World Antibiotic Awareness Week at AIGHD

Day 1- AMR: what is it and why is it so pressing? We introduce SoNAR-Global

Antimicrobial resistance (AMR) occurs when microorganisms like bacteria, viruses, fungi, and parasites change in ways that render ineffective the drugs used to cure infections. In other words, medicines become less effective, making infections harder, and sometimes impossible, to treat. Because of increased exposure to antimicrobials – antibiotics, antimalarials etc. – AMR has serious impacts on our ability to treat infectious diseases – in humans and animals. Experts suggest that if we do not address the emergence and spread of AMR, we will be faced with a global health crisis with commonly used drugs left useless.

On day 1 of AMR awareness week, we stress the urgent need to address this issue through education and communication. AIGHD researchers involved in the SoNAR-Global project have been very active in this area. Together with SoNAR partners and through consulting other experts in the field, researchers at AIGHD have developed an open-access curriculum on the social dimensions of AMR.

Aimed at students and social scientists with little background in AMR, the curriculum serves as a resource for educators to convey the many social drivers and implications of AMR. Intended as a five-day training course, it draws on insights from public health, political science, economics, sociology, and anthropology.

The curriculum is free to use and can be found here:

Day 2- AMR & covid-19: we need surveillance and monitoring, introducing MAGIcIAN

The world’s antibiotic arsenal is declining in size due to the decreasing effectiveness of these drugs. The current pandemic is only making the problem worse as the world looks away from AMR and prioritizes covid-19. However, by treating covid-19 patients with antibiotics, resistance to antibiotics is increasing.

What will we do when antibiotics no longer work? Our health will be at stake as currently curable bacterial infections will become uncurable due to AMR. While low-income countries are disproportionally burdened by infectious diseases, the magnitude of clinical AMR in these countries is largely unknown since structural surveillance is expensive in terms of direct costs, human resources, and infrastructure. This is where the MAGIcIAN project comes into play. MAGIcIAN aims to support prioritization of surveillance efforts in low-income countries, by filling the gaps in the global map of clinical AMR using state-of-the-art data science and machine learning algorithms that link socioeconomic and demographic status of individual countries to their levels of AMR.

Day 3- Resistant E. Coli and potentially untreatable infections in the future? Introducing HECTOR

Antimicrobial resistance is one of the key research priorities of AIGHD. It, therefore, comes as no surprise that many of our projects are directly focused on combatting the rising AMR threat. On day 3 of AMR awareness week, we discuss our research contribution to understanding the spread of the Escherichia coli bacterium (E. coli), a common bacterium able to become resistant to antimicrobials and able to cause diarrhea, urinary tract infections or bloodstream infections.

To better understand the transmission of resistant E. coli between humans and animals, the HECTOR project was introduced. Within this project, AIGHD researchers are studying the specific bacterial characteristics that allow E. coli to efficiently spread antimicrobial resistance between humans and animals. Because E. coli is becoming increasingly resistant to antimicrobials, its associated infections are becoming more difficult to treat.

Imagine diarrhea becoming untreatable because it is caused by a resistant E. coli: HECTOR aims to prevent that scenario of becoming a reality. Gaining deeper insights into the mechanism of transmission is key to eventually containing the rapid development of resistance and adapting treatments to prevent further spread of this common bacterium, a major contributor of AMR.

Day 4- Improper use of medicine contributes to AMR: what is at stake in the Fake?

AMR is partially caused by antibiotics losing their efficacy. Timing, dosage, and quality are crucial when taking medicines to fight infections. In the context of AMR awareness week, we focus on the impacts of substandard and falsified (SF) medicines worldwide on the AMR scene.

Monitoring medicine quality is highly country dependent as it relies on governance, regulations, capacity to enforce policies, certification procedures and infrastructures for determining whether pharmaceuticals meet standards. Deterioration can occur unintentionally or intentionally along the distribution chain when a medicine travels from its manufacturer to the hands of the patients. In the FAKE project at AIGHD, we aim to observe how people understand and ascertain the quality of medicines and their explanations as to why poor-quality medicines might have lost effectiveness.

Assumptions and suspicions around drug quality are spreading in the world of medicines, and the FAKE project tries to understand these suspicions and the effects thereof. SF Medicines can contribute to AMR directly because of their reduced efficacy. Furthermore, in settings where AMR is increasing, people are confronted with medicines that work sub-optimally. Since the necessary infrastructure for determining AMR is often lacking in these settings, faltering antimicrobials could trigger suspicion or mistrust, and propel people to use alternate treatments. This can contribute to AMR. It essentially comes down to an issue of trust; “can we trust in the people we trust (the ones who give us the medicine)?”

Day 5- How a vaccine impacts AMR: the ROTA-biotic project

In Low- and Middle-income countries (LMIC), childhood vaccinations have the potential to reduce the burden of AMR. At AIGHD, Dr. Vanessa Harris is leading the collaborative ROTA-biotic project that aims to measure the impact of a new rotavirus vaccine on antibiotic use in children.  Rotavirus is the leading cause of diarrhea-related death in children worldwide, annually killing thousands of children under five years of age. In LMIC, antibiotics are often administered to children with diarrhoea and rotavirus infection, despite having no therapeutic benefit because antibiotics do not treat viruses. Antibiotic usage is also the major driver of antimicrobial resistance.  The ROTA-biotic project aims to evaluate if effective vaccines against rotavirus diarrhoea can reduce antibiotic use and thereby decrease AMR in young children in LMIC.

The results of the ongoing ROTA-biotic project will inform our understanding of vaccines, possibly showing that they are effective not only in preventing diseases but also in preventing unnecessary antibiotic usage in children. The ROTA-biotic project will support policymakers by providing data on the impact of vaccination programs on antibiotic usage and the broader impact vaccination has on delaying the pace of AMR.