Considerations from emerging infection outbreaks and a pandemic for the global action plan on antimicrobial resistance

Project Details


Increased mobility, migration, growing population, changes in the human-animal interface (deforestation and large scale meat production), underfunded and dysfunctional health systems in LMICs, and a changing climate result in a resurgence of several infectious diseases and contribute to the global spread of AMR.

At the same time, scientific progress in terms of diagnostics, vaccines, treatment and information management systems used (eg. for surveillance) offer opportunities to improve outbreak control. to To build resilient public health systems ready to cope with outbreaks while also addressing outbreak/AMR prevention, a balance should probably be found between making use of those innovations and ensuring well established outbreak control strategies are not pushed aside.

Epidemiological parameters similar to those of emerging infectious disease outbreaks apply to the spread of AMR. The spread of AMR has however additional complexities. AMR spread occurs not only through transmission from a specific resistant pathogen spilling over from its reservoir, but also through permanent exchange of AMR genes between different bacteria and hosts or reservoirs, such as commensals in the human and animal gut. In high income countries, AMR burden is largely attributed to healthcare facilities (Cassini 2018). In contrast, in LMICs, hospital observed invasive infections caused by AMR pathogens are predominantly associated with community-acquired infections (MacFadden 2019). As a result, community-level factors contributing to transmission or emergence of AMR pathogens, such as community-level antibiotic use, hygiene and sanitation in households, or subsistence farming, potentially play a more important role. Therefore, this offers opportunities for synergies in the prevention and control of emerging infections and of AMR.

The aim of this PhD project is to demonstrate through a series of case studies the utility of existing public health tools during infectious disease outbreaks in low- and middle income countries, and discuss the potential of these tools and systems in the control of AMR.
Effective start/end date30/06/21 → …

IWETO expertise domain

  • B680-public-health