Interventional research to tackle antimicrobial resistance in Low Middle Income Countries in the era of the COVID-19 pandemic: lessons in resilience from an international consortium

Gabriel Birgand,Esmita Charani,Raheelah Ahmad,Candice Bonaconsa,Oluchi Mbamalu,Vrinda Nampoothiri,Surya Surendran,Tom G Weiser,Alison Holmes,Marc Mendelson,Sanjeev Singh

doi:10.1016/j.ijid.2022.02.013

Abstract

This article summarizes the consequences of the COVID-19 pandemic, on an international project to tackle antimicrobial resistance (AMR). The research leadership and process, the access to data, and stakeholders were deeply disrupted by the national and international response to the pandemic, including the interruption of healthcare delivery, lockdowns, and quarantines. The key principles to deliver the research through the pandemic were mainly the high degree of interdisciplinary engagement with integrated teams, and equitable partnership across sites with capacity building and leadership training. The level of preexisting collaboration and partnership were also keys to sustaining connections and involvements throughout the pandemic. The pandemic offered opportunities for realigning research priorities. Flexibility in funding timelines and projects inputs are required to accommodate variance introduced by external factors. The current models for research collaboration and funding need to be critically evaluated and redesigned to retain the innovation that was shown to be successful through this pandemic.

Highlights

The COVID-19 pandemic continues to impose significant health, economic, and social impacts. (Douglas et al, 2020) Nonpharmaceutical interventions implemented to prevent the spread of COVID-19, including intermittent lockdowns instituted in many countries, have suspended the lives of citizens, by disrupting their professional and social activities
Birgand). ∗ Equal first position. ∗∗ Equal last position. Spared by these restrictions, and the need for research and real-time evaluation was all the more important, universities and healthcare institutions closed laboratories and sites for all but essential work. (WHO, 2015; WHO; World Health Organization., n.d.) In response to the pandemic, many research activities were put on hold or redirected to investigate the evolving pandemic. (Lv et al, 2020) Global projects in the oft-labeled ‘continuous pandemic’ of antimicrobial resistance (AMR) were among those affected owing to the reliance on international collaborations and data sharing. (Charani et al, 2017) AMR projects were challenged by reliance on the workforce that is one of the most affected in the pandemic, namely antimicrobial stewardship and infection prevention and control resources
Elective surgeries were halted and the surgical teams were deployed to support the clinical response to the pandemic, with intensive care beds prioritized for patients with COVID-19

Summary

Introduction

The COVID-19 pandemic continues to impose significant health, economic, and social impacts. (Douglas et al, 2020) Nonpharmaceutical interventions implemented to prevent the spread of COVID-19, including intermittent lockdowns instituted in many countries, have suspended the lives of citizens, by disrupting their professional and social activities. Poor access to sites for local non-clinician researchers, compromising the data collection Diversion of resources from AMR prevention to COVID-19 research. Interruptions of elective surgery offered the opportunity to organize remotely reciprocal partnerships with surgeons, share learning on IPC and AMR from data collected during the pre-COVID-19 phase of the project.

Results

Conclusion