Novel Approaches to Characterizing and Tracking the Global Burden of Antimicrobial Resistance (Round 16)

The Opportunity

Increasingly, antimicrobial resistance (AMR) and drug resistant infections are being recognized as a crosscutting threat to global health. High rates of resistant infections have been documented in healthcare and community settings, in all WHO regions, and for a broad range of microorganisms. The increasing prevalence and geographic distribution of AMR threatens to undermine decades of progress in effective prevention and control of high-priority infectious diseases; these include multidrug-resistant TB, artemisinin resistance in malaria, and antibiotic resistance in the most common bacterial agents causing pneumonia, diarrheal disease, neonatal sepsis, enteric fever, sexually transmitted diseases, maternal infections, and other syndromic infections. A reliable evidence base that accurately describes and characterizes the global burden of AMR will be essential to addressing this challenge and will inform global and national priority setting, public health actions, and treatment decisions.

The Challenge

Despite the increasing global focus, considerable gaps remain in our understanding of AMR. There is an unmet need in the generation and dissemination of high-quality evidence describing the impact of resistant organisms on specific populations (e.g. children, newborns, and mothers), health outcomes (morbidity and mortality), costs, and target geographies. The relative impact of specific resistant pathogens is also poorly understood. Each of these gaps in evidence negatively impacts the community’s ability to fully understand the extent (incidence, prevalence), distribution (across geographies, specific populations, and settings), and diversity (across pathogens and populations) of AMR, and appropriately develop and prioritize interventions.

AMR is a complex problem with multiple interconnected drivers. A multipronged approach to evidence generation will be necessary to fully address knowledge gaps and effectively understand and control emerging resistance. A necessary first step will include strengthening surveillance capabilities and identifying novel methods to document and track burden, understand transmission, and describe the relative health impact of possible interventions.

What We Are Looking For:

We are soliciting innovative ideas for tools, technologies, models, analytics, surveillance platforms, and other approaches to generate evidence about the burden and impact of antimicrobial resistance and improve its translation into practice.

Specifically, we seek proposals that support the following:

1. Accelerating the generation of robust evidence to characterize and track the epidemiologic and economic burden of AMR
2. Understanding and describing the epidemiology of resistance and transmission of AMR
3. Evaluating and prioritizing the impact of existing and novel interventions on resistance patterns

We are particularly seeking approaches which identify and fill knowledge and practice gaps currently limiting progress in AMR surveillance and epidemiology. We will consider a wide variety of approaches, as outlined below, provided a case can be made for how the approach will facilitate and support the generation of evidence that will improve our ability to document and track the burden of AMR, and use the resulting data to inform policy making, prioritization, and action.

Proposals must i) have a testable hypothesis, ii) include an associated plan for how the idea will be tested or validated, and iii) yield interpretable and unambiguous data in Phase I in order to be considered for Phase II funding. Proposals and associated outputs must be directly relevant to developing countries.

A few examples of work that would be considered for funding:

• Innovative technology and surveillance platforms capable of accelerating the generation of robust evidence to document and track the burden of AMR. Specifically, we seek approaches that can provide detailed information about the extent (incidence, prevalence), distribution (across geographies, specific populations, and settings), and diversity (across pathogens and populations) of resistance.
• Methods to improve surveillance capacity and reporting of AMR beyond enhanced routine surveillance and targeted surveys (e.g. the application of genomics and machine learning).
• New approaches to analytic and/or epidemiologic modeling which accurately capture and quantify the contribution of AMR to global burden of disease, and the impact of resistant infections on health outcomes and costs.
• New metrics and analytic approaches (e.g. composite indexes) to describe and define the burden of AMR.
• Integrated approaches to understanding and describing the association between resistance patterns, anti-microbial use, access, and health and economic burden.

We will not consider funding for:

• Proposals without a clear application to surveillance or facilitating the development of new evidence describing the global burden of AMR.
• Applications proposing basic research not focused on in-scope work.
• Ideas not directly relevant to developing countries.
• Proposals focused on developing new targets, therapeutics, or interventions to treat or control resistant infections.
• Genomic and other laboratory-based approaches that lack a clear application to AMR surveillance and/or epidemiology .
• Proposals involving clinical trials in human volunteers or patients (note: use of existing datasets or other outputs from clinical trials may be considered, so long as the proposed approach is feasible within the time and financial envelopes provided).
• Ideas that provide only incremental improvements to conventional solutions (e.g. small improvements in surveillance, improving access to existing tools or technologies).