Ineoos Oxford Institute, University of Oxford, UK
I have been studying AMR mechanisms for over 30 years and published over 300 papers mainly involving understanding the issues of AMR in low-middle income countries (LMICs) which is a long-held passion of mine. I have discovered and named two of the most important antimicrobial resistance genes in the world; namely, NDM (now the global dominant carbapenemase) and MCR (co-discovered with my Chinese colleagues in 2015 and now globally disseminated). I also co-discovered the mobile tigecycline mechanism, TexX which is now increasingly disseminated across the globe.
I was PI of BARNARDS, the lead Gates Foundation project on clinical AMR, examining the burden of neonatal sepsis in Pakistan, India, Bangladesh, Rwanda, South Africa, Nigeria (Abuja and Kano) and Ethiopia. This project enrolled 36,000 mothers, 38,000 babies and analysed over 2000 sepsis cases. I am PI of DETER-XDR-CHINA which is the largest One Health AMR study in the world spanning human health, animal health, aquaculture and the environment. I am also PI of DX-China-HUB, a study examining the spread and burden of AMR in public health sectors and hospitals in 30 provinces in China. I hold an honorary Chair at the Chinese Agricultural University and I am an AMR advisor to the Chinese MoH and was centrally involved in the decision for the Chinese government to ban the use of colistin as a growth-promoter in farming in 2017 – removing over 8,000 tones/year of colistin from Chinese farms. I am also PI of CUT-SEC, a ‘one-health” project in China and Thailand.
Additionally, I have a vibrant and exciting collaboration with a formal student of mine, Qiu-e Yang, on a novel method to understand how AMR plasmids more throughout bacterial populations using non-culturable methods. Our work will soon be published in Lancet Microbe and Nature Communications and our follow-up studies have shown that small scale plastics enhance the spread of AMR and thus for the first time, we can show that plastic pollution mediates the global spread of AMR. Our follow up studies examine the role of temperature on AMR dissemination, linking global warming to the global dissemination of AMR. These datasets are novel and will revolutionise the way we understand AMR and how we design interventions in the coming decades.
In addition to BARNARDS, I also have AMR studies in Karachi and Peshawar, Niger (Clean Kids Study with Médecins Sans Frontières [MSF]) and support MSF Microbiology/AMR lab in Jordan. I also have clinical studies examining the burden of AMR in the community and hospitals San Paolo (Brazil), Phitsanulok (Thailand) and Tanta (Egypt) and Dhaka (Bangladesh).
In July 2020, I was appointed by University of Oxford to a Chair in Medical Microbiology and Antibiotics Resistance and concurrently became co-director of the Ineos Oxford Institute of Antimicrobial Research (IOI-AMR). I am the IOI Director of Biology and overall lead for Program A (novel non-antibiotic therapies in animal farming) and Program C (Societal impact of AMR with three main projects and support Program B (novel antibiotics for MDR human infections): Specifically, I am director of the following:
1. BARNARDS II – neonatal sepsis, AMR and economic burden in LMICs covering 26 hospitals in Nigeria, Pakistan, Bangladesh, Sierra Leone, Mozambique, Rwanda, Burundi, Ethiopia and Egypt. 2. BALANCE – clinical and economic burden of sepsis/AMR comparing LMICs [Niger, Pakistan, Bangladesh, Kenya, Sierra Leone] to HICs [Italy, Poland, and Turkey] and
3. AVIAR – global dissemination of AMR by insects linking to human infections [over 90 countries enrolled]. Additionally, we are using harmonics and radio-frequency identification tracking to understanding how flies disseminate MDR bacteria.
Whilst the IOI financial platform is extremely valuable, I have written a number of grants to synergise with the core activities of the IOI and enhance its longevity beyond 2030.
I have undertaken numerous news reports including the BBC, Channel 4, CNN and ABC as well as many news articles – Telegraph, Daily Mail, Independent and the Guardian. I have co-made an AMR film with Dame Sally Davies and Lord Jim O’Neill called the “Resistance Fighters” that has won many awards and shown at United Nations in September 2020. In addition to the above activities, I am making an Anime film on AMR called “Antibiotic Armageddon” in China aimed at “universal teens” which we hope will be exported world-wide in late 2023/24 and be part of the UK School curriculum.
I have presented over 200 international lectures. I have won numerous awards including the ASM Howard Florey Lecture (2017) and the Biomerieux Science Prize (2011). In 2020 I received the award of OBE (Officer of the British Empire) for services to “Microbiology and International Development”. In 2022, I was awarded my DSc from the University of Bristol and in 2023 was awarded membership to Academia Europaea.
In 2023, I have been liaising with the British Society of Antimicrobial Chemotherapy (BSAC), Trinity College, Cambridge (Dame Sally Davies), DHSC (Claire Oxley) and the All-Party Parlimentary Group on AMR to galvanise international support for the UN high-level meeting (HLM) on Health/AMR. As part of these international engagements, I have been nominally made Bangladeshi envoy for PM Sheikh Hasina’s office for the UN meeting to facilitate greater international reach and engagement. With BSAC (Michael Corley), this includes bringing together a network of countries to from an international AMR caucus prior to the UN HLM including many low-middle income countries and UN HLM convenors, and G7 and G20 presidency, necessitating meetings in embassies, high commissions, and governments. For example, we have organised an embassy AMR meeting for January 2024 to bring high commissioners together the AMR caucus. Additionally through the Bureau of Investigative Journalism we are organising an AMR photo gallery for London, Rome, Beijing and New York prior to the 2024 HLM meeting.