Microbiology is need for the Sustainable Development Goals

Director-General, your excellency the minster of Cuba, your excellency the Ambassador of Thailand, excellencies, colleagues and friends. I am deeply honored to stand here.

I would like to take this opportunity to tell you,

"why Microbiology is needed for the Sustainable Development Goals.”

About twenty-five years ago, I was a young doctor in Thailand. I met one of my patients — a rice farmer I will call Ma-Li (มะลิ). Like most farmers in our region, she worked barefoot in the paddy fields. What she did not know, what I did not know either, not yet, was that the bacteria, named Burkholderia pseudomallei, lived in the soil in tropical countries.

Through a small cut on her foot, it had entered her blood. The disease moved fast. By the time we understood what we were fighting, Mali was gone.

The disease that killed her is melioidosis; a disease of the poor. It strikes farmers, not ministers. We knew that only because the microbiology laboratory could grow the same bacteria from her blood. 

“Without that laboratory, her death would have had no name.
The disease is so neglected that it is not even on the W-H-O’s list of neglected tropical diseases.”
 
Mali's death taught me this.

“A patient who cannot be diagnosed cannot be saved.
A disease that cannot be counted cannot be funded.”

So we began to count. We conducted a research study, obtained and analysed the microbiology results that every Thai public hospital already held.

“We found, in a single year, more than four thousand four hundred cases of melioidosis, and more than one thousand two hundred of them died.”

Every one of those deaths had a positive culture result sitting in a hospital laboratory. We had the microbiology all along. We had simply never reported it.

But a research paper does not change a health system.

“To move a country, the truth has to enter the country's own data system.”

So we worked with a single hospital — Sunpasitthiprasong — to report its real melioidosis deaths into our national notifiable-disease system. That one change took the official national count from about ten deaths a year to one hundred and twelve, and that is the first big step. Today, Thailand has a national action plan for melioidosis, and this taught me that

“Science can reveal the truth, but only service can act on it. We need both.”

Now let me widen the lens, from one country to the world — and to a second, far larger shadow: antimicrobial resistance, or AMR for short.

Bacteria are not responding to the antibiotics we depend on.

Globally, the toll is now three deaths every minute.

On present trends, AMR will kill 39 million people between now and the year 2050.

But here the problem is harder.

In Thailand, the clinical microbiology laboratories are well established, and doctors routinely take blood cultures — we only had to uncover the results.

“But in much of the world — particularly in low and middle-income countries — clinical microbiology laboratories are rare, and doctors tend to give intravenous antibiotics without doing a blood culture.”

So there is little data to unlock; and even when we unlock it, the data does not show the truth — much like the COVID period:

“no testing, no COVID; no bacterial culture, no AMR.”

We have an S-D-G indicator for AMR — the proportion of resistance — but a proportion alone cannot tell what to do tomorrow morning.

So let me ask you — each of you:

“How many people in your country died from AMR last year?
How did you measure that number? 
Did it rise, or fall, from the year before? and why?”
 
If we cannot answer, we cannot act. So we built a tool to change that. A free, open-access automated application called AMASS, now used in hospital after hospital, for both Science and Service.

It empowers any hospital in any low and middle-income country to automatically analyse its own data, and telling them how many patients have AMR infections each year, and how many of them die.

AMASS is connecting microbiologists’ data to pharmacists' data, and is showing how many patients received intravenous antibiotics, yet were never tested for bacterial culture.

“Every one of those untested patients could have an AMR infection we never diagnosed.”
“With AMASS, at the hospital level, they can now act based on their real data.
At the national level, a country can now see the true scale of the problems and the gaps.”

In Thailand, AMASS now runs in every one of our large public hospitals; all one hundred and thirty of them
 
When we honour Dr. Carlos Finlay, we honour a man who insisted against ridicule that an invisible agent, carried by a mosquito, was killing people; and that if we could only see the mechanism, we could break it. He was right. His microbiology saved more lives than any army ever has.

I accept this prize in that same spirit and on behalf of all the microbiologists, healthcare workers, and policymakers across Thailand, who have been fighting melioidosis and AMR with everything they have, when it would have been easier to do the minimum.

So this is my call to you.

To the young scientists — especially the young women, watching from low and middle-income countries far from this hall:  the most important discovery you make may not be a new organism. It may be the stubborn, unglamorous act of uncovering what your community was told does not matter. You may not need a vast budget, a big sample size, or an expensive new technology.

“You can start small, with good research questions and good study designs.”

You can build — or simply use — a method that lets you make the invisible visible.
 
To the policymakers: the next time you visit a rural hospital, do not stop at the wards. Walk into the clinical microbiology laboratory.

Request to see how a patient's blood is cultured, and ask this single question:

“Is every patient who should have a blood culture actually getting one?”

Then do three things.

“One - Fund the clinical microbiology laboratory.

Two - Fund the culture of cultures - making it routine for doctors to take a blood culture from every patient who should have one.

And Three - fund the data systems - that carry microbiology results all the way up to national decisions.”

Twenty-five years ago, a young doctor stood at Ma-Li (มะลิ)'s bedside and could not see what was killing her. Today, that same hospital can culture, identify, and test for drug resistance in all bacteria, far faster and better; In Thailand, we can now count and monitor the total deaths from melioidosis and AMR - systematically and nationwide. That is what microbiology makes possible: not a miracle cure we do not yet have, but the simple, radical act of seeing, understanding, and taking action.  

Microbiology is needed for the Sustainable Development Goals.

Not because it is nice to have, but because the smallest things — bacteria, and the number of deaths they cause — when we refuse to look at them, can undo the largest dreams.

And the science, and the service, of understanding them can help us build those dreams instead.

Thank you very much.
 
Direk Limmathurotsakul at the UNESCO Head Quarters, 2026 Jul 16