Engineering Nature-based Solutions to Tackle Antimicrobial Resistance

A global survey showed that nearly 10 million people could die each year as a result of antimicrobial resistance (AMR) if the situation is left unchanged. The UK is at the forefront of the global fight against AMR and setting the vision to contain and control AMR by 2040. With reference to the World Health Organisation (WHO) AMR action plan, the global AMR surveillance programme is conducted to understand trends, monitor interventions and develop empiric treatment guidelines for AMR. However, in the water sector, this AMR surveillance effort mainly focuses on conventional treatment stages and does not include nature-based solutions (NbS) infrastructures.

Defra's 25-Year Environment Plan, the Water Industry's National Environment Programme, and the Environment Agency 2025 Plan have created a unique opportunity to consider constructed wetlands (CWs) as NbS to deliver wastewater treatment with the provision of environmental and societal co-benefits. All water utilities have deployed their strategies to further promote CWs in sewage works. Therefore, understanding if CW, as an emerging preferred green approach for tertiary treatment in wastewater treatment plants, can act as the final safeguard of natural waters to mitigate such risks while maintaining the contribution of co-benefits is crucial.

The experience and lessons learned from the global AMR action could significantly facilitate the current missing NbS focus area on AMR surveillance. Partner Prof Walsh has worked with the WHO on the AMR surveillance programme and the European Joint Programme with a specific focus on AMR. Her expertise and experience will strengthen this project team with key knowledge of the occurrence, transmission, and removal mechanisms of AMR. The AMR investigation in NbS is recently getting attention but suffers from a lack of international-scale assessment with a limited dataset. Partner Dr Carvalho is working on the EU NATURE project to evaluate AMR removal in different CWs from mainland Europe, and the findings will be shared with this project.

In this project, PI Dr Lyu will conduct the first field survey in the UK to collect evidence from four different applied CWs in England and Wales with the support of two industrial partners (Anglian Water and Welsh Water). Together with available datasets from the literature and the project partners' network, this project will conduct an international comparative study of AMR removal in CWs as NbS for wastewater treatment. Moreover, the team will also assess the undervalued contribution of reactive oxygen species and indicate adaptations of CWs toward promoting rhizosphere-activated free radicals to oxidise AMR. Ultimately, this project aims to establish a unique collaborative partnership between international academics and industrial practitioners, through sharing experiences, discovering knowledge gaps, exploring technology innovation, and supporting evidence-based policymaking, toward developing a resilient wastewater treatment infrastructure based on NbS to mitigate the spread of AMR.