Chicken or the Egg: Is AMR in the Environment Driven by Dissemination of Antibiotics or Antibiotic Resistance Genes?
Lead Research Organisation:
UNIVERSITY OF EXETER
Department Name: Institute of Biomed & Clinical Science
Abstract
Antimicrobial resistance (AMR) in the environment is driven by antibiotics released in the urine of humans and animals into sewage and ultimately the receiving rivers. AMR is also released from within the gut bacteria that are shed in faeces of both humans and animals. In both cases, antibiotics and AMR-containing gut bacteria are released into the environment through sewage. Despite the continued release of both antibiotics and antibiotic-resistant bacteria into our rivers, we still don't know the relative role that they play in explaining the amount of antibiotic resistance that we see in our environment. This is a critically important knowledge gap as it prevents industry and policy makers from determining where to spend our time and resources so as to lower this 'environmental reservoir of antimicrobial resistance'.
Sewage contains thousands of chemicals, many of which are at concentrations sufficient to inhibit or kill bacteria. Microbes defend themselves from these chemicals with a range of strategies, all of which have genes that are broadly classified as 'resistance genes'. Hence, sewage is an excellent place to find bacteria rich in resistance genes. Many of these genes are known to be mobile, which allows for the genes to be shared, thereby increasing its abundance within the environment. This mobility of genes is key to why it is so difficult to know what is driving AMR in the environment-a bit like 'which came first, the chicken or the egg.' Are the concentrations of antibiotics present in sewage sufficiently high to select for resistance genes in the environment or are the genes for resistance simply spreading from the gut-derived bacteria into the native environmental microorganisms? The keys to answering this question lie in the following two questions: 1) Do genes released from sewage move into and persist in the natural microbial community without continued exposure to critical threshold concentrations of antibiotics; and 2) Are the critical threshold concentrations in the environment sufficiently high to maintain gut-derived AMR genes in the natural microbial community or select for them all on their own?
In the proposed research we aim to answer these two key questions using four innovative experimental systems: 1) a small laboratory microfluidic system for the precise control and manipulation of microbial biofilms; 2) an in situ river mesocosm and 3) ex situ macrocosm which can also control and manipulate microbial biofilms under controlled conditions with the addition of antibiotics and/or antibiotic resistance genes; and finally 4) the use of the freshwater shrimp, Gammarus pulex, as an indicator species of environments where the reservoir of antibiotic resistance is elevated. In the case of the Gammarus, we will study the microorganisms that live within this shrimp and determine if these microbes acquire similar antibiotic resistance traits as those found in identically-exposed biofilms. Modern molecular techniques (i.e, metagenomes, plasmid metagenomes, qPCR, meta-transcriptomes), will be used to quantify treatment effects within biofilms and Gammarus. The data from these studies will be used to parameterise a mathematical/statistical model that will be designed for use by regulators, industry and academia to better predict and understand the risks posed by AMR in the environment.
Sewage contains thousands of chemicals, many of which are at concentrations sufficient to inhibit or kill bacteria. Microbes defend themselves from these chemicals with a range of strategies, all of which have genes that are broadly classified as 'resistance genes'. Hence, sewage is an excellent place to find bacteria rich in resistance genes. Many of these genes are known to be mobile, which allows for the genes to be shared, thereby increasing its abundance within the environment. This mobility of genes is key to why it is so difficult to know what is driving AMR in the environment-a bit like 'which came first, the chicken or the egg.' Are the concentrations of antibiotics present in sewage sufficiently high to select for resistance genes in the environment or are the genes for resistance simply spreading from the gut-derived bacteria into the native environmental microorganisms? The keys to answering this question lie in the following two questions: 1) Do genes released from sewage move into and persist in the natural microbial community without continued exposure to critical threshold concentrations of antibiotics; and 2) Are the critical threshold concentrations in the environment sufficiently high to maintain gut-derived AMR genes in the natural microbial community or select for them all on their own?
In the proposed research we aim to answer these two key questions using four innovative experimental systems: 1) a small laboratory microfluidic system for the precise control and manipulation of microbial biofilms; 2) an in situ river mesocosm and 3) ex situ macrocosm which can also control and manipulate microbial biofilms under controlled conditions with the addition of antibiotics and/or antibiotic resistance genes; and finally 4) the use of the freshwater shrimp, Gammarus pulex, as an indicator species of environments where the reservoir of antibiotic resistance is elevated. In the case of the Gammarus, we will study the microorganisms that live within this shrimp and determine if these microbes acquire similar antibiotic resistance traits as those found in identically-exposed biofilms. Modern molecular techniques (i.e, metagenomes, plasmid metagenomes, qPCR, meta-transcriptomes), will be used to quantify treatment effects within biofilms and Gammarus. The data from these studies will be used to parameterise a mathematical/statistical model that will be designed for use by regulators, industry and academia to better predict and understand the risks posed by AMR in the environment.
Planned Impact
This proposal will determine the degree to which antibiotics and antibiotic resistance genes are driving antimicrobial resistance (AMR) within the freshwater environment. There are a range of stakeholders for whom the research outputs could be valuable detailed below.
Regulators
Defra and the Environment Agency require sound science to inform their response to the European Water Framework Directive (WFD) and Urban Waste Water Treatment Directive (91/271/EEC) which has a major influence on the way chemical risks are assessed and chemical control measures might be considered. As described in the scientific case for support, antibiotic resistance gene prevalence could be mediated by antibiotics and antibiotic resistance genes, but to different degrees. Understanding the relative role of these drivers for AMR selection and maintenance in the environment, will help stakeholders and policy makers prioritise the most efficacious solution to minimising the risks to humans. CEH holds regular meetings with Defra Central Evidence group and the EA Evidence group, which represent opportunities for our science to be communicated across the agencies.
Water Industry
The central suggestion of this proposal could reasonably apply to the entire network of sewage treatment plants in the UK and is therefore potentially of great relevance to the Water Industry. If control measures for antibiotics or antibiotic resistance genes were required by the WFD it would be the Water Industry that would have to implement discharge controls to limit this risk (e.g. through enhanced waste water treatment). Thus, evidence from the proposed research will be critical for the industry's risk assessments and response. It may be that the minimum selective concentration for antibiotics are prohibitively low for the solution to lie with the water industry. We are liaising with Tony Griffiths of Southwest Water and Howard Brett of Thames Water, links that will be strengthened during the project.
Public Health
Public Health England are responsible to Government for clearly identifying and reporting on challenges to public health. AMR is a significant issue for PHE as evidenced by their 5 year Antimicrobial Resistance strategy, published in September 2013. Clarification on the potential for human exposure to a wide range of different antimicrobial resistance genes through wide-spread environmental prevalence will be important for their future review of the topic. As part of this project, we aim to engage with PHE, with particular reference to the further development of our statistical model that aims to predict high AMR exposure areas and the implications of our Gammarus 'sentinel' research for rapid monitoring of the environment.
We aim to conduct three seminar/workshops with an open panel discussion about the implications to policy, regulators, academics and industry of our research in light of changing national and international priorities on antibiotic use and regulation. The PI is very active on twitter (>1100 followers) and will use this to engage with the wider scientific community, along with the CEH twitter account. We will post blogs to the CEH website, which will be disseminated via Twitter and Press Releases. Our science outputs will be prepared for publication in high impact, open access journals. Our policy relevant messages will be communicated both through blogs and policy briefings and disseminated to the many relevant stakeholders already identified as well as CEH's wider stakeholder contacts. The PI will draw upon the expertise of the CEH Business Development and Engagement Section for advice on social media, events and workshops, public relations, media activities and science writing.
Regulators
Defra and the Environment Agency require sound science to inform their response to the European Water Framework Directive (WFD) and Urban Waste Water Treatment Directive (91/271/EEC) which has a major influence on the way chemical risks are assessed and chemical control measures might be considered. As described in the scientific case for support, antibiotic resistance gene prevalence could be mediated by antibiotics and antibiotic resistance genes, but to different degrees. Understanding the relative role of these drivers for AMR selection and maintenance in the environment, will help stakeholders and policy makers prioritise the most efficacious solution to minimising the risks to humans. CEH holds regular meetings with Defra Central Evidence group and the EA Evidence group, which represent opportunities for our science to be communicated across the agencies.
Water Industry
The central suggestion of this proposal could reasonably apply to the entire network of sewage treatment plants in the UK and is therefore potentially of great relevance to the Water Industry. If control measures for antibiotics or antibiotic resistance genes were required by the WFD it would be the Water Industry that would have to implement discharge controls to limit this risk (e.g. through enhanced waste water treatment). Thus, evidence from the proposed research will be critical for the industry's risk assessments and response. It may be that the minimum selective concentration for antibiotics are prohibitively low for the solution to lie with the water industry. We are liaising with Tony Griffiths of Southwest Water and Howard Brett of Thames Water, links that will be strengthened during the project.
Public Health
Public Health England are responsible to Government for clearly identifying and reporting on challenges to public health. AMR is a significant issue for PHE as evidenced by their 5 year Antimicrobial Resistance strategy, published in September 2013. Clarification on the potential for human exposure to a wide range of different antimicrobial resistance genes through wide-spread environmental prevalence will be important for their future review of the topic. As part of this project, we aim to engage with PHE, with particular reference to the further development of our statistical model that aims to predict high AMR exposure areas and the implications of our Gammarus 'sentinel' research for rapid monitoring of the environment.
We aim to conduct three seminar/workshops with an open panel discussion about the implications to policy, regulators, academics and industry of our research in light of changing national and international priorities on antibiotic use and regulation. The PI is very active on twitter (>1100 followers) and will use this to engage with the wider scientific community, along with the CEH twitter account. We will post blogs to the CEH website, which will be disseminated via Twitter and Press Releases. Our science outputs will be prepared for publication in high impact, open access journals. Our policy relevant messages will be communicated both through blogs and policy briefings and disseminated to the many relevant stakeholders already identified as well as CEH's wider stakeholder contacts. The PI will draw upon the expertise of the CEH Business Development and Engagement Section for advice on social media, events and workshops, public relations, media activities and science writing.
People |
ORCID iD |
William Gaze (Principal Investigator) |
Publications
Bürgmann H
(2018)
Water and sanitation: an essential battlefront in the war on antimicrobial resistance
in FEMS Microbiology Ecology
Gaze W.H.
(2017)
Antimicrobial Resistance: Investigating the Environmental Dimension.
Gaze, W.H.
(2017)
Have we opened the floodgates on antimicrobial resistance?
Larsson DGJ
(2018)
Critical knowledge gaps and research needs related to the environmental dimensions of antibiotic resistance.
in Environment international
Lear L
(2023)
The effect of metal remediation on the virulence and antimicrobial resistance of the opportunistic pathogen Pseudomonas aeruginosa.
in Evolutionary applications
Manaia C
(2020)
Antibiotic Resistance in the Environment - A Worldwide Overview
Murray AK
(2020)
The 'SELection End points in Communities of bacTeria' (SELECT) Method: A Novel Experimental Assay to Facilitate Risk Assessment of Selection for Antimicrobial Resistance in the Environment.
in Environmental health perspectives
Powell N
(2017)
Developing a local antimicrobial resistance action plan: the Cornwall One Health Antimicrobial Resistance Group.
in The Journal of antimicrobial chemotherapy
Stanton IC
(2020)
Evolution of antibiotic resistance at low antibiotic concentrations including selection below the minimal selective concentration.
in Communications biology
Zhang L
(2019)
Novel clinically relevant antibiotic resistance genes associated with sewage sludge and industrial waste streams revealed by functional metagenomic screening.
in Environment international
Description | Antibiotics tested so far show that selection can occur at the top end of environmental residue concentration range. In addition our laboratory experiments are showing very good predictive ability to what we see in more realistic mesocosm and flume experiments. Further data suggests that changes in temperature, microbial inocculum and nutrient levels do not change selective thresholds for AMR by a large degree. This increases confidence in our model of laboratory experiments to predict selective concentrations of antimicrobials. |
Exploitation Route | Could be incorporated into government / EU policy |
Sectors | Environment Healthcare Government Democracy and Justice Pharmaceuticals and Medical Biotechnology |
Description | They make up part of the evidence base that is informing Defra and EA policy and approaches to environmental AMR surveillance. We are currently finalising writing up research on the effects of temperature and nutrients on selection for AMR in aquatic systems which we hope will make a useful contribution to the field. |
First Year Of Impact | 2020 |
Sector | Chemicals,Environment |
Impact Types | Societal Policy & public services |
Description | ? Participated in Epi-Net meeting Dec 3rd 2021. |
Geographic Reach | Europe |
Policy Influence Type | Membership of a guideline committee |
Impact | Will determine future AMR surveillance policy and practice on Europe |
Description | ? Second consultative meeting in preparation of the report on the environment and health impacts of pesticides and fertilizers (UNEP, WHO, FAO). Geneva, UNEP. 2019. |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Membership of a guideline committee |
Impact | I sit on the WHO/FAO working group on pesticides and fertilizers where the risks of AMR and environment are being discussed in relation to manure based fertilizers and biosolids amendments to agricultural land. |
Description | Acknowledgement in O'Neill Report on ANTIMICROBIALS IN AGRICULTURE AND THE ENVIRONMENT: REDUCING UNNECESSARY USE AND WASTE |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in other policy documents |
Description | Advised European Bank for Reconstruction and Development on AMR |
Geographic Reach | Europe |
Policy Influence Type | Contribution to new or improved professional practice |
Impact | Advised European Bank for Reconstruction and Development on AMR |
Description | Advising Deloitte on evaluation of the UK gov AMR surevillance programme PATH-SAFE |
Geographic Reach | National |
Policy Influence Type | Participation in a guidance/advisory committee |
Impact | Informing national policy |
Description | Co-authored a box in Chief Medical Officers annual report |
Geographic Reach | National |
Policy Influence Type | Citation in other policy documents |
URL | https://www.gov.uk/government/publications/chief-medical-officer-annual-report-2017-health-impacts-o... |
Description | Consulting for DG Sante on AMR policy |
Geographic Reach | Europe |
Policy Influence Type | Contribution to a national consultation/review |
Impact | Informing EU policy |
Description | Informing decision making around the WFD watch list of antibiotics |
Geographic Reach | Europe |
Policy Influence Type | Citation in other policy documents |
Impact | Research has influenced decision making on inclusion of antibiotics on the WFD hazardous compound watch list |
Description | Invited by British Society of Antimicrobial Chemotherapy to contribute to discussion around new AMR National Action Plan. One of a small number of academics to be invited. |
Geographic Reach | National |
Policy Influence Type | Participation in a guidance/advisory committee |
Description | Invited to participate in Surveillance and Epidemiology of Drug Resistant Infections Consortium (SEDRIC) Genomic Surveillance of Antimicrobial Resistance working group workshop lead by Professor Kate Baker, Dr Elita Jauneikaite, Professor Sharon Peacock and Professor Nicholas Feasey. |
Geographic Reach | Europe |
Policy Influence Type | Participation in a guidance/advisory committee |
Impact | NA |
Description | Invited to sit on UK AMR national action plan steering group |
Geographic Reach | National |
Policy Influence Type | Participation in a guidance/advisory committee |
Description | Member of UK AMR NAP Stakeholder group |
Geographic Reach | National |
Policy Influence Type | Participation in a guidance/advisory committee |
Impact | iNFORMING NATIONAL HEALTH POLICY |
Description | Second consultative meeting in preparation of the report on the environment and health impacts of pesticides and fertilizers (UNEP, WHO, FAO). |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Membership of a guideline committee |
Description | Three papers cited in the Download the JPIAMR Strategic Research and Innovation Agenda on Antimicrobial Resistance 2019 |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in other policy documents |
URL | https://www.jpiamr.eu/wp-content/uploads/2019/05/JPIAMR_SRIA_final.pdf |
Description | UNEP Frontiers 2017 report only one of two cited papers/reports on AMR and the environment in Interagency Coordination Group on AMR Final report presented to the UN Secretary general |
Geographic Reach | Multiple continents/international |
Policy Influence Type | Citation in other policy documents |
Impact | This is arguably the most important document on AMR produced by the WHO/FAO/OIE and scientific experts in recent years as it will shape the global response to AMR by the UN/WHO. |
URL | https://www.who.int/antimicrobial-resistance/interagency-coordination-group/en/ |
Description | Mapping the evidence for the risks of human exposure and transmission of AMR in the natural environment |
Amount | £80,590 (GBP) |
Funding ID | NE/S015965/1 |
Organisation | Natural Environment Research Council |
Sector | Public |
Country | United Kingdom |
Start | 01/2019 |
End | 09/2020 |
Description | The environmental dimension of antimicrobial resistance: informing policy, regulation and practice. |
Amount | £72,525 (GBP) |
Funding ID | NE/S006257/1 |
Organisation | Natural Environment Research Council |
Sector | Public |
Country | United Kingdom |
Start | 01/2019 |
End | 12/2021 |
Description | Towards Developing an International Environmental AMR Surveilance Strategy |
Amount | £44,356 (GBP) |
Funding ID | MR/S037713/1 |
Organisation | Medical Research Council (MRC) |
Sector | Public |
Country | United Kingdom |
Start | 01/2019 |
End | 12/2020 |
Description | We are currently involved in five AMR PATH-SAFE contracts in collaboration with UKCEH on three contracts and WSP on one contract |
Amount | £200,000 (GBP) |
Organisation | Environment Agency |
Sector | Public |
Country | United Kingdom |
Start | 08/2022 |
End | 03/2023 |
Description | Working with UKCEH on PATH-SAFE projects |
Organisation | UK Centre for Ecology & Hydrology |
Country | United Kingdom |
Sector | Public |
PI Contribution | We have jointly bid and are delivering three contracts on AMR for the Environment Agency through PATH-SAFE |
Collaborator Contribution | Joint delivery of three contracts |
Impact | Three reports which may lead to publications |
Start Year | 2022 |
Description | ? Attended a Joint Programming Initiative on Antimicrobial Resistance (JPIAMR) workshop in Gothenburg |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | Attended a Joint Programming Initiative on Antimicrobial Resistance (JPIAMR) workshop in Gothenburg in September 2017 to explore and identify critical research needs that relate to the environmental dimensions of AMR, both in the longer term for providing input to an updated JPIAMR Strategic Research Agenda, but also in the shorter term to provide guidance for specific calls. |
Year(s) Of Engagement Activity | 2017 |
URL | https://www.jpiamr.eu/wp-content/uploads/2017/11/Report-_JPIAMR-workshop-on-Environmental-dimensions... |
Description | ? Gaze WH. Co-selection for AMR by quaternary ammonium compounds. Royal Academy of Science. Stockholm. March 2016. |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other audiences |
Results and Impact | Talk at the Royal Academy of Science in Stockholm on AMR in the environment |
Year(s) Of Engagement Activity | 2016 |
Description | ? Gaze WH. The environmental aspects of antibiotic resistance. Learned Societies AMR meeting. June 25th, 2015 London. |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Antimicrobial resistance: environments,evolution and transmission Networking workshops for researchers |
Year(s) Of Engagement Activity | 2015 |
URL | https://www.responsibleantibioticuse.org/#xl_xr_page_index |
Description | ? Gaze WH. The environmental aspects of antibiotic resistance. Learned Societies AMR scoping meeting. Society for Applied Microbiology symposium on AMR, Royal Society of medicine. December 2015. |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Talk to diverse audience on AMR in the environment |
Year(s) Of Engagement Activity | 2015 |
Description | ? Gaze, W.H. Selection for, dissemination of and exposure to antibiotic resistant bacteria in the natural environment. |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Industry/Business |
Results and Impact | 4th International Conference on Responsible Use of Antibiotics in Animals, The Hague, September 2016. |
Year(s) Of Engagement Activity | 2016 |
URL | https://www.responsibleantibioticuse.org/#xl_xr_page_index |
Description | ? Gaze, W.H. Taking action to improve healthcare by addressing the links with environment chemistry. Scotland (NHS), |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Talk to NHS Scotland on AMR in the environment |
Year(s) Of Engagement Activity | 2016 |
Description | ? Invited by MRC to work with Viadynamics to develop an AMR framework to map out research challenges and ways in which we are addressing those challenges. |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Advise RCUK policy on research priorities on AMR |
Year(s) Of Engagement Activity | 2017 |
Description | ? Invited to EA meeting on AMR in waste water to plan EA programme of investigation. March 2017 |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Help inform water industry AMR research programme |
Year(s) Of Engagement Activity | 2017 |
Description | ? NERC Planet Earth article "Have we opened the floodgates on antimicrobial resistance?" Winter 2016/17. |
Form Of Engagement Activity | A magazine, newsletter or online publication |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | ?Article for Planet earth detailing role of flooding and climate change on environmental transmission of Amr |
Year(s) Of Engagement Activity | 2017 |
Description | ? Presented to the APPG on Antibiotics with report generated requestruing AMR be included in the new Environment Bill |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Myself, Aimee Murray and Isobel Stanton gave evidence to the APPG on Antibiotics, highlighting the importance of the environmental dimension of AMR. We presented evidence that should inform the environment bill which is currently at amendment stage. |
Year(s) Of Engagement Activity | 2020 |
Description | Attended AstraZeneca meeting on pharmaceutical contaminants in LMICs in Nairobi |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Industry/Business |
Results and Impact | I led a working group on AMR and environment, considering the issue from a LMIC perspective |
Year(s) Of Engagement Activity | 2019 |
Description | Contributed to Aviva Investors report on AMR, biodiversity loss and climate change |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Presentation of report at Aviva Investors, London |
Year(s) Of Engagement Activity | 2022 |
URL | https://www.avivainvestors.com/en-gb/views/aiq-investment-thinking/2022/11/antimicrobial-resistance/ |
Description | Filming for BBC4 program on AMR |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Media (as a channel to the public) |
Results and Impact | Filmed with freelance program makers for a Michael Mosley BBC4 documentary on AMR |
Year(s) Of Engagement Activity | 2017 |
Description | GW4/BristolBridge: Systems approaches to AMR in Different Environments (16 Mar 2017) |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | Presented outline of grant to researchers working on AMR in the environment |
Year(s) Of Engagement Activity | 2017 |
Description | HCWH webinar with myself and Dame Sally Davies, I hr to journalists and other specialists eg. WHO. |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | Webinar with myself and Dame Sally Davies answering questions from policy makers and media around AMR |
Year(s) Of Engagement Activity | 2019 |
Description | Invited speaker UK:Russia AMR roundtable, Nov 23rd organised by BSAC. |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | ~30 AMR specialists from the UK and Russia discussing potential collaborations, coordinated by the British Society for Antimicrobial Chemotherapy. |
Year(s) Of Engagement Activity | 2021 |
Description | Invited to speak at Bolivian conference on AMR attended by the minister of health. Santa Cruz, June 2019. |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | I had previously been invited to travel to Bolivia and speak to the AMR Action plan committee hosted by the British Embassy in La Paz, this was a follow up presentation to a similar group including the Minister of Health. |
Year(s) Of Engagement Activity | 2019 |
Description | NERC KE Fellowship working with EA, Defra, Water and pharmaceutical industries |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | This is in its early stages but it has already resulted in a JPIAMR (MRC) funded network on environmental AMR surveillance which has resulted in engagement with gov stakeholders and national / international partners |
Year(s) Of Engagement Activity | 2019 |
Description | Presentation at the Environmental Dimension of AMR meeting in Hong Kong |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Other audiences |
Results and Impact | Presentation from EDAR5 (basis for UK:Argentina grant detailing conceptual framework for Environmental AMR) requested by Tim Jinks (Head of Infection at Wellcome) and David Sutherland (WHO Technical Officer One Health Tripartite Coordination Group for Asia and the Pacific). "I'd be very grateful if you could send your presentation. It will be treated in confidence but will help with my briefing to WHO and FAO (duly acknowledged) and modifications to my risk framework". |
Year(s) Of Engagement Activity | 2019 |
Description | Quadripartitie one health priority research agenda for antimicrobial resistance |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Policymakers/politicians |
Results and Impact | Contributed towards the report, sitting on a panel of experts who contributed to teh report |
Year(s) Of Engagement Activity | 2023 |
URL | https://www.who.int/publications/i/item/9789240075924 |
Description | Speaking at House of Commons UKRI AMR research strategy refresh |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Policymakers/politicians |
Results and Impact | Speaking at House of Commons UKRI AMR research strategy refresh focusing on existing UKRI funded work in the area of AMR and the environment |
Year(s) Of Engagement Activity | 2019 |
Description | Wrote opinion piece on One Health and AMR for the Microbiology Society |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Professional Practitioners |
Results and Impact | Wrote opinion piece on One Health and AMR for the Microbiology Society |
Year(s) Of Engagement Activity | 2020 |
URL | https://microbiologysociety.org/static/c7d8d35c-6936-4d8d-af7576c5d28b2722/Antimicrobial-Resistance-... |