AMRADAR: AMR Assessment through Distributed Analysis and Response

AMRADAR empowers communities to combat AMR through a tiered surveillance system. It combines low-barrier community testing with advanced lab analysis, enabling real-time data, targeted interventions, and informed policy decisions, ultimately safeguarding public health from the growing threat of antibiotic resistance.

Olayinka Osuolale is a dedicated researcher with expertise in environmental microbiology and antimicrobial resistance. Passionate about community engagement, Olayinka excels in facilitating inclusive research initiatives in diverse settings.

The scale of the problem on a global level is immense. Antimicrobial resistance poses a significant threat to public health and economic security worldwide. According to the World Health Organization (WHO), an estimated 1.27 million deaths were directly linked to AMR in 2019, with projections indicating a substantial increase if left unaddressed. LMICs bear a disproportionate burden of this crisis due to limited resources, weak healthcare infrastructure, and inadequate surveillance systems.

The specific problem we are addressing revolves around fragmented, resource-intensive, and slow AMR surveillance methods in LMICs. This results in delayed detection of emerging AMR threats and hampers effective implementation of control measures. Insufficient community engagement further restricts data collection and understanding of local AMR dynamics, hindering targeted interventions and community-level awareness efforts.

In LMIC communities, this results in delayed diagnoses and treatments, unnecessary antibiotic overuse, and limited public awareness regarding the risks and responsible use of antibiotics.

AMRADAR seeks to address this problem by:

1. Mitigating resource constraints through cost-effective and user-friendly technology.

2. Empowering communities via training and engagement, fostering local ownership and capacity enhancement.

3. Addressing fragmented data through a centralised dashboard that integrates data from various sources, providing a comprehensive real-time overview of AMR patterns.

AMRADAR is designed to engage a wide array of stakeholders in the battle against AMR and bacterial infections, particularly in LMICs.

Community Members: We empower local communities by incorporating them into AMR surveillance, fostering ownership, and responsibility for public health. Our tiered approach includes community consultations and participatory workshops, ensuring solutions meet local needs. We also plan to recruit and support local volunteers for AMR pathogen testing, enhancing community engagement.

Community Health Workers: These workers are pivotal in our strategy. We provide them with the necessary technology and training to boost their data collection and analysis capabilities concerning AMR and bacterial infections. Supporting these workers with specialised equipment and continuous learning ensures effective surveillance activities.

AMR Specialists: Our program values the expertise of laboratory personnel in analysing community-collected samples. We encourage collaboration and knowledge exchange to uphold scientific standards and contribute meaningful analysis to the surveillance effort.

Health Authorities and Policymakers: We offer real-time data access through a centralised dashboard, enabling informed policy decisions and quick action to address AMR issues. Regular updates and shared insights help these stakeholders implement effective public health interventions.

AMRADAR delivers a set of public goods, contributing significantly to the well-being of communities and global health efforts by generating valuable data, empowering communities, and fostering knowledge sharing.

1. Open-source technology, data and knowledge:

• Real-time AMR data and Knowledge sharing: We contribute valuable open-source AMR data from communities in LMICs, filling crucial gaps in global surveillance efforts. This data will be disseminated and can inform research, policy, and interventions worldwide.

• Open-source technology: We contribute to the development and accessibility of the open-source WaterScope platform, empowering others to leverage its versatile testing capabilities allowing expansion and replication of the project in various resource-limited locations.

2. Community empowerment and engagement:

• Increased awareness: The project educates communities about AMR, fostering responsible antibiotic use and hygiene practices.

• Enhanced local capacity: Community health workers gain valuable skills and knowledge, contributing to long-term health improvements.

3. Enhanced public health services:

• Improved AMR surveillance: Early detection of AMR threats can enable timely public health interventions, preventing outbreaks and safeguarding communities.

• Targeted antibiotic stewardship: Data-driven insights guide efforts to optimise antibiotic use, preserving their effectiveness and combating resistance.

Strengthened healthcare systems: AMRADAR empowers local healthcare systems with vital data and capacity building, improving their responsiveness to AMR challenges.

Our impact model aims for AMR impact reduction through community engagement and data-driven approaches.

Theory of Change Model:

1. Community Empowerment: By involving local communities in the surveillance process, AMRADAR enhances their capability to understand and respond to AMR. This leads to improved health literacy and proactive management of health risks.

2. Strengthened Healthcare Systems: The real-time data provided by AMRADAR supports healthcare systems in making informed decisions and implementing targeted interventions.
   

3. Informed Policy Making and Behavioural Shifts: The data facilitates evidence-based policymaking and encourages behavioural changes at the community and national levels, promoting prudent antibiotic use and adherence to public health guidelines.

Expected Impact for Target Populations:

• For Communities: Enhanced capacity to detect and respond to AMR threats, leading to improved public health outcomes and reduced exposure to drug-resistant infections.

• For Healthcare Systems: Greater efficiency and effectiveness in managing AMR, resulting in better patient care and reduced healthcare costs.

• For Policymakers: Access to reliable data to guide policy decisions, leading to stronger regulatory frameworks and public health strategies.

Evidence of Impact: Pilot studies in Nigeria, South Africa, and Kenya are expected to show enhanced engagement, informed strategies, and reduced antibiotic misuse, aiding in sustainable AMR reduction. 

In the first year, our goal is to launch pilot programs in Nigeria, South Africa, and Kenya to refine our AMRADAR tiered model. These pilots will identify best practices and adapt our approach to local needs, enhancing effectiveness and engagement.

As we collect data feedback from these pilot programs, we will refine our methodologies and tools, focusing on enhancing user-friendliness, increasing accuracy, and ensuring scalability. Establishing local and governmental partnerships will support long-term sustainability of the project.

Based on the outcomes and lessons learned from the initial pilots, we will expand our reach beyond these countries. We will target new regions and communities, particularly those in LMICs that are most affected by antimicrobial resistance. Our expansion strategy will involve adapting the AMRADAR methodology to new contexts, building local capacities, and fostering partnerships with global health organisations.

By systematically scaling our operations and refining our approach based on real-world feedback, we aim to make the AMRADAR tiered methodology a globally recognized framework for monitoring antimicrobial resistance. This will not only increase the geographical footprint of our solution but also amplify its impact by empowering more communities worldwide to detect and respond to AMR threats effectively.

We utilize a mix of quantitative and qualitative indicators to track progress and ensure we are delivering tangible benefits:

1. Community Engagement and Empowerment:

• Number of volunteers trained and actively participating: Pilot data: X volunteers trained in Nigeria, Y actively collecting data in Kenya.

• Knowledge and attitude surveys: We assess changes in community awareness and understanding of AMR through pre- and post-intervention surveys. (Pilot data: Z% increase in knowledge of AMR among participants)

2. Improved AMR Surveillance:

• Timeliness of data collection and reporting: We will measure the speed and efficiency of data flow from communities to central platforms. (Pilot data: Average time for sample collection to data upload: X days)

• Early detection of AMR hotspots: Pilot data: Z hotspots identified; W interventions implemented within X days.

3. Enhanced Healthcare System Capacity:

• Number of healthcare workers trained in AMR management: Pilot data: X healthcare workers trained in Y skills.

• Utilization of data for informed decision-making: Pilot data: W policy changes based on AMRADAR data.

4. Global Knowledge and Impact:

• Number of data downloads and publications:  Pilot data: X data downloads, Y publications citing AMRADAR findings

• Replication and adaptation of the model: Pilot data: Z inquiries received from other countries.

Financial Barriers: Our project faces financial challenges, primarily in securing adequate funding for comprehensive research, development, and scaling activities. To overcome this, we plan to diversify our funding sources by applying for other grants, seeking partnerships, and exploring philanthropic donations.

Technical Barriers: Ensuring the accuracy and reliability of our data collection and analysis is crucial, yet challenging. We plan to address this by instituting stringent quality control protocols and conducting extensive training sessions for all individuals involved in data collection. Collaboration with technical experts and academic institutions will be crucial to refine our methodologies and incorporate the latest technological advancements, ensuring the data's integrity and usefulness.

Logistical Barriers: Dependency on the Western supply chain for necessary consumables and equipment poses risks, including delays and inflated costs. To mitigate this, we are investigating the feasibility of locally manufacturing essential components, which could not only reduce costs and lead times, but also bolster local economies. 

Infrastructure issues in target regions may hinder data collection and interventions. We will address this by leveraging local knowledge and partnering with community organizations, customizing our methods to local needs, and enhancing local skills. Working closely with local stakeholders will help integrate our initiatives seamlessly into communities.

AMRADAR is driven to address the critical challenge of limited AMR surveillance in LMICs and is excited to apply to The Trinity Challenge for several compelling reasons:

1. Alignment with Challenge Objectives:

• AMRADAR's innovative, data-driven approach perfectly aligns with the Challenge's emphasis on new methods and capabilities for collecting and utilising data in LMIC settings.

• We contribute significantly to developing insights and actions for global health emergencies by empowering communities and strengthening healthcare systems.

2. Overcoming Barriers:

• The Challenge's funding and support will be instrumental in overcoming critical barriers we currently face:

  • Scaling up: Expanding our program to reach more communities and maximise impact requires substantial resources.

  • Sustainability: Securing long-term funding is crucial for ensuring the program's continued effectiveness beyond the initial project period.

  • Global advocacy: The Challenge's platform and network will provide invaluable opportunities to amplify our reach and advocate for the adoption of AMRADAR's model in other countries.

3. Collaboration and Knowledge Sharing:

• We value the opportunity to connect with leading experts and organisations participating in The Trinity Challenge. This fosters valuable collaboration, knowledge exchange, and potential partnerships that can further strengthen our project.

We would like to partner with the following three organisations if possible:

1. Ineos Oxford Institute for Antimicrobial Research: For expertise in AMR research to inform our solution's development.

2. Resistomap: For environmental AMR monitoring and data analysis enhancement.

3. Amazon Web Services (AWS): For cloud computing support to enhance our data processing and scalability.

These collaborations will boost our technological, scientific, and analytical capabilities, essential for our solution’s development and global impact against AMR.