AMR is a known as a One Health problem because it impacts upon human, animal and environmental health. COSTAR will take an holistic, One Health approach.
Our formative research will engage communities to consider how behaviours linked to animal and environmental issues impact on AMR. We will then use these findings to inform our materials, intervention development and evaluation.
Achieving a One Health approach
The COSTAR team will share their specialist knowledge as part of our capacity building strategy. This, combined with community knowledge, will ensure that we develop interventions which capture the breadth of AMR challenges across the One Health sphere, and focus on the contextual issues of the regions in which we are working.
Lead by veterinarians Dr Sophia Latham (University of Liverpool, UK) and Dr Amam Siddiki (Chittagong Veterinary and Animal Sciences University, Bangladesh) the animal aspect of One Health often focuses on food-producing animals. We need to understand how and where antimicrobials are used in this sector and for what purposes. Antimicrobials are often used as growth promotors or prophylaxis, which both constitute misuse. Understanding why this occurs and how medications are accessed, regulated and disposed of in animal health are key questions for the COSTAR team.
Dr Jess Mitchell (University of Leeds) has a background in Zoology and supports the COSTAR team to consider Environmental Health issues. Antimicrobials can reach the environment and wildlife through waste from hospitals, homes and farms. Here they can challenge naturally occurring microbes, in soil and water, to develop resistance and allow AMR to spread to new areas. Climate change and other forms of pollution can also cause AMR to develop in the natural environmental. The COSTAR project needs to consider these environmental dynamics of AMR throughout it's interventions.
Dr Dani Barrington (University of Western Australia) is a Water, Sanitation and Hygiene (WaSH) engineer. Her expertise will support the COSTAR team to understand how antimicrobials and infectious microbes can move through our built environment (sanitation systems) and reach the natural environment. This is a key area of interest, as LMIC water and sanitation systems can be vulnerable to infection and contamination. Improper disposal of human waste is a huge contributor to infection in general, and risks the development and spread of AMR.
The majority of the COSTAR team have expertise in the human dynamics of AMR. This includes the misuse and overuse of antibiotic medicines, often without prescription. Many team members have also worked on projects considering community knowledge, attitudes and practice (KAP) in order to better understand why drug misuse occurs and in what context. The previous CDA and PV projects, upon which COSTAR builds, have focused on the human aspect of AMR.