Epidemiology and global health
People living in resource-limited settings continue to experience high mortality and morbidity from infectious diseases, particularly in the Global South.
This impact is compounded by undergoing the epidemiological transition towards an increased burden of non-communicable diseases (NCDs), which, in turn, are often modified by the presence of particular infections such as HIV or Streptococcus pyogenes infection.
People living in low-resource settings are disproportionately affected by the effect of antimicrobial resistance, while the prevalence of AMR is increased by the lack of reliable diagnostic tests, uncontrolled use of antimicrobials, and counterfeit, poor quality or access to medicines.
Equitable research partnerships with researchers and clinicians in LMICs
Members of the Florey Institute have high quality established partnerships with teams in a number of LMICs, including in Africa in The Gambia, Ghana, Malawi, South Africa, Uganda, Kenya, Zambia and Zimbabwe, and in Asia in India, Nepal, Bangladesh and Sri Lanka.
We regard respect for the autonomy and best interests of the LMIC researchers as central to these partnerships, and share expertise and resources in an equitable manner, as well as contributing wherever possible to building local research capacity and promoting south-south cooperation and partnerships.
Reducing the burden of infections and AMR in LMICs
We will work with our LMIC partners to deploy strategies aimed at reducing the burden of infections and their longer-term consequences. This will include collaborations to assess the efficacy of new vaccines, both to prevent infections and also to reduce the extent of AMR.
We will also collaborate to evaluate and implement new diagnostic approaches, particularly those that can be used at point-of-care (POC), to improve the fair and rational use of antimicrobials. We will work with our partners to understand how infections may contribute to the growing NCD burden, for example the increasing burden of chronic comorbidities in people with HIV infection (PWH).
We will provide platforms that bring together experts across a range of disciplines to discuss, develop, and share best practice. We will develop mechanisms to explore and promote the exchange of methods and learnings between partners / countries. For example, developing and implementing frameworks of engagement that promote, where applicable, the application of learnings in one theme / expertise area and setting to another (e.g. from a LMIC partner to the UK context)
Informed and intelligent pathogen surveillance
The future of infectious disease control relies upon forecasting emerging public health issues and responding to these before they become unmanageable, and upon ensuring prevention and treatment programmes targeted ongoing issues are evidence-based / data driven.
To achieve the goal of sustainable infectious disease control, we will use a combination of sequencing- and phylogenetic-based methods of discovery to identify shifts in pathogen biology and drug resistance patterns.
Increasingly bioinformatics and AI data analysis are vital tools to combat pathogens at global scales and we look to develop and inform these areas, aiming to use large datasets to identify how pathogens adapt to their hosts, how AMR arises in this context, and what may be done to stop it. To meet the needs of different countries and communities, we will also explore and promote the collection and use of routine data in more equitable (rights-based / person-centred), sustainable and epidemiologically robust frameworks and measurement approaches, and in our analytical and modelling activities.
We will improve the interpretation of these data in global, national and sub-national model calibrations.
Improved Evidence and Decision Making for Communicable Disease Control
Florey colleagues also have considerable public health topic and methodological expertise across a broad range of areas to support public health policy and systems work related to communicable disease control, such as through evidence reviews and synthesis, quantitative and qualitative studies, policy studies, health economics. modelling and decision science.
We have been engaged, through external consultancy and research, with various global initiatives to strengthen infectious disease surveillance and response to outbreaks. These include collaborative work, for example, with the International Association of National Public Health Institutes (IANPHI) on Integrated Disease Surveillance and Response (IDSR), and ongoing work to develop the Global Health Emergency Corps (GHEC).
Similarly, we are part of a UK-South East Asia Vaccine Manufacturing Research Hub (UK-SEA Vax Hub), a multidisciplinary research consortium with colleagues in our engineering department as well as other universities internationally, working on strengthening vaccine manufacturing research in SE Asia. In this collaboration, our modelling and health economics expertise and research work provides a key perspective to guide vaccine manufacturing processes.
In addition to our international partners, we also work with regional and national partners, such as the UK Health Security Agency and Robert Koch Institute (Germany), on various projects that build the evidence base to inform national public health decisions. Recent examples include evidence reviews on mass population testing for COVID-19, modelling COVID-19 infection in prison settings, determinants of delays in TB diagnosis and treatment in high income country settings such as the UK, and studies of antibiotic drug-bug pairings associated with AMR.
Finally, we have collaborated with local partners such as the NHS to provide analytical support for various evaluations and studies on health interventions such as Outpatient Antimicrobial Treatment (OPAT), and in doing so building the evidence base for locally relevant initiatives and interventions that meet local population health needs around infection, and bridging the evidence-into-practice gap.