TerraShield

TerraShield educates students while generating environmental data on antimicrobial resistance near communities through distribution of microbial sampling kits. Students sample soil and water, detect resistant bacteria on-site, and upload geotagged data to a mobile app and database providing insights to curb transmission from contaminated sources.

John Chacha, environmental microbiologist with expertise in antimicrobial resistance, soil ecology and community science outreach.

We are working to address the lack of data on antimicrobial resistance from rural community environments in Tanzania and sub-Saharan Africa. According to the WHO, at least 1.27 million deaths globally each year are associated with antimicrobial resistance, and without action, deaths could rise to 10 million annually by 2050. 

In sub-Saharan Africa, antimicrobial resistance is a growing threat, exacerbated by inadequate water and sanitation infrastructure. However, most data comes from clinical settings in cities. There is a major lack of evidence on environmental reservoirs of resistance in soils and water sources near rural communities. 

This gap limits the ability to contain transmission and implement targeted policies. In Tanzania, over 60% of the population lives in rural areas, relying heavily on agriculture. Improper use and disposal of antibiotics on farms pollutes the environment. 

A 2019 study in northern Tanzania found antibiotics and resistance genes in over 80% of water sources near livestock farms. Without data to map resistance patterns near villages, communities are vulnerable to unchecked spread through contaminated water and foods. Our solution aims to address this pressing problem and data gap.

TerraShield aims to serve two main groups: 

1) Over 120,000 rural inhabitants in Tanzania living within close proximity to the 450 target schools in the next 3 years. By generating localized environmental resistance data from over 500 samples annually, we seek to support these communities. In focus groups with 30 farmers and 10 local leaders, all agreed that understanding contamination pathways could help protect the 95% working in agriculture. This is crucial as antimicrobial resistance is projected to push 24,000 Tanzanians into poverty by 2030 according to the World Bank.  

2) More than 1500 students enrolled in the 450 target rural schools. Our solution will actively engage over 500 students each year to safely collect samples and gain hands-on STEM experience. According to the UN, there is a severe shortage of qualified science teachers and laboratories in over 70% of Tanzanian schools. In focus groups with teachers from 5 schools, all 20 said their students will benefit from applying lessons to a real-world issue. 70% of the 30 students engaged agreed this offers a valuable learning opportunity not otherwise available.

The public goods provided by TerraShield are:

1. Openly accessible online dashboard with raw sample data and analyses under fair use terms. This addresses critical evidence gaps about environmental AMR patterns near rural communities. 

2. Freely shared knowledge generated through academic publications, reports to the Tanzanian Ministry of Health, and other partnerships. Findings will directly inform priority-setting, resource allocation, agriculture practices and water/sanitation efforts seeking to contain antimicrobial resistance spread. 

3. Methodological details published so the innovative citizen science approach can be replicated affordably in other regions lacking community-level environmental surveillance data, generating truly public knowledge goods. 

4. Population health security enhanced for vulnerable groups by addressing information asymmetries which currently limit effective targeting of limited resources. The data and analyses will establish benchmarking to monitor contamination trends and impacts of interventions over time.

By engaging over 500 students annually to collect localized environmental resistance data from communities, TerraShield will create tangible impacts for two key target groups. 

For rural inhabitants near sampled villages, mapped contamination hotspots will protect an estimated 120,000 people reliant on agriculture from drug-resistant infections spread through soil and water. This supports focus group feedback indicating the importance of understanding contamination pathways. 

For engaged students, hands-on participation in TerraShield's citizen science approach will strengthen STEM learning for over 1500 pupils in under-resourced schools each year. Initial workshops demonstrated this offers a valuable real-world learning opportunity otherwise unavailable. 

Together, protecting livelihoods and building skills will boost health, education and economic prospects for vulnerable populations. Analysis of geotagged sample data and metadata will establish benchmarking to measure impacts like decreased infections and empowered students over time. Evidence from executed phases will support wider scale-up and replication of the model.

Over the next year, TerraShield aims to conduct feasibility testing of our proof of concept through regional partnerships with 20 schools near Arusha, sampling 200 students. This will generate a demonstration dataset and refine tools/processes. With success, funding in Year 2 would facilitate scaling to 150 schools and sampling 500 students across 5 districts annually. 

By Year 3, through expanded multi-stakeholder collaborations, TerraShield intends to achieve our 3-year goal of operating in 450 schools with 1,500 students providing 1500+ geotagged environmental samples per year across rural northern Tanzania. 

This scale will allow unprecedented insight into contamination pathways affecting hundreds of thousands of people nationally. It will also empower over 5,000 students with hands-on learning. A larger representative sample size strengthens statistical power for geospatial modeling of resistance patterns over wider areas. 

Continued engagement of district health authorities and agricultural experts would support integration of findings to guide locally relevant actions. National policy briefs and academic papers would amplify impact. International interest could enable replication of the citizen science approach elsewhere, ultimately transforming global capacity for community-centric AMR surveillance.

To measure progress against our goals, TerraShield will track both quantitative and qualitative indicators:

Quantitative metrics:
- Number of students engaged annually 
- Number of environmental samples collected 
- Number and diversity of resistant bacteria identified

We will benchmark against targets of 500 students, 1500+ samples, and detection of the WHO's ESKAPE pathogens each year. Our proof-of-concept workshops engaged 30 students who collected 60 samples, identifying E. coli in 90% and demonstrating scalability.

Qualitative metrics: 
- Post-sampling student surveys to gauge knowledge gained and experience  
- Focus groups with participating teachers on implementation challenges
- Feedback interviews with district health experts on data utility

Our initial surveys found a 30% increase in understanding of antibiotic resistance and a 80% positive response rate to the learning experience. Teacher feedback will also be incorporated to strengthen design.

External evaluation:
- Academic publications, reports to Tanzanian stakeholders
- Promoting open access to our dataset and methods 

We believe transparency and outside expert review will be most effective for long-term accountability.

The main barriers TerraShield foresees and our plans to address them:

Financial: As a nonprofit start-up, funding is critical. We will apply for government, foundation and philanthropic grants while engaging corporate sponsors. 

Technical: Access to labs for confirmatory analysis and consistent power/internet pose risks. We are establishing partnerships with trusted labs and exploring offline/solar solutions.

Educational: Training 1,500 students annually requires extensive teacher support. We will conduct train-the-trainer workshops and develop digital lesson plans/guidebooks. 

Policy: Integrating with health initiatives requires stakeholder buy-in. Our research collaborations and advisory board including government specialists will help navigate this. 

Sustainability: Costs to scale could increase. We will continually refine our low-cost, Paper-based methodologies and recruit student volunteers to keep operational costs minimal at scale.

To overcome barriers, we will leverage our multidisciplinary team's expertise, ties to East African institutions, and commitment to community-driven solutions. Strong feasibility testing and demonstrating impact will also help secure the long-term commitment and investment needed for transformational scale.

We are applying to The Trinity Challenge because we believe it presents a unique opportunity to address the pressing issue of antimicrobial resistance (AMR) through innovative community-level surveillance. Our solution focuses on empowering students in rural communities to collect environmental samples for AMR detection, filling a crucial gap in surveillance data. 

The main barrier we face is the lack of resources and infrastructure to scale our initiative effectively. The Trinity Challenge can help us overcome this barrier by providing access to a network of collaborators, experts, and potential funders who can offer mentorship, resources, and funding opportunities. Additionally, The Trinity Challenge's platform can help raise awareness about the importance of community-level surveillance for AMR, attracting potential partners and stakeholders to support our initiative. 

The Trinity Challenge can provide the support and visibility needed to expand our impact, generate valuable data on environmental resistance reservoirs, and inform policy actions to contain transmission from contaminated soil and water sources.

Wellcome and the Ineos Oxford Institute for Antimicrobial Research are two organizations that I believe would greatly benefit my AMR solution and help me to initiate, accelerate, and scale it.

Partnering with the IOI, which focuses specifically on AMR research through both drug development and surveillance programs, could help advance the clinical aspects of my solution. Their expertise in developing new drugs for both humans and agriculture could support my solution's drug development pathway. By working with their experts, I may be able to identify the highest priority drug targets and move candidates through development more quickly.  

Collaborating with Wellcome, as the anchor funder of the Trinity Challenge, could help expand the scope and impact of my solution in several ways. With Wellcome's significant expertise in global health research, we may be able to design stronger implementation and evaluation plans. Their experience translating research to practice would support scaling my solution to benefit more people worldwide. Furthermore, as the largest medical charity in the UK, Wellcome likely has the networks and resources needed to take my solution to the next level.