Effective argumentation for action in AMR: A textual case study of the UK’s Review on Antimicrobial Resistance final report


It’s rare to find a science-focused policy report described as much-awaited, groundbreaking, influential and highly regarded, but the UK’s 2016 report on antimicrobial resistance (AMR) has garnered all that acclaim and more. Commissioned by the UK government and led by economist Jim O’Neill, Tackling Drug Resistant Infections Globally: Final Report and Recommendations (the report), summarized two years of an independent review and aimed to spark action to address the dire and growing issue of AMR – the process where microbes develop the ability to resist drugs that were once effective at treating them. The report stands out among other knowledge translation products for its high profile, policy impacts, and lasting circulation. Its influential estimates, recommendations and framings continue to feature prominently within global reports, news coverage, books and research on AMR five years after its release. 


This paper uses a humanities-based, close textual analysis to answer two key dissemination research questions: First, how did this report avoid falling prey to manufactured controversy and anti-science stalemates that happen in other science-based policy areas? These “manufactroversies” are defined as contrived disagreements, typically motivated by profit or ideology, designed to create public confusion concerning an issue about which there is no substantial academic dispute. Many science-based policy debates can fall prey to manufactroversy-creating tactics, with examples including AIDS treatment, global warming and evolution, links between smoking and cancer, vaccinations, and COVID-19. But debates of AMR – including those catalyzed by the report – have mostly avoided questions about their core scientific facts.  The second key research question is, within existing AMR debates, how did the O’Neill report get more and longer-lasting engagement than other AMR reports with similar content created in similar contexts?

Using stasis theory from classical rhetoric, the case study analysis of this successful evidence-to-action report reveals three key argumentative moves that tailored its dissemination strategies to its context and audiences. 


The argumentation strategies in this report effectively focus debate on policy action, while preventing an unproductive rehashing of scientific questions that could stall action or misdirect debate. The report achieved this by using a “beachhead” strategy that swiftly moved past conjectural, definitional, and qualitative arguments to focus the battle on procedural points; by directing debate through shifting indicative, imperative, and subjunctive moods; and by launching a preemptive, conjectural counterargument that shifted the burden of proof and forced opponents to defend their assumptions about the harms of policy action.


This paper presents a case where knowledge translators were able effectively circumvent the counter-tactics of manufactroversy while persuasively arguing for action. By layering multiple sets of arguments, flagging areas of debate, and strategically questioning the facts of opponents, the report maneuvers its readers and potential debaters onto the most appropriate and productive grounds to debate action for AMR. Concrete examples and lessons from this case study can inform both the development and evaluation of dissemination strategies for other science-based policy communications, especially for those seeking to spark action among cross-sector and policymaker audiences.

Christine Ackerley slides

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