The Fleming Initiative

Keeping antibiotics working for the next 100 years

red and brown medication pill

This year, Professor Darzi has been leading on and galvanising support for the Fleming Initiative. Founded on partnership between Imperial College London and Imperial College Healthcare NHS Trust, the Fleming Initiative is beginning a movement of change that puts society at the heart of solving the problem of antimicrobial resistance (AMR). A significant fundraising effort is in motion to establish a Fleming Centre.  

The Initiative will build on Imperial’s rich heritage in Infectious Diseases with the establishment of the Fleming Centre on the same site where Alexander Fleming discovered penicillin in 1928, and an allied global network. A place of convergence, the Fleming Centre will uniquely co-locate experts across research, behavioural science and policy in an effort to tackle antimicrobial resistance from all angles and on a united front. Driving global change requires public buy-in and the Fleming Initiative will involve people and patients at every stage to maximise success in the fight against AMR. Starting in the Paddington Centre, the public will be invited inside a Discovery Centre to learn about AMR, partake in research and inform real-world solutions to protect the health security of local populations around the world.

Developing the Fleming Initiative

Patronage announcement

In July 2023, HRH Prince William, Prince of Wales, was announced as the patron of the appeal to build the Fleming Centre. 

This announcement acted as a springboard for the initiative and brought a significant boost in terms of amplifying reach of the project’s message. 

Professor Darzi says the next global health threat is antibiotic resistance. The pioneering surgeon is working to launch our new Fleming Initiative, which, with the backing of Prince William, aims to combat the crisis. “We could end up in a scenario where we don’t have any antibiotics to treat an infection. "That’s not a place we want humanity to be in ― where we have the latest advances in surgery but we can’t treat a bug.” Read more in the Times feature.

Kicking off our behavioural research

Just before the patronage was announced, our behavioural science team, led by Dr Kate Grailey, began its inaugural programme of work in collaboration with the Behavioural Insights Team around the framing of AMR. Co-created with the public, this research project has generated new ways of presenting AMR that we hope resonate better with the public, testing these in an upcoming randomised controlled trial. 

A second behavioural science workstream, supported by YouTube Health, aims to better understand the real-world outcomes of video-based health content. Additionally, this work leans into the Fleming Initiative's communications strategy, creating a novel network of health content creators focused on AMR. This network aims to spark a ‘pulse’ of engagement around AMR, using coordinated social media messaging and video content. 

The Fleming Centre is a nexus to build new collaborations across Imperial's world-class themes in infection and antimicrobial resistance. From partnering in a specialist fungal network, to supporting work addressing the link between environmental health and AMR, the Fleming Centre is looking to advance existing efforts through a convergence approach. In collaboration with the Institute of Chemical Biology, the Fleming Centre is also co-creating PhD studentships, to support the next generation of scientists working to tackle AMR. 

Engaging with our local communities

In May 2023, we commissioned The Liminal Space to kickstart Fleming’s public involvement and engagement work. Working with Public Involvement Lead, Anna Lawrence-Jones, they arranged a series of workshops and a spot test in Paddington Station: starting the process of co-developing the vision of the Fleming Centre and the future of antibiotics with our hyperlocal public. 

World Antimicrobial Awareness Week in November 2023 proved to be an excellent opportunity to engage with our hyperlocal public. We partnered with our colleagues at Imperial’s NIHR HPU for Hospital Acquired Infection and AMR to run engagement activities in Paddington and White City, giving us the chance to understand local knowledge around antibiotics and AMR. 

Seed funding announcement

As part of the 2023 Autumn Statement, the Chancellor of the Exchequer announced £5 million in seed funding for the Fleming Centre. This funding will not only help to catalyse further investment but will also allow us to commence the early design process for a Fleming Centre on the St Mary’s Hospital site. It signals national endorsement for the project and caps off a year of hard work from the team. 

Petri dishes
Public engagement activity shows person next to sign that reads "I want a future where antibiotics are..."

Establishing global partnerships 

The production of penicillin was only made possible due to a shared vision between scientists, governments, philanthropists and industry from across the world. If we are to solve the problem of AMR, we must be similarly ambitious and bring these groups together once again. We are therefore seeking to establish and mobilise the global strategic partnerships and collaborations needed to make the Fleming vision a reality. 

The Fleming Initiative is focused around enhancing what already exists. It is uniquely positioned to smooth the transition between research, people and policy through co-location. To this end, we have been fully engaged with government partners since the outset of the project and have received endorsement in the Chancellor's Autumn statement. Working with policymakers, we are identifying the areas in which more collaboration is needed, and where the Fleming Initiative can be most impactful. 

The UN General Assembly and the AMR High Level Meeting scheduled for September 2024 is a unique opportunity to bring antimicrobial resistance into sharp global focus and secure much-needed policy change. In the run up to these events, we will be looking to maximise our reach to keep AMR and the Fleming Initiative at the forefront of the global agenda to keep antibiotics working for the next 100 years. 

The team: Ara Darzi, Rachel Davies, Eleanor Vale, Kate Grailey, Peter Howitt, Amish Acharya, Simon Dryden, Jack Cooper, Anna Lawrence-Jones