Innovate4AMR is a competition bringing together students from around the world to develop innovative projects to improve antibiotic stewardship in low-resource settings. Students from these teams had the opportunity to present their proposals at a capacity-building workshop, supported by the WHO, South Centre and ReAct, in Geneva during World Antibiotic Awareness Week. Meet the winning teams and learn about their innovative projects.
With over 1000 people signed up for the listserv, Innovate4AMR received 145 proposals from student teams around the world. After several rounds of judging, first by a Technical Review Panel comprised of IFMSA, ReAct and World Health Organization (WHO) representatives and then by a panel of Expert Judges, six winning teams were selected.
Meet the eleven winning teams
The eleven winning teams are from Peru, India, Uganda, Honduras, Nigeria, Canada, the Philippines, the USA and China.
Team ACME from India
Team ACME was composed of Mr. Digbijoy Bose and Ms. Satarupa Mukherjee from Nilratan Sircar Medical College and Hospital, Kolkata, West Bengal, India. Their proposal aimed to reduce the burden of antimicrobial resistance through low cost interventions, by using the existing infrastructure and government initiatives to streamline AMR initiatives. They proposed a Distribution System Analysis through “Antimicrobial purchase mapping” which consisted of identifying individuals purchasing antibiotic strips with the help of biometric data analysis. It will be regulated and monitored by a Central Monitoring Body. Their target is to evaluate patterns of antibiotic use in patients and of antibiotic prescribing among health service providers using the collected information about antimicrobial prescription, purchasing and use.
Team Soldiers for Global Health from Peru
The Peruvian Soldiers for Global Health from Universidad Peruana Cayetano Heredia in Lima and Universidad Catolica de Santa Maria in Arequipa aimed to empower mothers and caregivers in both urban and rural communities of Peru, by giving them the necessary knowledge to use antibiotics appropriately and address AMR in the pediatric population through a project titled AMR Hark’ay. The two team members, Ms. Alicia Maldonado from Universidad Peruana Cayetano Heredia and Mr. Omar Bellota from Universidad Católica de Santa María proposed to work with immunologists and with the Ministry of Culture to prepare the education sessions. These lessons would address myths and analyze case studies of common infectious pediatric illnesses to explain why is it important to avoid giving children antibiotics unnecessarily. In follow-up, the team would conduct visits to the schools to evaluate the behavioral change in the mothers’ antibiotic use. In particular, they hoped to adapt their intervention to rural communities that speak Quechua or Aymara to overcome cultural barriers and empower those communities in their native language.
Read more about the prize the winners received
Students from these teams had the opportunity to present their proposals at a capacity-building workshop, supported by the WHO and South Centre, in Geneva during World Antibiotic Awareness Week on November 14 to 17, 2018. There, students attended talks and workshops on antimicrobial resistance, discussed with experts how to make strategic improvements to their innovation, and received feedback on how best to operationalize their project.
The Indian Alliance for AMR Control from India
The Indian Alliance for AMR Control, represented by Hazique Jameel from the Aligarh Muslim University, India, presented a new model for behavior change in the healthcare sector, compiling a range of interventions. Starting with a baseline Knowledge, Attitudes and Practices (KAP) assessments the team aims to develop focused training on appropriate prescribing for selected personnel; facilitate peer-to-peer dialogue and training; establish hospital IPC committees and standard inventory protocols; and improve IPC trainings for different cadres of healthcare workers and communities. For doctors, the trainings would focus on the prescription protocol. Nurses and pharmacists would be sensitized to the different antibiotic classifications and trained in communication techniques to express the dangers of overuse and misuse of antibiotics to patients. Community awareness camps, led by the Department of Community Medicine, Rural Health Training Centers and grassroot workers (ASHA) would focus on raising awareness about AMR in order to decrease the ‘pressure to prescribe’.
Team BioRegulation from Pakistan and Honduras
Team BioRegulation’s proposal was two-pronged: first, the team designed a behavioral intervention strategy to improve antibiotic treatment adherence by the general population; and second, they planned to use mass data collection on antibiotic use to create a database supporting research in the field and to track inappropriate consumer use of antibiotics. Mr. Augusto Baron from the Universidad Nacional Autónoma de Honduras and Ms. Nisha Azeem from the Fatima Jinnah Medical University, Pakistan, made up the multinational team. They hope to enable such racking and surveillance by creating a label on medication boxes which would include product information, a “scratchable” calendar to help the patient keep track of the completed treatment days, and a QR code linked to relevant drug information, along with an antibiotic warning message. The label would also be linked to a smartphone application for patients with an alarm and interactive adherence support system. Going forward, Biotrack’s hopes to create the necessary network of strategic alliances that might convert BioTrack from essence to a tangible tool for impact.
Team MUMSA from Uganda
Team MUMSA (Makerere University Medical Student Alliance) aimed to increase the knowledge and awareness about AMR among secondary school students in Kampala, Uganda. David Mpaju and Nelson Twinamasika proposed to use various educational tools such as indoor power point presentations and outdoor health-related activities, such as handwashing trainings. They also plan to lead a range of school-based activities such as poem and essay writing, quizzes and debates, and plays and dramas for the local community. The team anticipates that these activities will increase the awareness among various key partners, such as the Ministry of Health and the Ministry of Education, of the need to include AMR concepts into the curriculum of secondary schools in Uganda. The team seeks to give the Kampala community the opportunity to partner with the health sector in combating AMR.
Team Pilipinas from the Philippines
Team Pilipinas was composed of Mann Cyron Sarmiento, Lucky Sunshine Go, and Anna Gabriele Castro from St. Luke’s Medical Center – College of Medicine William H. Quasha Memorial. Through Project ARMED, the team aimed to decrease antibiotic resistance by fostering knowledge and inculcating the proper use of antibiotics to the Filipino community. Project ARMED focused on implementation of the delayed antibiotic prescribing strategy in the management and treatment of respiratory tract infections. Such delayed prescribing would hopefully decrease the pressure on medical practitioners to prescribe medications to expectant patients as well as decrease the number of unnecessary medical visits and antibiotic use by people with viral respiratory tract infections. Moreover, through education programs in local languages, Project ARMED aimed to improve the community’s knowledge and understanding of antibiotics, AMR and upper respiratory tract infections to promote proper antibiotic use and decrease self-medication practices.
The Global Health Enthusiasts from Nigeria
The Global Health Enthusiasts from the University of Ibadan in Nigeria developed strategies to restructure Nigeria’s supply chain of antibiotics to reduce access by vendors unauthorized to dispense these drugs over the counter. They proposed a Central Antibiotics Store (CAS), one for each of the six geopolitical zones in Nigeria, where all the antibiotics produced by different drug companies would be stored to facilitate dispatch of product by the network of distributors. Authorized healthcare professionals and community pharmacies would order antibiotics online through a CAS website using a personalized Smart Antibiotic Purchase Authorization Card (SAPA-Card), just like ATM or VISA card, thereby preventing unauthorized vendors to access antibiotics. The four team members, Adebisi Adebayo, Adeola Bamisaiye, Omolayo Awolola and Damilola Olaoye, were unable to attend the capacity-building workshop in Geneva because the Swiss Embassy in Abuja denied all four of their visas and could not entertain in time an appeal–supported by ReAct, South Centre and the World Health Organization–by the students. Despite this, the students presented their project to the expert panel via video conference.
Team PRIME from the USA
Team PRIME (Preventing Resistant Infections through Monitoring, Machine Learning, and Education) designed a mobile- and web application-based education intervention, drawing from other low-cost technological and educational solutions with proven outcomes in low-income countries. Team members Jarjieh Feng from George Washington University, Kathryn Vivirito from the University of Illinois Urbana-Champaign, and Gayatri Sanku from Georgetown University designed a multidisciplinary intervention, all in the US. PRIME could be incorporated into healthcare and agricultural settings and incorporates three key components:
- PRIME Guide to give care providers the most up-to-date prescribing guidelines and expert support. Offline access to country- and practice-specific data will be available for healthcare providers, ensuring adherence to the latest practice guidelines.
- PRIME Watch to create a resistance pattern surveillance infrastructure for rural health practitioners. Demographic and clinical data on suspected cases of antibiotic resistance will be collected and used to inform public health professionals and researchers to better respond to outbreaks.
- PRIME Predict to integrate local and regional data sources into a functional clinical decision support tool. Using machine learning, the team proposes tailoring algorithms to respond to the local setting, existing resistance patterns, and patient medical history.
Team Anti²biotics from China
Team Anti²biotics, composed of five medical students from Sichuan University, China, proposed to create a QR code-based system to track-and-trace antibiotics through the supply chain. When a package of antibiotics is first produced, a unique QR code would be attached to it and uploaded to the database to indicate the antibiotics have entered the market. When sold at the hospital or pharmacy level, the QR code would be scanned to record the price and document the sale. After making a prescription, doctors would also scan the code, not only to check the doctor’s certification but also to record the prescription information (time, doses, instructions for the patient). Finally, on the patient end, scanning the code with the necessary phone application would indicate the patient’s identity and display consumption instructions and educational information for the patient. Xu Ying, Xiang Mengya, Ji Jianrui, Wang Haoyuan, and Zhang Yutian’s goal through this project is to create a database of traceable production-to-consumer information to better digitally manage the flow of antibiotics, to disseminate guidelines on appropriate antibiotic prescription and use, and to standardize the purchase of antibiotics to minimize unnecessary use.
The Safer Informality from Canada
The Safer Informality team was composed of Jessica Yu and Prateek Sharma from the School of Population and Public Health in Vancouver, Canada. Their approach recognizes informal antibiotic prescribing as an action benefitting low-resource communities but also threatening their continued access to effective antibiotics. By using mobile health units to deliver stewardship training to informal private providers (IPPs) in West Bengal, they aim to produce quantitative and anecdotal evidence to document the potential of harm reduction methods in improving the prescribing practices of antibiotics. By engaging with key stakeholders at every stage of the process, they expect to form new collaborations and strengthen existing links between formal and informal communities as IPPs become antibiotic stewards. Their goal is to facilitate community-led mobile stewardship training teams and strengthen existing informal network collaboration, so that the respective organisations can carry on the messaging after the project completion.
Team AntiResist from India
From the Maharashtra Institute of Medical Education and Research Medical College, India, Vincy Koshy and Raveena Kataria, or team AntiResist, aim to curb antibiotic use among patients and providers through a two-pronged intervention. On the patient side, they proposed the introduction of a simple card for patient antibiotic use documentation (P.A.U.D.). The patient would carry it when visiting a healthcare centre, and drug information and details of their antimicrobial prescription would be filled by the clinician on one side. The other side would include educational information for patients, including information about conservative management for viral illnesses such as upper respiratory tract infection or simple diarrhoea, and information about infection prevention and control strategies. On the healthcare provider side, team AntiResist will create a Hospital Infection Control Committee (HICC) in their pilot hospital to formulate a protocol using the Treat Antibiotics Responsibly Guidance, Education and Tools (TARGET) toolkit. They also hope to support continuing medical education on antibiotic use and infection control practices through hospital seminars and workshops. This would also be a platform to distribute and explain the PAUD patient card to physicians.
Innovate4AMR is a global online competition inviting student teams from around the world to design innovative solutions for antimicrobial stewardship in resource-limited, healthcare settings. In organizing the competition, ReAct and the International Federation of Medical Student Associations (IFMSA) asked student teams to propose strategies to tackle the underuse, overuse and misuse of antibiotic prevalent in a range of settings, from hospitals and clinics to outpatient pharmacies. The goal of Innovate4AMR was to engage the next generation of leaders in developing innovative, scalable approaches to address the challenge of conserving existing antibiotics, as student teams working across disciplines have much to contribute in proposing how to redesign the healthcare system.