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The project aims to assess the value of integrated surveillance systems for AMU and AMR in the UK from a One Health (OH) perspective.

Challenge

Antimicrobial resistance (AMR) is a global health threat with major economic implications. Bacteria carrying resistance genes can be transmitted between humans, animals and the environment. Therefore, an integrated surveillance programme for AMR and antimicrobial use (AMU) needs to take into consideration the various routes of AMR transmission. Several integrated surveillance strategies exist globally but their effectiveness and economic efficiency are rarely evaluated systematically. This project aims to address this gap and assess the value of integrated surveillance systems for AMU and AMR in the UK from a One Health (OH) perspective.

The objectives are:

1. To conduct a document review to characterise and map the surveillance system for AMR and AMU in the UK
2. To conduct a literature review of existing frameworks for the evaluation of AMR and AMU surveillance from a OH perspective and select and adapt relevant evaluation approaches
3. To apply selected methodologies for the evaluation of integrated surveillance system for AMR and AMU in the U
4. To identify a case study and conduct an economic evaluation to measure the added value of integrated surveillance
5. To analyse the overall findings and provide recommendations for decision makers

Solution

To achieve the objectives of the study, firstly, a systematic literature review was conducted to identify the frameworks and methodologies that are available for the evaluation of integrated AMR surveillance systems. A framework consisting of a logic model with five evaluation levels was selected and adapted as the basis for the evaluation of AMU and AMR surveillance in the UK and used to define data collection protocols. Secondly, a document review was conducted to characterize and map the surveillance system for AMU and AMR in the UK as preparation for the evaluation. Following this, a qualitative study using semi-structured interviews was conducted to collect information on cross-sectoral collaborations on AMU and AMR surveillance to populate the evaluation framework. The links between the different outputs generated by OH surveillance activities and the expected outcomes and how this might impact decision making were explored. Finally, an economic analysis would be conducted to evaluate the costs and benefits impacts of a OH approach to AM/AMR surveillance using a case study.

Impact

The results would allow to understand the wider benefits of integrated surveillance for AMU/AMR in the UK and provide insights on how the system could be improved and efficiency increased and promote better health for all.  This topic is of growing importance globally, and our results would contribute to this new and dynamic field of research on OH evaluation. In addition, the knowledge produced would be valuable for evaluators in other countries who are planning to conduct evaluations of their surveillance systems. The need for better evidence on the value of OH surveillance for AMU/AMR has been underlined by policy makers.

Partners

This project is funded by a Studentship 

Publications/Presentations