NIHR Research Award — NIAMR Project (NIHR168786)

NIHR Research Award — NIAMR Project (NIHR168786)

Plain English Summary

Research Question: Can an integrated Digital AMR data capture, processing and sharing platform at National scale improve AMR detection and monitoring for enhanced AMR surveillance health outcomes in Uganda?

Background: Antimicrobial resistance (AMR) is an urgent global public health threat that complicates treatment of infectious diseases. It is responsible for an estimated 1.3 million deaths worldwide each year. The burden is disproportionately high in low- and medium- income countries (LMICs) including Uganda, where AMR-associated mortality surpassed deaths due to malaria, HIV, and tuberculosis in 2019. Recognising this threat, the Global Action plan on AMR (2015) and Uganda's National Action Plans on AMR (2018 2023; 2024 2029) identify surveillance particularly the systematic collection and use of data on AMR and antimicrobial use as a core intervention. Such data are essential for effective clinical management, public health surveillance and design and implementation of AMR control strategies. However, as highlighted at the United Nations General Assembly High-Level Meeting on AMR, the Africa CDC Landmark Report and Uganda NAP (2024 2029), AMR data in many LMICs including Uganda, remain fragmented, incomplete, and underutilised for decision-making, despite investments in microbiology laboratory capacity. Key challenges include shortage of skilled personnel at facility and national levels, disjointed data systems, and limited clarity regarding national AMR data needs.

Project aim: To develop and evaluate a national interoperable integrated digital AMR data capture, processing and sharing platform (NIAMR) at national level, bringing together human health AMR data from multiple existing AMR data capture systems, to support timely AMR detection, monitoring and evidence-based decision-making for improved surveillance and response in Uganda, with a scalable architecture for extension to other One Health sectors (i.e., animal health, water, wildlife and environment).

Methods: This retrospective, three-year project will be implemented in five sequential phases. Phase 1 will involve a national situation analysis and baseline assessment of AMR data generation, management, and dissemination in Uganda, using desk reviews and community engagement and involvement (CEI). Phase 2 will focus on the development and pilot implementation of the integrated NIAMR platform in selected districts identified as AMR high-burden (red zones) heat maps, to assess feasibility, acceptability and ethical considerations. Phase 3 will evaluate the impact of the NIAMR platform at scale on AMR surveillance performance and data use. Phase 4 will assess system performance, data quality, and user uptake to inform optimisation and national roll-out. Phase 5 will estimate the costs of scaling the NIAMR platform using a micro-costing approach to support integration across all One Health sectors (humans, animals, water and environment). Throughout all phases, engagement with AMR CEIs will be maintained to ensure that the NIAMR meets stakeholder data capture, processing, and sharing requirements needs.

Outputs: Key outputs will include: i) an interoperable and integrated digital AMR data capture, processing and sharing platform (NIAMR), ii) a national AMR data management situation analysis report for Uganda, iii) clearly defined national AMR data needs, iv) clarified and documented AMR data governance structures and v) NIAMR user and training guides.

Outcomes: Enhanced availability and use of integrated AMR data to support timely, evidence-based decision-making for AMR surveillance and response.

Impact: Reduced AMR burden across human, animal, and environmental health in Uganda.

Dissemination: Policy briefs for policy makers. Academic journals for researchers. Social media & formal media, MoH & other One Health sectors' websites, workshops and National AMR conference for CEIs.

Award Details