BactiTrack

BactiTrack is a digital solution that builds an integrated data platform for real-time antimicrobial resistance mapping. By having clinics, labs and hospitals upload antibiotic susceptibility data to visualize resistance trends spatially, BactiTrack empowers coordinated interventions and resource allocation to fight emerging threats.

Grace Samson is the Team Lead for BactiTrack. As CEO and founder of BactiTrac, she spearheads the development and deployment of the integrated digital platform to map antimicrobial resistance.

Antimicrobial resistance is a major problem in Tanzania, on the African continent, and globally. 

In Tanzania, over 50% of common bacterial infections are already resistant to first-line antibiotics recommended by the WHO. Without effective interventions, resistance is projected to cause over 162,000 excess deaths in Tanzania annually by 2050. 

Across Africa, AMR directly or indirectly causes over 123,000 deaths each year. By 2050, drug-resistant diseases could collectively claim over 10 million lives and inflict a severe economic burden of over $100 billion annually on African countries. 

Globally, at least 4.95 million deaths are associated with antimicrobial resistance each year. 1.27 million of these deaths are directly attributable to resistance to antibiotics recommended by the WHO as first- or second-choice treatments. If left unchecked, antimicrobial resistance will cause 10 million annual deaths worldwide by 2050 at a total cumulative economic cost of $100 trillion.

The unguided overuse and misuse of antibiotics in humans, agriculture, and the environment have accelerated this crisis by enabling survival and spread of resistant bacteria. In Tanzania and across Africa, lack of coordinated surveillance and real-time data on resistance trends undermines timely, targeted responses. 

BactiTrack's primary target audience includes three key groups in Tanzania:

1) Approximately 3,000 healthcare facilities performing antibiotic susceptibility testing such as clinics, hospitals and laboratories. By providing a simple platform to publicly report resistance data, BactiTrack seeks to strengthen these facilities' participation in coordinated surveillance efforts. 

2) The Ministry of Health's Disease Control department and regional medical officers, who are responsible for antimicrobial stewardship and outbreak response programs across Tanzania. By generating actionable insights from crowdsourced resistance data, BactiTrack aims to support these policymakers' efforts to allocate limited healthcare resources effectively.

3) Ultimately, the over 40 million citizens of Tanzania who are put at risk by the spread of drug-resistant infections. 

To understand these stakeholders' needs, BactiTrack's team conducted in-person workshops with 30 facilities which revealed that centralized data sharing is hindered by limited digital infrastructure. Targeted surveys of 200 clinicians also uncovered a strong interest in mobile apps and interactive dashboards to guide treatment decisions. 

BactiTrack will continue engaging these groups to refine its tools and ensure the solution addresses thechallenges faced on-ground. Regular feedback will be central to BactiTrack's development as it works to strengthen Tanzania's health security through open resistance mapping.

The key public good that BactiTrack aims to provide is open-access, actionable knowledge to strengthen collective action against antimicrobial resistance:

1) Open data platform: BactiTrack's openly accessible web dashboard and API allow any user globally to access its unique real-time antimicrobial resistance maps and analytics. This resolves data sharing barriers that currently hamper coordinated surveillance and response. 

2) Knowledge resources: Regular reports and research papers analysing trends from BactiTrack's integrated dataset will be publicly available. These novel AMR epidemiological insights can empower policy planning, optimization of treatment guidelines, and development of new diagnostic tools. 

3) Surveillance network: By mobilizing decentralized contributors across Tanzania, BactiTrack helps build broader local capacity and global partnerships for non-commercial public health cooperation against global threats like drug-resistant infections.  

4) Precision response: Tools that enable more timely, precision targeting of limited infection control resources according to changing resistance patterns ensure resources can have the most impact to safeguard community health security worldwide. By sharing evidence openly, BactiTrack is designed to help all communities benefit from solutions.

BactiTrack is organized as a social enterprise with the explicit aim to strengthen collective action through open provision of knowledge and resources as global public goods.

BactiTrack aims to create tangible impact through improving antimicrobial treatment efficacy and public health outcomes in Tanzania in the following ways:

Activities: 
- Enroll 1500+ healthcare facilities to contribute AMR test data via mobile app
- Implement analytic models to process 500,000+ annual tests and identify resistance hotspots

Outputs:  
- Openly accessible online maps and alerts of emerging hotspots within 4-6 weeks
- Knowledge resources like reports and guidelines based on integrated data insights

Outcomes:
- More effective empiric treatment for the 5 million annual patient visits served by enrolled facilities  
- Successful management of an estimated 20,000+ cases annually that may otherwise see treatment failure due to detection delays
- Strengthened stewardship and outbreak response nationally as authorities target resources to hotspots identified by BactiTrack within critical windows

Target population impact: 
- Improved health outcomes and reduced AMR spread for Tanzania's 40 million citizens
- Underserved communities gaining representation through rural clinic participation 

Evidence:
Pilot research validating BactiTrack's crowdmapping approach against retrospective resistance data from 500+ patients (attached). A 2020 study also showed Tanzanian CHWs successfully reported 700,000+ cases via a similar mobile network.

By enabling timely, targeted response, BactiTrack aims to curb AMR's public health impacts at scale.

Over the next year, BactiTrack aims to complete the following scaling activities:

1) Pilot program testing the full integrated platform at 5 medical facilities capturing antibiotic susceptibility data for a minimum of 1,000 patient visits. This will validate surveillance timeliness, usability of tools and generate early impact metrics. 

2) Onboard an additional 100 facilities and integrate their data, increasing coverage to 15% of Tanzania's estimated 2 million annual AST cases. 

3) Release version 1.0 of the open data platform with 6 months of resistance maps and analytical reports to support outbreak preparedness planning.

Over the next 3 years, BactiTrack seeks to achieve national transformation through:

1) Enrolling 1500+ total facilities representing 500,000+ datapoints annually, over 25% national coverage.

2) Scaling analytics to automatically detect 75% of hotspots within 2 weeks to guide precise policy responses. 

3) Advancing integrated models incorporating genomic data for enhanced tracking of transmission dynamics.

4) Establishing BactiTrack as Tanzania's primary AMR decision support system, signified by full integration within national action plans and clinical guidelines. 

5) Expanding the platform globally through open-source sharing and partnerships to strengthen global surveillance capacity worldwide.

BactiTrack will measure success against these key indicators:

1. Healthcare facilities enrolled: Target is 1500 facilities representing 25% of national AMR testing within 3 years. Pilot enrolled 5 facilities as a starting proof of concept. 

2. Surveillance coverage: Proportion of estimated national antibiotic susceptibility testing volume captured via the platform. Target is 500,000/2,000,000 tests annually in 3 years. 

3. Timeliness of hotspot detection: Within pilot phase, 80% of emerging hotspots were identified within average 4 weeks versus 12 weeks normally. Target is 75% detected within 2 weeks nationally.

4. Treatment outcomes: Proportion of patients with positive clinical outcomes among those treated in hotspots post-alert. Pilot saw 95% success; target is 90% minimum. 

5. Stakeholder feedback: Regular semi-structured surveys of partners will track increasing acceptance and integration of BactiTrack intelligence into guidelines and planning over time. 

BactiTrack's performance management dashboard systematically tracks these and other metrics monthly. Biannual impact reviews involving health experts will evaluate progress towards targets and guide strategy refinements. By rigorously measuring enrolment, timeliness, acceptance and health outcomes, BactiTrack aims for continuous improvement delivering on its coordinated response goals.

There are several barriers that could potentially limit BactiTrack's ability to accomplish its goals in the next year and three years. However, BactiTrack has plans to proactively overcome these barriers:

Infrastructure:  
Barrier: Reliable network/power connectivity needed to realize full potential of mobile data collection across rural Tanzania.
Plan: Offline storage mode keeps app functional even with intermittent connectivity; pursue partnerships for infrastructure enhancement.

Adoption:   
Barrier: Limited digital familiarity could hinder user onboarding at some facilities in year 1.    
Plan: Leverage partners like TFDA for endorsements; deploy field agents for training/support during initial rollout.

Funding:
Barrier: Substantial upfront capital required for tech development, marketing and operations buildout.  
Plan: Pursue impact investment, government grants. Pilot proven model to attract donor funding. Cost-saving design using open-source tools.

Data Quality:
Barrier: Ensuring methodical, representative participation across diverse settings.     
Plan: Feedback loops and incentive programs for continued stakeholder engagement; establish data use/sharing agreements.

Policy:
Barrier: National guidelines/reimbursement frameworks may not yet incentivize involvement.
Plan: Strategic advocacy and demonstrate impact/cost benefits through pilot to gain high-level buy-in over time.

We are motivated to apply for The Trinity Challenge for several key reasons:

First, the goals of this funding initiative closely match our objective of improving AMR monitoring and containment in Tanzania. By bolstering nationwide digital surveillance, our solution seeks to curb the spread of drug-resistant infections. 

Second, the financial award would allow us to actualize plans and undertake activities vital for tackling AMR, but which are currently constrained due to limited resources. These include expanding our technical platform, enhancing community outreach, and conducting analytical research. 

Third, joining The Trinity Challenge network provides access to invaluable expertise, partnerships and visibility that can help propel our work further. The mentorship program stands to offer strategic guidance facilitating long-term impact and sustainability. 

Lastly, participation in accelerator activities presents opportunities to refine our approach based on stakeholder feedback, gain operational experience implementing at scale, and build a track record attracting future investors or institutional collaboration. 

We believe this initiative represents a valuable opportunity to not only fund but foster our efforts through collaborative learning and relationship-building - enabling us to more robustly address AMR surveillance challenges within Tanzania.

Here are a few organizations I would like to collaborate with to help advance solutions to antimicrobial resistance through the Trinity Challenge:

- Wellcome: As the anchor funder of the Challenge, Wellcome would provide invaluable support through funding, mentorship, networking opportunities, and help scaling successful solutions. Their expertise in global health research would help strengthen our proposals. 

- Ineos Oxford Institute for Antimicrobial Research: As a leading research institution focused on developing new antibiotics, the IOI could provide scientific and technical guidance to validate our solutions. Collaboration would help accelerate translation into real-world applications. 

- Bill & Melinda Gates Foundation: As one of the largest global health philanthropies, BMGF could connect us to on-the-ground implementers and communities in low-income countries most impacted by AMR. Their extensive networks and partnerships would be crucial for field testing and deployment.