Exploring the potential impact of a large-scale vaccine campaign on Antimicrobial Resistance and Use in Harare
Working with academics, clinicians and public health officials in Zimbabwe and the London School of Hygiene & Tropical Medicine to evaluate the impact of a new typhoid conjugate vaccine on antimicrobial prescribing and resistance (AMR) in Harare, Zimbabwe.
Can you share a brief outline of a recent knowledge exchange activity with an external partner?
Supported by funding from the Wellcome Trust and with partners from the Zimbabwe National Microbiology Reference Laboratory (NMRL) and London School of Hygiene & Tropical Medicine (LSHTM), we evaluated the impact of a large Typhoid Conjugate Vaccine on antimicrobial prescribing and consumption in Harare, Zimbabwe. We used what we learnt to contribute to international policy including setting priorities for Antimicrobial Resistance (AMR) research (World Health Organisation (WHO) Research Agenda) and evaluating the role of vaccines in mitigating the impact of AMR.
What motivated you to work with these partners?
Following the publication of an opinion piece in a trade newsletter, I was approached by the Wellcome Trust and asked to consider applying to their ‘Vaccines and AMR’ call. Building on our collaborative partnership with colleagues at LSHTM and in Zimbabwe, we developed a successful interdisciplinary approach for addressing this complex problem. Our research included a range of policy partners and stakeholders in Zimbabwe and we shared our results with the Ministry of Health and local public health experts. Based on my background in typhoid research and antimicrobial resistance, I was approached to participate in a WHO Technical Advisory Group (TAG) and have contributed to meetings, agenda setting, and preparation of guidance documents.
How did you engage with them?
By working on a collaborative Wellcome Trust funded project in Zimbabwe with partners from LSHTM and NRML, and participating in a WHO Technical Advisory Group.
What benefits have you seen as a result of this, both for your research and more widely?
The results of our research in Zimbabwe led us to question how vaccines could best be deployed to have an impact on how medical teams manage illness in complex environments. To have any impact on antimicrobial use or resistance, a broad holistic approach rather than disease specific programmes are needed.
From this work, we now consider a much wider range of variables in our research, ranging from capturing the health systems infrastructure to identifying behavioural changes needed to realise the true value of vaccines in this setting.
More widely, work performed with the WHO TAG has led to a number of reports (Critical role of vaccines in addressing antimicrobial resistance (AMR)) and an interactive dashboard for use by researchers, policy makers, and health economists (Vaccines for Antimicrobial Resistance (AMR)). Vaccines are one of the few effective tools we currently have to prevent the spread of antimicrobial resistance. This work has sought to define their role in low-resource settings and highlights important areas of research still needed.