From fighting bacteria to dancing with life

2026-10-21

For two decades, Reimagining Resistance has explored and challenged the widespread metaphor of "waging war against bacteria" as a way of understanding and responding to antimicrobial resistance (AMR). The publication *Reimagining Resistance: A Journey in Creative Disruption* documents an intellectual and practical journey that began by questioning the language of AMR and evolved into a wider exploration of the relationships between humans, microorganisms and the living world. Bringing together science, art, ecology, Indigenous knowledge, philosophy and community action, it invites us to rethink not only AMR but also the foundations of public health.

The initiative emerged from a recognition that metaphors shape responses. When bacteria are portrayed as enemies and antibiotics as weapons, the logical response appears to be their elimination. Yet bacteria are ancient, diverse and indispensable participants in the ecosystems that sustain life. Many perform essential functions within our bodies and the wider environment. The question was never whether antibiotics were necessary: they remain indispensable, and equitable access to them is essential. Rather, could a model centred on combat and eradication adequately address the complex relationships through which health and disease emerge?

From war to dance: putting a new idea into practice

Beginning with the ‘Microbes and Metaphors‘ report in 2008, the initiative developed its defining alternative: “Dancing with Bacteria”. Dance evokes interaction, adaptation, rhythm, balance and mutual responsiveness. Instead of imagining a one-sided battle, it encourages us to consider how humans and microorganisms continually influence one another within changing biological and environmental conditions.

Crucially, this was not simply a change in vocabulary. The process explored ways of making the invisible microbial

world accessible through **gardening, visual art, photography, music, dance and educational activities**. These approaches offered opportunities for people to encounter microbial life through observation, creative expression and shared experience, rather than learning about it exclusively through scientific explanations or warnings about infection. Artists and musicians helped translate complex ideas into experiences that people could see, hear, feel and discuss.

The practical significance is considerable. Preventing infections, strengthening immunity, maintaining healthy environments and using antibiotics responsibly become complementary activities in sustaining life. The metaphor does not romanticise microorganisms or suggest that dangerous infections should go untreated. It challenges the assumption that killing microbes is the only meaningful response.

Learning across disciplines and cultures

Another concrete achievement has been the creation of a collaborative process that brings together people who rarely share the same platforms. Microbiologists, clinicians, public health practitioners, artists, musicians, educators, activists and Indigenous communities have contributed different forms of knowledge and experience. Mary Murray, Arturo Quizhpe, Satya Sivaraman and Kléver Calle are among those who helped shape this journey, alongside a wider network of collaborators across Latin America and beyond.

The incorporation of ‘Sumak Kawsay’, often translated as Good Living, illustrates how this exchange widened the project’s perspective. Rooted in Indigenous thought, the concept connects wellbeing with the health of Mother Earth and all living beings, visible and invisible. It offers a different starting point from approaches that treat human health as separate from ecological wellbeing.

Community participation has reinforced another important principle: learning with people is different from merely delivering information to them. Gardening and other educational activities, for example, can provide shared spaces in which communities explore their relationship with the living world. Art becomes a method of inquiry, not decorative packaging for scientific messages. It can provoke questions, communicate uncertainty and engage emotions in ways that conventional health communication may not achieve.

Rethinking public health and the polycrisis

The publication draws out practical implications for AMR policy. Antibiotic stewardship must be balanced with equitable access: inappropriate use accelerates resistance, but denying effective treatment to people who need it also causes avoidable suffering and death. Hospitals, farms, food systems, waterways and urban environments must be understood as interconnected ecological settings. Infection prevention therefore requires not only medicines but also hygiene, sanitation, infrastructure and environmental protection.

Equally important is attention to the social conditions that shape infection and treatment. Clean water, adequate nutrition, safe living conditions and timely healthcare can reduce infections and the need for antibiotics. AMR action must consequently connect with efforts to strengthen health systems, protect ecosystems and reduce inequality.

Perhaps the initiative’s most far-reaching contribution is its anticipation of today’s concept of the ‘polycrisis’: the interaction of multiple crises whose combined consequences exceed those of their individual components. Long before the term became prominent in policy discussions, Reimagining Resistance was bringing AMR into conversation with ecology, economics, social justice, food systems and Indigenous knowledge.

Climate change, pollution, industrial food production, poverty and fragile health systems interact to shape microbial life and human vulnerability. Treating resistance as an isolated technical problem obscures these connections. The same reductionist thinking that seeks a single enemy and a simple solution also limits our ability to respond to interconnected threats to human and planetary health.

From creative disruption to collective action

Reimagining Resistance demonstrates the value of combining scientific understanding with artistic imagination, community experience and ecological thinking. Its concrete experiments in gardening, photography, music, dance and education show how a different conceptual framework can open new possibilities for public engagement, while its interdisciplinary foundations challenge public health to look beyond conventional professional boundaries.

The task now is to translate these insights into sustained collective practice. Safeguarding antibiotics requires more than changing prescribing behaviour; it also means reconsidering how societies organise healthcare, produce food, manage environments and understand their relationship with microbial life. After twenty years of dialogue and experimentation, the initiative offers a compelling challenge: rather than attempting to control life through an endless war against its complexity, we must learn to understand its relationships and “dance with it”.