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GLOBVAC-Global helse- og vaksin.forskn

Building equity in digital global health: the case of antimicrobial resistance in low- and lower-middle-income countries

Alternative title: Rettferdig antibiotikapraksis: bruk av digital teknologi i globale helsetiltak mot antimikrobiell resistens i lav- og mellominntekstland

Awarded: NOK 12.0 mill.

Antimicrobial resistance has been identified as a key global health threat, one which threatens to leave humanity with no recourse to antibiotics.This threat is much more magnified in the context of Low and Lower Middle Income Countries, who experience high disease burdens, the lack of adequate surveillance systems, limited diagnostics facilities particularly at the community level, and experience large-scale and non-responsible use of antibiotics. These conditions contribute to build very inequitable situation for AMR identification, diagnostic and care. To address these challenges head on, this project will take an "equity lens" to understand the policy-practice gaps, and to design frugal and appropriate digital interventions, aimed at bringing more equity into surveillance, diagnostics and prescription practices. To achieve these aims, the project has a strong multi-disciplinary team of researchers and supported by R&D partners in India and Sri Lanka, the sites for our empirical research. The partnership will itself be based on equity, with the South receiving equivalent funding as the North and also gender balance will be maintained. The project will be implemented through five Work Packages: 1) Understanding policy to practice research gaps; ii) delivering digital interventions as public goods; iii) Building more responsible prescribing practices; iv) Build an excellent international research environment in Norway for interdisciplinary AMR research; and, v) Project coordination and management. EquityAMR will impacts research, policy, practice and society. In addition contribute to reach SDG1 "No poverty" and SDG3 “Good health and well-being”,of significant societal relevance. The pathways to the scaling of impact will involve mechanisms in both the north and south. The HISP R&D initiative of IFI, spans more than 70 countries, and outputs of the research will be disseminated as public goods to the network, and to WHO, with whom IFI is a Collaborating Centre.

EquityAMR will take an interdisciplinary approach from informatics, global health, microbiology, implementation science and critical social science to develop and implement enabling digital technologies for tackling the global crisis of Antimicrobial Resistance (AMR). The research will build and apply an “equity lens” to understand the world of AMR policy, gaps that occur in practice, and how digitization can bridge these gaps. Two domains of WHO policy will be addressed - strengthening knowledge and evidence base and building more responsible prescribing of antibiotics. Digitization will be applied in 3 domains: i) strengthen surveillance by making the AMR problem in underserved populations visible at required levels of granularity for policy makers to take action; ii) integrating diagnostics information with surveillance; and, iii) integrating prescribing practices with surveillance. Taken together, these initiatives will help build and apply an equity perspective, and produce insights of relevance for science, policy and practice about how digitization can enable achieving SDG3 “Good health and well-being”. The project will be implemented through high-quality and equitable partnership of IFI and SHE at UiO, KI in Sweden, 3 Indian educational institutions (BITS, SCIMST, RDGMC) and R&D partners HISP India, Doctors for You and HISP Sri Lanka. Empirically, the project will be implemented in 3 Indian states and 2 Sri Lankan provinces. Five interventions are planned across all sites: i) analysis of policy-practice gaps; ii) understanding prescribing practices of antibiotics; iii) testing feasibility of low cost point of care diagnostic tools; iv) designing, developing and implementing digital interventions for strengthening surveillance and integrating diagnostics and prescribing information; v) evaluating efficacy of interventions to bridge policy-practice gaps, and contribute to bringing more equity through improved surveillance, diagnosis and prescribing.


GLOBVAC-Global helse- og vaksin.forskn