and political one. Governments took notice. The G7 and G20 put AMR on their agenda. For a time, the message worked.

But repetition dulls impact. Psychologists call this habituation: the more you hear something, the less you respond. Psychologist Paul Slovic, who has studied how humans perceive risk, calls it psychic numbing: the bigger the numbers, the less we feel. A single patient’s suffering moves us; 10 million deaths become an abstraction. As journalist Paul Brodeur wrote, “Statistics are human beings with the tears wiped off.” In talking about AMR only in statistics and distant futures, we have wiped off the tears and lost the human connection.

Today, the media is tired of AMR stories. Policymakers are distracted by other crises. Even doctors are weary of hearing the same warnings at conferences. Among the public, AMR barely registers. This is not because resistance is less dangerous than before. If anything, the problem is worse. The real crisis is that our words no longer move people. AMR has become, above all, a communication crisis.

Making it personal

If the language of catastrophe no longer works, what can? I believe the answer lies in making the story personal. Instead of talking only about the future collapse of healthcare systems, we must talk about the present impact on individual bodies. The focus must shift from statistics to biology.

The human body is not just human. It is microbial. Trillions of bacteria, viruses, and fungi live in and on us, shaping our health in ways we are only beginning to understand. This community, called the microbiome, helps digest food, produces vitamins, trains immunity, and protects our skin. It even communicates with our brain, influencing mood and cognition.

Antibiotics, while life-saving, are not neutral. Even a single dose can disrupt the microbiome for months. In some cases, the balance never fully recovers. The consequences ripple through what scientists call the “axes” of communication between the gut and the rest of the body. Disturbances in the gut microbiome affect the brain, worsening anxiety or depression. They affect the lungs, increasing the risk of asthma and severe respiratory infections. They alter metabolism, raising the likelihood of obesity and diabetes. They influence the skin, aggravating conditions like eczema or acne. They reshape the immune system, making allergies and autoimmune diseases more common. These are not distant predictions for 2050. These are impacts on us, on our children, today.

The good bugs

For too long, we have told only the story of the bad bugs—the resistant pathogens that kill. But there is another story we must tell: the story of the good bugs. And one of the most surprising, even delightful, examples of their role comes from something as ordinary as perfume.

Why does the same perfume smell different on different people? Perfumers usually say it is because of differences in skin chemistry, in pH or moisture or oiliness. But research is showing another dimension: the microbes on our skin. Bacteria on the skin produce enzymes that interact with fragrance molecules. These enzymes break some molecules down, amplify others, and sometimes even create new scents. That is why a floral perfume may smell fresh on one person but heavy on another. Or why a woody note lingers on one wrist but fades quickly on another. It is not only the perfume; it is the partnership between fragrance molecules and bacterial enzymes on the skin.

This is a reminder that microbes are not only about disease. They are about individuality, diversity, and beauty. They shape our daily experiences in invisible ways. Bugs are not just enemies. They are part of who we are.

So if we can tell such positive, fascinating stories about microbes, why can’t we do the same for AMR? Instead of only warning that antibiotics cause resistance in society, we can say: antibiotics can harm your microbiome. Protect your good bugs—they protect you. This is not a softer message. It is a more effective one, because it connects to people’s own lives. It replaces dread with responsibility. It offers hope.

Shifting the story

This is the shift we need. From resistance in hospitals to resilience in the body. From global catastrophe to personal consciousness. From fear to fragrance. From the language of war to the language of wisdom.

The good, the bad, and the ugly bugs all live with us. The question is: how will we tell their story? If we continue with pessimism alone, people will turn away. If we change our language, if we bring in positivity, biology, and human connection, we can keep AMR on the agenda—not as an abstract threat, but as a living, urgent, and solvable challenge.

(Dr Abdul Ghafur is senior consultant, infectious diseases, Apollo Hospitals, Chennai and coordinator, Chennai Declaration on AMR. drghafur@hotmail.com)

Published – October 10, 2025 06:00 am IST

“You are more microbes than human.”

It is possible you have had this factoid thrown at you, with the thrower claiming that the microbes in our bodies outnumber our own cells 10 to one.

But according to an assessment published in Nature Microbiology, this is a myth. In a 2016 study the assessment’s authors cited, researchers from Israel and Canada estimated a 70 kg “reference man” to have 38 trillion bacterial cells and 30 trillion human cells. Most current estimates of the size of the gut microbiome are also based on adults living in the urban areas of high-income countries, they added.

The authors, Alan Walker, senior research fellow at the Rowett Institute, University of Aberdeen, and Lesly Hoyles, professor of microbiome and systems biology, Nottingham Trent University, poked holes into this and 11 other popular claims that assail the human microbiome – the community of microbes living in the human body.

In the last two decades, microbiome research has gone from a “niche subject area” to “one of the hottest topics in all of science,” Dr. Hoyles said. The flip side of this is “hype and a temptation to over-simplify the really complex microbial interactions and activities occurring in our guts”.

Varun Aggarwala, assistant professor of biomedical and life sciences at Jio Institute, Navi Mumbai, who studies microbiome therapeutics, described the assessment as a “timely intervention that can bring nuance to the field of microbiomes.”

Here are the 11 other claims the article checked:

1. The age of the field

One of the more benign misconceptions the assessment takes aim at is that microbiome research is a new field. But according to the authors, scientists had described bacteria inhabiting the gut, such as Escerichia coli and Bifidobacteria, and speculated on their benefits in the late 19th and early 20th centuries itself.

2. Who named the field?

Many have credited Joshua Lederberg, a medicine Nobel laureate, with naming the field in 2001. But researchers had used the term in its modern form more than a decade earlier. According to a June 2017 paper that the authors cite, Whipps J.M., Lewis K., and Cooke R.C. used the term in 1988 to describe a community of microbes in a book.

3. The real number of microbes

Some of the more prevalent and more harmful myths concern the size of the microbiome. The absolute microbial cell numbers in one gram of human faeces have been exaggerated 10- to 100-fold. The actual number is around 10¹⁰-10¹², according to the authors.

4. The mass of the microbiome

Many research articles have stated that the human microbiota weigh 1-2 kg, but it only weighs about half a kg or less, the authors wrote. The 2016 study by Israeli and Canadian researchers estimated that it weighed about 200 grams.

5. From mother to child

Contrary to some opinions, mothers don’t pass their microbiomes to their children at birth. Some microorganisms are directly transferred during birth but they constitute a small fraction of the human microbiota. A smaller fraction of these microbes also survives and persists through the child’s life. “Every adult ends up with a unique microbiota configuration, even identical twins that are raised in the same household,” the authors noted.

6. Good or bad?

Some researchers have suggested (see here, here, and here, e.g.) that diseases are caused by undesirable interactions between microbial communities and our cells. But the authors wrote that whether a microbe and its metabolite are ‘good’ or ‘bad’ depends on the context. For example, most humans carry a species of bacteria called Clostridium difficile without any diseases for life. It causes problems only in the elderly or in people with compromised immune systems.

They acknowledged that diseases have been correlated with changes in the composition of the microbiome and that such changes could exacerbate some diseases (like inflammatory bowel disease). But they added that it is “extremely difficult” to implicate a specific profile of microbes, or changes to them, in a disease.

7. The firmicutes-bacteroidetes ratio

One myth correlates obesity with the ratio of two phyla of bacteria, firmicutes and bacteroidetes. The problem: the level of phyla is too broad to comment on effects with confidence. A phylum is a group within a kingdom. In the descending order of classifying organisms, a kingdom comprises different phyla; a phylum comprises classes; then there are orders, families, genuses, and, finally, species. Even within a bacterial species, several strains behave differently, causing the host to manifest different clinical symptoms. 

8. Not redundant

Some researchers have swung the other way, claiming that different microbes are actually functionally redundant. But the authors wrote that while different bacteria in the human microbiome perform some common important functions, many functions are the preserve of a few species.

9. Sequencing is not necessarily unbiased

The authors noted that the notion that “sequencing is unbiased” is a misconception – that biases can be introduced at various stages of studies based on the microbes’ genetic material, from collecting samples to storing them, even in the choice of software to analyse sequence data.

10. The standards question

According to the authors, there is a common opinion in microbiome research that researchers need standardised methods so that they can compare the findings of different studies. But the assessment stressed that no methodology is perfect and that adopting one universal methodology would come at the cost of turning a blind eye to the limitations of the chosen method.

11. The culturable microbiome

Is it difficult to grow microbes from the human microbiome in the lab? Yes, many say, but the authors pointed to work in the 1970s when scientists cultured diverse microbiome species from the gut. “So current gaps in culture collections are at least in part attributable to a lack of previous effort rather than an inherent ‘unculturability’,” they noted.

Joel P. Joseph is a freelance science journalist and researcher.