DOSA - Diagnostics for One Health and User Driven Solutions for AMR

Microbial pathogens resistance to antibiotics is a major challenge to societies around the globe. Microbes are becoming resistant to antibiotics rapidly to due to variety human action i.e., unnecessary prescription in healthcare, blanket prescription in agriculture and careless release of antibiotics into the environment. Lack of appropriate diagnostic methods is one of the major reasons for in appropriate and overuse of antibiotics. In this project, led by the University of Edinburgh and the IIT Delhi, researchers from India and UK with background in social sciences, technology innovation, and experts in different community settings come together to jointly address this issue. They plan to study current practices, user behaviors, social and economic reasons behind antibiotic consumption in India. Based on a user mapping study, they plan to formulate target product profiles i.e., specification of the diagnostic test for three communities setting. They aim to develop/validate rapid diagnostic assays for three different community settings i.e., urinary tract infections in human health, mastitis (infection of cows' udder) in dairy sector and antibiotics residue detection in water from the environment. Currently, due to lack of appropriate diagnostic technologies, doctors are prescribing broad spectrum antibiotics empirically (i.e. in a trial and error fashion) and farmers are using huge quantities of antibiotics in agriculture and fish farming without appropriate guidance and monitoring. Development of these diagnostic methods will help to reduce the unnecessary consumption, blind prescription and release of antibiotics. An improved diagnostic solution built into health/agriculture and environment settings will help to treat patients effectively and reduce mortality; will help agriculture farmers to get a better economic return for their produce and will reduce resistant transmission. This study brings together an interdisciplinary and international team to learn and support each other towards development of solutions to the global anti-microbial resistance challenge.

The DOSA project aims to develop diagnostic solutions for antimicrobial resistance (AMR) which is one of biggest threats to global health in an interdisciplinary collaboration of research groups from UK and India. DOSA stands for 'Diagnostics for One Health and User Driven Solutions for AMR' referring to the approach to inform diagnostics development through user engagement rather than a technology push and the three sectors DOSA will be operating in India: human health, veterinary health and the environment. Here, DOSA will gather the user needs for rapid diagnostics directly from the people who are in need for tools to make better decisions of using antibiotics and offer better services and products. These user requirements will critically inform the diagnostic developments carried out in the project.

DOSA is focussing on three indications: urinary tract infections as prime example for infections of humans, mastitis as infection of cows, and antibiotic residues in water (and products) from aquacultures. Today, antibiotic use is conventionally done empirically in the chosen sectors and indications, and rapid diagnostic tools are unavailable because they are too expensive, not fit for purpose or don't exist because developers cannot overcome technical hurdles or do no know the user needs. Antibiotic users simply have no other choice than using antibiotics in a trial and error fashion.

We have identified six beneficiary groups 1.) Primary healthcare stakeholders (e.g. clinicians, nurses, hospital management staff and patients); 2.) Dairy farmers, veterinary practitioners, animal husbandry and industry associations; 3.) Aquaculture specialists; 4.) Educationalists; 5.) Local government and policy makers; 6.) Technology experts and developers. In primary healthcare, beneficiaries will have new tools (new diagnostics and instructions to use them, training material) which will enable them to offer better services. These groups will be reached through dissemination activities including publications, conferences and finally the product releases. In a similar way, dairy, fish farmers and their affiliated stakeholders will be reached and benefit from equivalent tools to offer better services and products with positive impact on their animals health, productivity and environment they are operating in. The educational sector will strongly benefit from the user requirements and service design outputs. These set precedence for diagnostics development and implementation as well as successful interdisciplinary research. This sector together with the technology experts and diagnostic innovators will be directly engaged through the DOSA consortium through dissemination and direct collaboration. Here, DOSA offers a unique chance to impact on sustainable development through the fight against AMR by educating the next generation of innovators and providing them with the means to take their ideas forward for further amplified impact. For this, DOSA partners are globally active in networks promoting knowledge exchange and teaching and training. These networks and activities will also help to inform policy makers about new developments in the area of rapid diagnostics to tackle antimicrobial resistance. Finally, and most importantly, the general public will benefit from better services, less harmful animal products and improved quality of life. In summary, the direct immediate outputs of DOSA will be user requirement specifications and service designs for three community settings in India and three performance tested diagnostic prototypes together with a strong network of innovators and researchers trained in advanced service design approaches and cutting edge technologies. These outputs will contribute to the long-term fight against antimicrobial resistance and sustainable development in India and beyond.