Policy Webinar 4
The Public and the Private sectors:
Points of intersection, points of departure
Dr Gemma Buckland-Merrett, Research lead for drug resistant infections at the Wellcome Trust, introduced the first presenter, Dr Catrin Moore. Dr Moore is Research Group Leader of the Oxford Global Burden of Disease Project, working on the Global Research on Antimicrobial Resistance project (GRAM), funded by the Fleming Fund and Wellcome Trust. She described the background of AMR and need for such a project as GRAM, which produces health metrics and geospatial maps relating to the global disease burden of antimicrobial resistance.
“Our main goals were to build a comprehensive up-to-date, global synthesis of the data available, to really understand what was causing AMR, the selected bacteria and the resistance that we saw: to then use that data to understand the prevalence of resistance over time and space, so to perform the geospatial mapping”.
Dr Moore described the methods used to estimate AMR; the importance of the various types of data collected, and the algorithms and modeling to then estimate the burden of disease.
“Ideally, we would like to have a database that has a level, a line for each patient…having clinical data on a patient, having the microbiology data, and the outcome data; whether the patient lived or died.“
However, in many countries data actually isn’t available electronically: it’s in paper format, particularly clinical information, which GRAM is working on – including with CAPTURA – to bring this data into an electronic format which can then be shared more widely both with Ministries of Health and globally.
Dr Moore highlighted work on modeling the prevalence of resistance, based on microbiology data collected through over 50 collaborations between researchers, hospitals and private laboratories worldwide, particularly low- and middle-income countries (LMICs) where the data is quite sparse. She emphasized that building trust is essential for effective collaboration.
Dr Buckland-Merrett introduced the second presenter, Dr Bruce Altevogt, Vice President and Head of External Medical Engagement in Pfizer’s hospital business unit. Dr Altevogt described Pfizer’s commitment to addressing AMR, and the role of public-private partnerships. Dr Altevogt highlighted the importance of research and development – for both new antibiotics, and also for new vaccines, which could reduce the need for some antibiotics – and of stewardship.
Dr Altevogt described Pfizer’s ATLAS surveillance platform, which collects data on nine out of thirteen WHO priority pathogens, and looks at how bacteria are resistant. The data is provided free to users, through a web portal, and allowing understanding of the emergence of resistance patterns. ATLAS has a global reach of 241 centres in over 50 countries. He also introduced the SPIDAAR project, a surveillance partnership to improve data for action in sub-Saharan Africa:
“…a scalable surveillance platform that’s supported by a robust public private partnership, and this is absolutely critical to expand AMR resistance data, strengthen public health capacity and and, most importantly, improve patient outcomes in low- and middle-income countries.”
SPIDAAR initially focuses on Ghana, Kenya, Malawi and Uganda, with two collection sites in each country, working through national reference labs to support the collection of resistance data; and a real world evidence study which integrates real world data to explore the impact of AMR and patient outcomes, looking at demographics, clinical and economic outcome data, to assess the influence of AMR on mortality and morbidity.
“A lot of what this work is, it’s not just about collecting the data, but strengthening the capacity within the countries…but most importantly it’s about improving outcomes for the patients, and I think we always have to bear in mind that when we’re talking about anything around antimicrobial resistance we’re talking about what this means to the patient…and why we are doing this for them.”
Both presenters highlighted the importance of awareness and communication of AMR, including with the public – and in engaging the patient community to expand understanding – and importantly, with focused advocacy campaign with government officials or public health officials
Dr Buckland-Merrett summarized some of the key takeaways from the presentations and Q and A, highlighting the importance of collaboration across sectors, and broadening participation in collaborations, and working together to ensure that knowledge is translated into action.
“We do need to focus on collaborating across sectors, both public and private and thinking who’s going to be using the outputs, and involving them in the partnership so, whether that be Ministry of Health or patients: they have a very key voice and should be at the table from the beginning.”
Moreover, data and evidence generation is crucial to underpinning action, and requires translation into intervention and policy.