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EU action against antimicrobial resistance: EDCTP’s contribution

15 November 2017

Antimicrobial resistance and improper use of antibiotics are a potential global threat to healthcare. During the European Antibiotic Awareness Week 13-19 November 2017, many parties involved seek to widen public knowledge of this threat and the actions that are needed.

This year, the European Commission published its new European One Health Action Plan against Antimicrobial Resistance (AMR). One of the key objectives is to boost research, development and innovation by closing current knowledge gaps, providing novel solutions and tools to prevent and treat infectious diseases, and improve diagnosis in order to control the spread of AMR.

“Antimicrobial resistance poses a growing threat to public health in sub-Saharan Africa where many people remain vulnerable to HIV, tuberculosis and malaria. EDCTP responds to this threat by investing in research for better diagnostics and treatments, and in laboratory capacities to provide essential data.”

Prof. Moses Bockarie, EDCTP Director of South-South Cooperation and Head of Africa Office

EDCTP's contribution

EDCTP contributed to controlling the spread of AMR throughout its first programme (2003-2014), and continues to do so under its second programme (2014-2024), by providing support for projects which:

  • strengthen laboratory capacity;
  • support and improve processes in the drug regulatory environment;
  • strengthen capacity for pharmacovigilance; and
  • support the establishment of collaborative research groups working on drug resistance.

 

EDCTP prioritises research efforts to identify diagnostics and appropriate treatment for poverty-related infectious diseases affecting sub-Saharan Africa, including strains of pathogens which are drug resistant. Efforts to support pharmacovigilance capacity are also made in view of the need for more knowledge on AMR through surveillance in affected countries. As suggested by experts in the January 2017 report of the Uppsala Monitoring Centre, pharmacovigilance tools can play an important role in tackling AMR.

In the first years of the second EDCTP programme (EDCTP2) several projects with a specific focus on antimicrobial resistance have been funded. These projects can be found via the public portal of the EDCTP grants management system and include:

HIV
Children with HIV in Africa – pharmacokinetics and acceptability of simple antiretroviral regimens (CHAPAS-4). Project coordinator: Dr Mutsa Bwakura-Dangarembizi.
TRIA2015-1078

Low frequent HIV drug resistant polymorphisms in infants born to HIV seropositive mothers: implications on response to therapy (HIVDR). Senior Fellow: Dr Immaculate Nankya.
TMA2015SF-1037

Evaluation of treatment response, drug resistance and HIV-1 variability among adolescents on first- and second-line antiretroviral therapy in Cameroon: The READY-Study. Career Development Fellow: Dr Joseph Fokam.
TMA2015CDF-1027

Tuberculosis
Culture free diagnosis and follow-up of multidrug resistant tuberculosis patients (DIAMA). Project coordinator: Dr Dissou Affolabi.
DRIA2014-326

Novel biomarkers predictive of susceptibility and treatment response in patients with MDR-TB (DTB). Senior Fellow: Prof. Keertan Dheda.
TMA2015SF-1043

Optimising linezolid use for drug-resistant tuberculosis in South Africa: the effects of linezolid exposure on toxicity, treatment response, and linezolid resistance (Linezolid for DR-TB in South Africa). Career Development Fellow: Dr Sean Wasserman.
TMA2015CDF-1018

Biomarker profile predicting unsuccessful treatment response in patients with MDR-TB (BTR-TB). Career Development Fellow: Dr Ali Esmail.
TMA2015CDF-1052

Malaria
IPTp with dihydroartemisinin-piperaquine and azithromycin for malaria, sexually transmitted and reproductive tract infections in pregnancy in high sulphadoxine-pyrimethamine resistance areas in Kenya, Malawi, and Tanzania (IMPROVE). Prof. Feiko ter Kuile.
TRIA2015-1076

IPTp with dihydroartemisinin-piperaquine and azithromycin for malaria, sexually transmitted and reproductive tract infections in HIV-infected pregnancy in Kenya and Malawi: a multicentre 3-arm placebo-controlled trial (IMPROVE-2). Prof. Feiko ter Kuile.
TRIA2015-1076b

Determinants and prevalence of parasite resistance among pregnant women receiving Intermittent Preventive Treatment with Sulphadoxine-Pyrimethamine (IPTp-SP) in a malaria endemic community (IPTp-SP resistance in Nigeria) (Career Development Fellow: Dr Atinuke Olaleye.
TMA2015CDF-973

EDCTP-supported research networks

EDCTP regional Networks of Excellence have also conducted important work within the AMR sphere; for example, WANETAM established laboratory capacity and provided essential data on the extent of drug resistant tuberculosis in eight West African countries (Burkina Faso, The Gambia, Ghana, Guinea-Bissau, Mali, Nigeria, Senegal and Togo).

In 2016, EDCTP called for proposals which aimed to support the establishment of multidisciplinary consortia able to provide accelerated evidence for the optimal clinical management of patients and for guiding the public health response to any severe infectious outbreak caused by pathogens within the scope of the EDCTP programme with pandemic potential or that may cause significant damage to health and socio-economics in Africa (including antimicrobial-resistant pathogens). The awardees are expected to have an impact on research capacity preparedness, and design of optimal prevention and clinical management strategies. Two networks have been identified through this call and the grant agreements are expected to be signed soon.

More on antimicrobial resistance

Antimicrobials are chemical compounds designed to kill or inhibit the growth of disease-causing pathogens. These compounds have become increasingly ineffective due to resistance developed by the targeted bacteria, viruses, protozoa or fungi. When microbes are exposed to antimicrobial compounds, they are subjected to a selection pressure which kills susceptible organisms, leaving behind a population of resistant individuals. Microbes become resistant by mutation or by transfer of resistance genes from other already resistant microbes. Pathogens can also develop resistance to multiple agents, and as a result, very hard to control multi-drug resistant infections emerge and spread.

  • The European Antibiotic Awareness Day falls every year on 18 November. (Dedicated Twitter account: @EAAD_EU; hashtags on Twitter: #EAAD; #AntibioticResistance; #AntimicrobialResistance; #KeepAntibioticsWorking; #AMR)
  • European Commission AMR factsheet AMR: a major European and Global challenge.
  • Dedicated Twitter account: @EAAD_EU
  • Hashtags on Twitter: #EAAD; #AntibioticResistance; #AntimicrobialResistance; #KeepAntibioticsWorking; #AMR

Upsala Reports Covering the world of pharmacovigilance, Issue 74, January 2017

Interview with Prof. Feiko ter Kuile, coordinator of the IMPROVE projects (see above), on malaria drug resistance and malaria in pregnancy (in Horizon: the EU Research & Innovation Magazine).

WHO Global Action Plan to tackle antimicrobial resistance

UN High-level meeting on antimicrobial resistance

World Bank report Drug Infections: a threat to our economic future