Presented by Barbara Wieland at the ICARS Meeting, World Bank, Washington, D.C., 26 February 2019

1. The need for solution driven AMR research
– a One Health perspective
Barbara Wieland, Team Leader Herd Health
ICARS meeting at World Bank, Washington DC, 26 February 2019

2. Launched during partner event, 21/22 February in Nairobi
Antimicrobial
Resistance
Hub
www.amr.cgiar.org

3. For more information:
www.amr.cgiar.org

4. AMR in the CGIAR: Activity focus
Partnerships
AM use and
value chains
Transmission
dynamics
Interventions
Enabling
policy
Capacity

5. Role of the CGIAR AMR hub
• Convene stakeholders across disciplines with interest in antimicrobial
resistance research and development
• Provide an enabling environment for research partnerships, intensify
collaboration within CGIAR (incl. technological platforms)
• Better communication around agriculture-associated antimicrobial
resistance, esp. across CGIAR
– Communication of hub with a wider audience: maintain website,
regular blogging with links to resources, add case studies
– Virtual seminars
– Communication strategy targeting different stakeholders
– Translating evidence into public messages
• Set aside seed money to initiate projects/partnerships
• Outline strategy to engage with donors shape agenda
• Stakeholder mapping and capacity development needs

6. Antimicrobial use, behaviour and value chains
We research behaviour around antimicrobials used, the distribution networks of
veterinary drugs, and the role of formal and informal markets in perpetuating
cycles of inequity.
Outputs:
• Metrics for AM use in different systems
• Better understanding of systems
influencing AM use behaviour

7. 15,6
20,6
75,0
0,8
18,5
2,3 0,8
16,114,1
2,4
78,2
0,0 0,0
13,7
0,0
10,0
20,0
30,0
40,0
50,0
60,0
70,0
80,0
90,0
Highland crop-livestock Lowland crop-livestock Low/midland Pastoral
Oxytetracycline Tetracycline (Human preparation)
Sulfonamide Penstrep (Penicillin and aminoglycoside
Procain Penicilin Tylosin (Macrolids)
Proportion of farmers using different
antibiotics in Ethiopia

8. • Use of antibiotics (and other drugs)
across public health and livestock
sectors
• KAP on withdrawal period
• Anthropological research, role of
women
• Work on metrics on antibiotics
 two workshops with vets and public
health researchers
Use of antimicrobials
across species

10. Understanding systems
Example aquaculture in Vietnam

11. AMFORA project, L, Brunton et al. 2018, in prep

12. Understanding systems
Example aquaculture in Vietnam
AMFORA project, L, Brunton et al. 2018, in prep
• System analysis suitable to facilitate
interdisciplinary process
• Resulted in system maps with all value
chain actors: overlay of input suppliers,
producers, consumers, policy,
environment
• Allowed identification of hotspots for
AMR emergence/selection and hotspots
for human exposure

13. Transmission dynamics, AMR residues
To better understand AMR risks for people, we study the biology,
ecology, and epidemiology of resistant microbes at the animal,
human and environment interface.
Outputs
• adequate study designs for genotyping research
• evidence on the extent of antimicrobial-resistant bacteria and
antimicrobial residues found in livestock, fish, humans, the
environment, water and food
• transmission and genetic mechanisms of resistance in
agriculture and health implications

14. AMR gene transmission in ecosystems
Samples collected in urban, peri-urban and rural eco-niches
 Several thousands of isolates being analyzed
 Phenotyping and genotyping: fill important data gaps on
circulating strains, inform genotype surveillance
 Role of food-system linking animals and humans evident
• Bedside genotyping with
Nanopore technology (so far 10
E. coli strains fully sequenced)
• Close to real time, comparably
cheap, suitable for remote
areas

15. Interventions and incentives
Based on One Health approaches, we design, test and evaluate
interventions and incentives that lead to behavioural change and
reduce agriculture-associated AMR.
Outputs
• Typologies of interventions
• Decision support tools to
identify best-bet interventions
• Gender sensitive interventions
to mange drivers of AM use
• Cost and benefits of
interventions from a One
Health perspective

16. Community conversation as gender
transformative approach
• Successfully piloted for other topics
• division of labour, exposure to zoonoses
• New module on AMR
• Women as caregivers to children and animals need to
play an important role in discussions on AM use

17. Enabling policy environment
We translate evidence into convincing
arguments to engage policymakers and
other stakeholders in the AMR
discussion. Accepted and feasible
policies are key for sustainable solutions
that achieve impact.
Outputs
• Synthesized evidence for policy
makers
• Advocacy materials
• Integrated policy approaches
towards One Health solutions

18. Capacity development
Capacity development is a key enabler on the pathway to impact.
An important area of research is how solutions can be brought to
scale. We capitalize on a network of AMR experts to support
capacity building on researching AMR issues and to facilitate access
to international AMR research for professionals and institutions in
LMICs.
Outputs
• Guidance for scaling of
interventions
• Training, mentorship and
exchange programs
• Training materials

19. Partnerships as critical
factor for success
Ability to excite and convene national
partners in technical, institutional and
policy innovations
Ability to facilitate true One Health
partnerships
-Ability to engage with international
organization for effective linkages
- Adequate human and financial
resources to establish a critical mass of
researchers and partners
AM use and
value chains
Transmission
dynamics
InterventionsEnabling
policy
Capacity
amr.cgiar.org

20. This presentation is licensed for use under the Creative Commons Attribution 4.0 International Licence.
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