One Health in Action: Combatting AMR through Data in Malawi

Our solution empowers Malawian communities to combat AMR using data and analytics. By implementing comprehensive surveillance, targeted education, and strengthening healthcare systems, we aim to reduce the impact of  AMR. This One Health approach fosters community engagement, supports responsible antibiotic use, and contributes to global AMR mitigation efforts

The principal investigator is Dr. Thoko Kapalamula. He is a researcher at Malawi Liverpool Wellcome Trust based in Blantyre, Malawi

The specific problem we aim to address is the escalating threat of AMR in Malawian local communities. In Malawi, the impact of AMR is not precisely known, but it could be significant due to factors such as limited access to quality healthcare, inadequate surveillance, improper antibiotic use, and limited public awareness. The scale of the problem is substantial, affecting millions of individuals and placing a strain on healthcare systems.

Globally, the challenge of AMR is severe, with an estimated 4.95 million deaths annually associated with AMR. This toll is projected to increase to 10 million by 2050 if unchecked. The causes of the problem include overuse and misuse of antibiotics, lack of surveillance, and inadequate regulation of antibiotic supply chains. Our solution addresses these causes by implementing comprehensive surveillance to monitor antibiotic usage, bacterial infections, and resistance patterns. It also focuses on targeted education to improve community understanding of responsible antibiotic use and the consequences of AMR. Strengthening healthcare systems is a key component, ensuring regulated antibiotic supply chains and monitoring prescription practices. By addressing these causes, our solution aims to mitigate the impact of infections and contribute to the global effort to combat AMR.

The solution addresses the challenge of AMR in Malawi by serving diverse stakeholders, including healthcare providers, the general population, regulatory bodies, and the global health community. It supports healthcare providers through a surveillance system, providing real-time data for informed decision-making. The general community benefits from targeted educational campaigns, empowering individuals to make responsible healthcare choices. Regulatory bodies gain strengthened healthcare systems and guidelines to enforce proper practices. Global collaboration contributes to the international fight against AMR. To understand the needs of these groups, the solution employs feedback mechanisms, community surveys, collaborations, and participation in global forums. When developing this solution, we are engaging stakeholders through consultations, to ensure an inclusive tailored and effective approach throughout the solution's development.

Our solution provides significant public goods by addressing AMR in Malawi and globally. It enhances health and well-being by improving surveillance systems and healthcare practices. Through educational campaigns and community engagement, it empowers local communities to understand and combat AMR, promoting responsible antibiotic use. The solution actively contributes to global health security by participating in international collaboration efforts, sharing crucial information, best practices, and resources. Additionally, it enforces policies related to antibiotic prescriptions and supply chain management, preventing overuse and misuse. The emphasis on advanced data manipulation ensures informed, data-driven decision-making, and ultimately, the solution works to safeguard the effectiveness of antibiotics for current and future generations.

Our solution is poised to create tangible impact by improving health outcomes, empowering communities through education, preventing antibiotic misuse, fostering global collaboration, influencing policy and regulatory enforcement, and contributing to long-term health security. The beneficiaries span individuals in Malawi, local communities, and the global population grappling with the challenges ofAMR. Through comprehensive surveillance systems, advanced data manipulation, and community engagement, our solution seeks to directly address the root causes of AMR, ensuring responsible antibiotic use and preserving the efficacy of these crucial medications for the well-being of present and future generations.

Over the next year, the plan is to expand the pilot project to additional communities within the Lilongwe district, intensify community outreach efforts, analyze and refine data collected during the pilot phase, strengthen stakeholder collaboration, and continuously optimize the technological components of the solution. In the next three years, the focus will shift to regional expansion, national integration into healthcare systems, capacity building for local healthcare providers, global collaboration, advocacy for responsible antibiotic use policies, continuous innovation, and robust monitoring and evaluation. This strategic roadmap aims to systematically scale the impact of the solution, addressing AMR challenges locally in Malawi and contributing to the global fight against AMR.

Our plan for monitoring and evaluating impact is multi-faceted, encompassing specific, measurable indicators across various dimensions of our solution. Key indicators include the reduction in antibiotic-resistant infections, increased community awareness and engagement, adherence to responsible antibiotic use guidelines, effectiveness of policy enforcement, impact of global collaboration, technological optimization, geographical expansion, success in capacity building, advocacy influence on policies, adoption of innovation, and the establishment of a robust monitoring and evaluation system.

Performance from the pilot phase serves as a baseline for comparison against these indicators. Regular assessments, surveys, data analysis, and stakeholder feedback contribute to ongoing improvements and adaptations. This comprehensive approach ensures a holistic evaluation of our solution's progress and impact, fostering continuous enhancement and alignment with our overarching goals.

Examples 

1. Reduction in antibiotic-resistant infections:

   • Indicator: Decrease in reported cases of antibiotic-resistant infections.
   • Methodology: Compare pre-implementation infection rates with post-implementation rates, analyzing healthcare data.

2. Community awareness and engagement:

   • Indicator: Increase in community awareness and active engagement.
   • Methodology: Conduct pre- and post-implementation surveys, focus group discussions, and track community participation in health initiatives.

3. Geographical expansion:

   • Indicator: Increased coverage in additional communities and regions.
   • Methodology: Monitor the geographical expansion of the solution, assessing reach and impact in new areas.

1. Limited resources:

   • Barrier: Insufficient funding and resources for expanding the pilot and outreach efforts.
   • Strategy: Seek additional funding through grants, partnerships, and fundraising initiatives. Optimize resource allocation through cost-effective strategies.

2. Limited healthcare infrastructure:

   • Barrier: Inadequate healthcare infrastructure in some target communities.
   • Strategy: Collaborate with local healthcare providers, leverage mobile health clinics, and advocate for infrastructure improvements through partnerships with relevant authorities.

Next 3 Years:

1. Scale-up complexity:

   • Barrier: Scaling up operations to a national level poses logistical and operational challenges.
   • Strategy: Develop a phased scaling plan, leverage technology for efficiency, and establish partnerships with organizations experienced in large-scale healthcare initiatives.

2. Resistance to policy changes:

   • Barrier: Resistance to policy changes related to antibiotic use and healthcare practices.
   • Strategy: Conduct targeted advocacy campaigns, engage with policymakers, and showcase the positive impact of policy changes through data and case studies.

3. Community sustainability:

   • Barrier: Ensuring the sustainability of community engagement initiatives over the long term.
   • Strategy: Empower local community leaders, integrate community members into decision-making processes, and develop programs that encourage self-sufficiency.

Our participation in The Trinity Challenge is motivated by the pressing global issue of AMR. Specifically focusing on Malawi, our solution faces barriers related to limited resources for scaling, the need for global collaboration, policy advocacy and implementation, technology and data integration, and community engagement and education. The Trinity Challenge can assist by providing financial support for scaling, fostering global collaboration, supporting policy advocacy efforts, offering technological resources, and sharing insights on effective community engagement strategies. The collaborative nature of The Trinity Challenge aligns with our vision of creating a comprehensive and globally connected approach to combat AMR.

We seek collaboration with organizations such as the World Health Organization (WHO), International Telecommunication Union (ITU), The Global Fund, Bill & Melinda Gates Foundation, local and international NGOs, tech companies, and academic institutions. These collaborations will provide expertise in global health, technology, policy advocacy, and community engagement. The aim is to accelerate the impact of our solution by leveraging diverse perspectives, resources, and mentorship opportunities. The mentorship from The Trinity Challenge collaborators will further guide us in optimizing our approach and addressing challenges effectively.