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25th November 2019
Perspectives on AMR from The Bloomsbury SET in World Antibiotic Awareness Week

Antimicrobial Resistance (AMR) is considered one of the biggest threats to global health, food security and development today, says the World Health Organization (WHO). This year, World Antibiotic Awareness Week happened during 18th to 24th November and the annual campaign aims to increase awareness of the topic and encourage best practice amongst members of the public, health professionals and policy makers.

Attending the ‘Funding Landscape for AMR Research’ event at the London School of Hygiene and Tropical Medicine at the end of October, we heard about a new report[1] produced by UK Collaborative on Development Research (UKCDR) that provides a comprehensive picture of UK’s investment in this area.  The report shows that UK funders have committed £464.4m for research for the period of 2016-2022. This funding supports more than 25 strategic initiatives. In January, the UK Government also published its 20-year vision for AMR[2] and a 5-year action plan[3]. All this information is helping us to understand how the UK and co-funded international development initiatives are responding to global AMR agendas and defining research priorities.  These cover all pathogens developing antimicrobial resistance including bacteria, viruses, fungi and parasites. To date the main focus has been on bacterial diseases which have received significantly more funding than antiparasitic or antifungal resistance research.

At Bloomsbury SET, researchers are addressing the fight against infectious diseases in human and animal health. Most of the studies focus on specific diseases looking to develop more effective diagnostic tools to support early-detection and surveillance; the development of new vaccines; and better mathematical models to monitor and prevent epidemics, and support evidence-informed decision-making for infectious disease control. But one particular project goes further and looks at the potential role of wildlife in antimicrobial resistance and ecosystem contamination. The team led by Professor Ayona Silva-Fletcher, aims to empower public health practitioners and policymakers in Sri Lanka to better meet the challenges of its growing AMR problem. In South East Asia wastewater from hospitals, livestock, poultry, aquaculture, and human dwellings is often released, without any treatment, into the environment. The project is exploring the extent of AMR incidence in humans, livestock, selected wildlife, soil and water in the environment in three different areas: one with a high density of poultry farms, one with a high density of aquaculture sites and one from a remote area with no large-scale commercial livestock farms. These sites will be compared to evaluate ecosystem contamination.

A further interesting aspect of this project is to use Citizen Science to collect data and use such engagement to increase awareness of AMR amongst the local population. Related to this, last week, we attended the ‘Crowdsourcing Biomedical Research’ symposium at the Francis Crick Institute. This event showcased a series of projects showing how researchers are using innovative approaches for data collection and analysis through recruiting large numbers of volunteers via the Zooniverse platform[4]. Examples involved using the ‘crowd’ to help  analyse biological structures by  electron microscopy and segmentation; comparing the genetic sequence of TB infection samples to detect  changes in the genome that causes resistance to antibiotics; and to observe the behaviour of mice in a novel home-cage system   to increase  the welfare of the animals and the quality of information collected. Combined with advances in machine learning algorithms, human-computer colorations are helping academics to speed up the time for data analysis time with the potential of new identification of ‘unknown unknowns’. In addition, the projects are fostering lifelong science engagement and supporting efforts to raise scientific literacy amongst the population. For those interested in similar approaches, Zooniverse offers the possibility to create a citizen science project for free and present it as one of their official projects on the platform.

So, at this point in time, there are many aspects of tackling AMR that need raised awareness of the general public right through to health professionals and policy makers, and here are a couple of initiatives tackling both ends of this spectrum.

Dr Adelia de Paula

[1] UKCDR (2019) Antimicrobial Resistance in International Development – UK Research Funding Landscape
[2] DHSC (2019) Contained and controlled: the UK’s 20-year vision for antimicrobial resistance
[3] DHSC (2019) Tackling antimicrobial resistance 2019 to 2024: the UK’s 5-year national action plan
[4] Zooniverse is the world’s largest and most popular platform for people-powered research, resulting in new discoveries, datasets useful to the wider research community, and many publications.