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Tackling antimicrobial resistance in low- and middle-income countries

Background

There is growing awareness of the global threat related to antimicrobial resistance (AMR), and the magnitude of the problem is increasingly recognised at an international level. Indeed, if we do not find solutions to slow down the rise of AMR immediately, we could expect over 10 million deaths per year and a cumulative 100 trillion USD of economic output at risk by 2050, due to the rise of drug resistant infections. A major issue we are facing globally is that AMR is impeding the management of tuberculosis (TB) – a treatable disease that kills more people annually than any other infectious disease at present. There is currently no treatment regime available that does not contain a drug with known TB drug resistance – hence new TB drugs and validated drug combinations are urgently required. Secondly, large amounts of unnecessary antimicrobials are employed at the human–animal interface in agri- and aquaculture and are disseminated into the environment including water systems. Evidence needs to be generated for both AMR surveillance and response measures – to inform regulatory bodies for setting minimum standards for treatment and release of waste to reduce environmental pollution immediately.

Objective

The two main objectives of the proposed collaborative work are: i) to strengthen the efforts relating to the robust evaluation of new diagnostics and drug candidates for treating diseases with AMR problems (e.g. clinical trials); and ii) to promote surveillance and response mechanisms to AMR with an emphasis on low- and middle-income countries (e.g. monitoring and detection of environmental, human and veterinary sources for AMR).

Expected Benefits

  • In partner countries: This project will strengthen the development of improved health care through establishing AMR-targeted diagnostic platforms and evaluating new drug treatment strategies. If inexpensive and accurate diagnostics are available – ideally supporting clinical decision pathways and the correct use of drug combinations – a substantial reduction of AMR in diseases like TB can be achieved. We will perform robust validation of novel diagnostic approaches for TB and new TB drugs to improve case diagnosis, promote early adequate treatment, and inform on treatment failure – to reduce TB morbidity, mortality, and importantly decrease circulating drug-resistant strains. We will establish cohort studies, clinical trials and a surveillance platform - coupled with regular interaction between clinical researchers and pharmaceutical teams as the backbone for tackling AMR in LMICs.
  • In Switzerland: Developing and evaluating diagnostics and new drug candidates is expensive and requires close dialog between clinicians, researchers and pharmacologists with the industry. The benefits of academia teaming up with industry in Switzerland - via partnerships between the public and private sectors - in the battle against TB could be enormous. In this project we will support the development of improved diagnostics and drugs relating to predominant AMR issues by applying new technologies and liaising with experts in the field. An iterative approach of laboratory development with subsequent clinical evaluation will advance inter-sectoral working processes and mutual learning to produce clinically relevant tools to tackle AMR - these products will then undergo validation in target countries.

Contact Information

Daniel Paris, , phone: +41 61 284 81 11

Swiss Tropical and Public Health Institute, Basel

Tackling antimicrobial resistance in low- and middle-income countries
Tackling antimicrobial resistance in low- and middle-income countries

Partner countries: Burkina Faso, Côte d’Ivoire, Ethiopia, Ghana, Mozambique, Nigeria, Tanzania

Research Partners: Various Swiss research institutions (e.g. Agroscope, CDE, eawag, EPFL, ETHZ, IFIK, HAFL, HUG, Labor Spiez and Swiss TPH), as well as key stakeholders from the public and private sector (DNDi). In the project partner countries, long-standing research partner institutions will be associated.

Cost: CHF 40 Mio.

Duration: 4 years