ROHIC

The time is now to make major monitoring of antimicrobial resistance as a pillar of the healthcare system. By painting a clearer picture of antmicrobial resistance in Rwanda, we will use technology to understand and predict the future. 

Our team leader is Iradukunda Hyppolyte. He is the president and co-founder of ROHIC (Rwanda One Health and Innovation Club). He is a research enthusiast and One Health advocate. 

Many studies have shown that the global annual cost of antimicrobial resistance (AMR) could range from $300 billion to over $1 trillion by 2050. This is because treating patients with resistant infections may not be effective, resulting in longer hospital stays, more intensive care units (ICUs), and isolation beds than other patients in order to stop the infection from spreading (Dadgostar, 2019). The majority of antimicrobial classes used to treat bacterial infections in humans are also used to treat animals (zoonotic diseases). The spread of resistant species within the animal, human, and environmental sectors is one of the factors influencing antimicrobial resistance; for this reason, One Health was established in order to coordinate efforts in order to achieve the greatest results for humans, domestic animals, wildlife, plants, and the environment with attempts such as policy intervention, surveillance, stewardship, infection control, sanitation, and animal husbandry (McEwen and Collignon, 2018). 

In Rwanda, challenges such as limited resources, inadequate surveillance systems, and inappropriate antibiotic use exacerbate the AMR problem. To address these challenges and promote coordinated efforts, we focus on the "One Health" approach, emphasizing the interconnection of human and animal health within ecosystems (“Antimicrobial resistance: One Health approach,” n.d.)

ROHIC is designed to serve the Rwandan population, especially the communities with households and in the practice of agriculture. The National Institute of Statistics of Rwanda estimates that 10.5 million of the country's 13.15 million inhabitants lived in agricultural families as of 2020. This correlates with the community they live in where their children are usually the first generation to go to school and their income is middle- or low income. These are the ones who are prescribed the tablets without passing a diagnostic test, reuse the last antibiotics they have, and are the gateway to preventing the spread between humans, animals, and the environment. 

ROHIC Data is here for them and to ensure that antimicrobial resistance is not going to disrupt their lives but become a story of caution that they tell one another. 

ROHIC was started so that as future healthcare providers we are aware of what can disrupt the healing and prognosis of patients. In our implementation, we hope to implement our plan to collect data and information from the people. This will be done through surveillance, and research that will help us understand the way people understand antimicrobial resistance and the most common bacteria causing it.

After the end of our research, our team will then work on ensuring that this data can be used to start the campaign and organization. It is safe to say that although the national action plan exists, the country's institutions are not yet implementing it. With this data, the collaboration with government institutions is very assured. We will progress with the dissemination of the information so that the people can understand the threat at hand. Through our campaign, we will ensure that the areas given attention are the ones with big knowledge gaps and have had the most resistance, so they can change behavior and give attention to their use of medicine which can affect the way people use medicine to enhance production and or treatment in Rwanda.

We are a results-focused entity, and there is no better impact than to change the community we are part of. We will start with research that will span the people who are living in the community. Afterwards, we will have two well-designed papers, a course, and a mobile application. 

These are results that are going to be aimed at understanding the existence and impact of antimicrobials in our community so we can make the right call. The solutions will not rely on a global scale but on a socially appropriate and homegrown solution for the Rwandan people that can be taken as a formula for low and middle-income communities all over the globe. 

Our long plan can not be implemented in our year but a 3yeear-long tenure.  We will start by building a strong foundation for our plan by going into the community, understanding the situation, and gathering data for future purposes. We will collect data directly from the individuals who represent the whole population, not the health facilities like hospitals and likewise places. Our first year will end with data that will help share a clear image of the situation. 

The second year will be focused on the implementation of our idea by involving more stakeholders that can help clear confusion and also collect data for future purposes. Lastly, we will scale up to collect vast amounts of data and try to reach out to institutions in charge of policy, curriculum, and the health of the people to use our data and solutions.

We have clear and objective goals that can be used to clearly used as the measurement metric for our success as listed below:

Collect qualitative data that analyzes input from the people used as a sample. Use the personal details, demographics, status, and responses that will be input into a model for analysis. The minimum acceptable number of desired participants is 500 individuals

Implement a mass identification, but establish sites in common places that will collect biological samples that will be analyzed for specific data.

Building and running a course and app that will use the models to analyze the data that is input for every individual that goes to the community healthcare workers.

Publishing our findings and pursuing a policy change to raise awareness of the most alarming findings.

These are main metrics for our success so we can ensure that ROHIC has successful contributed through the Trinity Challenge

Our main foreseen limitations and challenges include budget constraints, difficulties in reaching all communities, technical difficulties, the need to address cultural and linguistic diversity, and resistance to behavioral change. This is because of the size of the data we aim to collect and the lack of appropriate grammar and vocabulary to address the issue in our communities. 

Other risks associated include the potential for misinformation and stigmatization (excessive fear about AMR without providing constructive guidance on prevention and treatment), which could lead to anxiety and the avoidance of healthcare.

Effective management of these risks and overcoming these challenges is essential to ensuring the success of the project by preparing ahead, preparing for cultural conflicts, recruiting technical experts, and pursuing financial contributions.

The Trinity Challenge is a chance for us to not only get the support to implement our plan but also to generate the data that will help our country. The Trinity Challenge is oriented toward collecting data from the community rather than emphasizing the health institutions ability to collect data that will reflect the country’s problems. 

In addition, Trinity Challenge is funded on innovation, which is one of our pillars as to ensure that we can use innovative approaches and unconventional methods to achieve our goal

INCATE 

WHO-Africa

Africa CDC

UNICEF