Exploring the Frontiers of Innovation to Tackle Microbial Threats Proceedings of a Workshop (2020) / Chapter Skim
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5 Systems Approaches to Spur Innovations in Tackling Antimicrobial Resistance
5 Systems Approaches to Spur Innovations in Tackling Antimicrobial Resistance
Pages 59-78
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From page 59... ...
Christine Kreuder Johnson, professor of epidemiology and ecosystem health, University of California, Davis, shared lessons from the One Health approach used in Kathmandu, Nepal, to enhance animal and human surveillance systems to bolster innovation in AMR. Wes Kim, senior officer, Antibiotic Resistance Project, The Pew Charitable Trusts, discussed the development and implementation of the Shared Platform for Antibiotic Research and Knowledge (SPARK)
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From page 60... ...
Central to the PREDICT project was engaging with communities to perform zoonotic disease surveillance within the community as a discrete epidemiological unit. Johnson presented Figure 5-1, which depicts the temporary settlement community in Kathmandu where PREDICT's surveillance model was used.
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From page 61... ...
The team screened a subset of samples for 88 AMR genes using quantitative polymerase chain reaction, and preliminary findings revealed that 69 of 88 AMR genes were detected in the community. Among the humans sampled, some predictive factors were identified.
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From page 62... ...
The PREDICT team also compared oral versus fecal sample types, she said. AMR genes were more similar in chicken and duck oral samples, while chicken, duck, and human fecal samples were the most similar.
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From page 63... ...
These findings echo the findings of PREDICT in Kathmandu on a much broader scale, Johnson added. Johnson highlighted USAID's vision of tackling pandemic threats and training One Health workforces as a defining moment for countering microbial threats: there are opportunities for success in having human health and animal health coordinated in the field, being sampled and tested together.
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From page 64... ...
The PREDICT project in Kathmandu demonstrated that the PREDICT strategy could be applied to AMR and yield informative findings, she noted. SPARKING ANTIBIOTIC DISCOVERY THROUGH DATA SHARING AND SCIENTIFIC COLLABORATION Wes Kim presented on an innovative avenue for data sharing and scientific collaboration to spur antibiotic discovery.
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From page 65... ...
The SPARK database has already received contributions from industry, including Novartis and Achaogen (The Pew Charitable Trusts, 2018, 2019b,c) , and they are currently in discussions with other pharmaceutical and biotechnology companies that are interested in sharing data.
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From page 66... ...
For instance, one company that has patented compound structures but has not released the biological activity data was comfortable sharing chemical structure data. Pew is working to further mitigate challenges related to intellectual property concerns and make organizations comfortable sharing their data, he added.
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From page 67... ...
INCENTIVIZING NOVEL DIAGNOSTIC TESTS TO COUNTER ANTIBIOTIC RESISTANCE Daniel Berman presented on incentivizing novel diagnostic tests to counter AMR. His organization, Nesta, is an innovation foundation with a focus on implementation rather than the act of innovating; they seek out projects that bring together technology and innovation to address social objectives.
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From page 68... ...
By definition, these types of prizes are designed to be difficult challenges, Berman remarked. Typically, test designers would make trade-offs among these criteria, but the Longitude Prize requires all eight criteria to be met.
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From page 69... ...
He reported that 29 teams were awarded Discovery Awards of £25,000, 3 Longitude Prize teams were awarded boost grants of up to £100,000 by the Biotechnology Industry Research Assistance Council, and three initial investments will be made from a £3 million impact investment fund established by an anonymous donor. Some of the teams from India and the United Kingdom have been hosted by accelerators or incubators.
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From page 70... ...
Based on the antimicrobial investment fund's initial success, scale up could be achieved through G20 or other multilateral institutions, he added. STRENGTHENING SYSTEMS TO OVERCOME BARRIERS TO INNOVATION Jyoti Joshi explored how AMR efforts can be integrated into existing interventions and initiatives, and she discussed strategies to strengthen health systems and overcome market and regulatory barriers to innovation on AMR.
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From page 71... ...
CDDEP supports countries in tackling AMR by helping them to develop national action plans for AMR (NAP-AMR)
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From page 72... ...
As a result, new chemical entities are not entering the market in places where they are most urgently needed. Challenges in Harmonizing Antimicrobial Resistance Efforts AMR control efforts are in different phases of evolution and management worldwide, Joshi noted.
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From page 73... ...
Addressing Regulatory and Systemic Barriers to Foster Antimicrobial Resistance Innovation Joshi discussed some of the regulatory barriers to innovation on AMR. The siloed approach to AMR interventions in human, animal, food, feed, and environmental sectors is a barrier to innovation, she remarked.
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From page 74... ...
Joshi added that funding will also be required to ensure that these systems are integrated, equitable, and sustainable in providing access to antibiotics, facilitating stewardship, and enforcing antibiotic prescription restrictions. She suggested that the AMR lens that is already being used in One Health approaches can also help to ensure that the appropriate balance is struck between access to effective treatment and protection from the overuse of antibiotics that promotes AMR.
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From page 75... ...
The resources being directed into the antibiotic discovery field are diminishing, so there is a growing need to be more efficient with the approach to scientific discovery and to avoid repeating mistakes. In collecting data for SPARK from discontinued programs, Pew hopes to prevent labs from repeating mistakes that have already been made elsewhere.
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From page 76... ...
However, until governments take the initiative, the issues of AMR will continue to go unaddressed, and new antibiotics will be lost to resistance. Espinal highlighted progress in the tripartite agreement among WHO, the Food and Agriculture Organization of the United Nations, and the World Organisation for Animal Health, as well as global and national action plans, but he noted that the action plans must be followed through to implementation to have an impact.
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From page 77... ...
PREDICT's findings have now been packaged around the human activities that potentially increase microbial threats. Obregón remarked that Joshi's recommendations for strengthening health systems did not include a recommendation regarding engaging communities and working around behavioral issues.
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From page 78... ...
78 FRONTIERS OF INNOVATION TO TACKLE MICROBIAL THREATS one-time peak in awareness, like an "antibiotic awareness week." Instead, AMR needs to be incorporated into systematic, routine activities, such as infection prevention and control. She emphasized the importance of messaging around the consumption of antibiotics, which must be uniform across primary health care physicians and specialists.
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