The Record: Why was the Lessons Learned Dialogue event important?

Kevin Outterson: The Intergovernmental Panel on Climate Change has been instrumental over the past decades in helping to organize and systematize the science around climate change. Scientists from around the world create scientific assessments that drive policy. Antimicrobial resistance is a complex multi-disciplinary field that would benefit from scientific leadership and a stronger science-policy interface. After years of discussion, the United Nations General Assembly unanimously agreed to create a similar panel in the second United Nations High Level Meeting on AMR in September 2024. A United Nations team, the Quadripartite Joint Secretariat, was invited to establish the new panel by the end of 2025, after consultation with United Nations Member States.

The idea behind the meeting in Lagos was to collect lessons learned from other previous science panels. This is an architectural moment to lay the foundations of a new organization creating global public science goods.

The Record: Can you share more about the decision to host the panel in Lagos, Nigeria?

Kevin Outterson: Africa is the region of the world most impacted by AMR, so we decided to host the conference there, filling the room with a majority of scientists from the global South, centering their voices. This is also a practical choice as visas and travel to many locations in Europe or North America are more difficult.

These values also drove the budget. We used more than 75 percent of the budget to provide travel grants to scientists traveling from lower-income settings. This enabled them to come to Lagos and share their expertise as some of those scientists closest to regions where the burden of antimicrobial resistance is the highest. At a place like Boston University, we have great faculty resources that enable professors to travel to important convenings like this. But if you’re at a well-known university in the global South, travel funds are simply not available. Many participants thanked us for prioritizing equitable participation. This lesson should be applied to the new Panel as well.

Finally, this was a science meeting, so the co-sponsors were the Nigerian Academy of Science and the US National Academy of Medicine. Scientists want the new Panel to work well.

The Record: Can you share more about those who participated? What was the structure of the event?

Kevin Outterson: Nearly 90 people participated in the event, about half of whom were attendees from African countries including Nigeria, Ghana, Kenya, South Africa, and more.

Speakers were generally experts on how these other international science panels work and could offer insight on elements that have worked as well as things to avoid. We commissioned seven academic papers in advance as pre-reads for the meeting.

We designed the meeting to maximize discussion, not top-down instruction from the podium. The majority of the time was spent in discussion at round tables of eight to ten people. This was designed as a bottom-up approach. The format was intended to provoke thought and discussion while recording takeaways from these small groups to be processed together in the plenary.

The Record: What happens next? How might the takeaways from this meeting inform the global dialogue around the AMR crisis moving forward?

Kevin Outterson: Based on our discussions, the seven papers will be revised and published. The meeting was held in collaboration with the Quadripartite Joint Secretariat (the group tasked with setting up the Panel), so they were represented and participated in the discussions. We will also disseminate the findings from this meeting to all of the participants so that they can work with their national science academies and governments during the UN consultation process leading up to the creation of the Panel before the end of 2025.

The Record: Can you share more about Boston University’s contribution to this event?

Kevin Outterson: Boston University President Dr. Melissa Gilliam was gracious enough to provide a $50,000 grant last summer, which was followed by a matching grant from the U.S. National Academy of Medicine and then a larger grant from Wellcome Trust. President Gilliam was the first mover on this effort to get this conference off the ground and ultimately made attendance possible for scientists who otherwise couldn’t afford to attend.

The Record: Any final thoughts?

Kevin Outterson: It is a rare privilege in your discipline to have the opportunity to design a global scientific process from scratch. Usually, the structures are in place for decades or centuries, encrusted with tradition. But this was a moment in which a new thing is being created that is global in scope and scientific in its methods, specifically on antimicrobial resistance. I am grateful that we can come together and think about lessons learned from history before everything has been settled. It’s a rare opportunity in science.