Resistance to treatment and control agents

Addressing global health challenges

4. Resistance to treatment and control agents

There is a dynamic interaction between interventions to control and eradicate diseases caused by microbes (such as bacteria, viruses, fungi and parasites) and the vectors that often transmit them (such as mosquitoes, flies and snails). Over time, resistance to interventions can develop and reduce their effectiveness.

Antimicrobial resistance, resistance to antiparasitic diseases and insecticide resistance now all pose significant global threats. TDR supports multisectoral research to inform national action plans and strategies to prevent and combat resistance. We contribute to research that strengthens resilience through improved surveillance, better risk assessment, enhanced awareness and better understanding of underpinning human behaviour related to the spread of resistance.

Disease focus
Antimicrobial resistance, drug-resistant tuberculosis.

Key activities

Building sustainable operational research capacity to generate and utilize evidence to tackle the emergence, spread and health impact of antimicrobial resistance (AMR) in LMICs.
Supporting research to assess the effectiveness, safety, feasibility, acceptability, cost and impact of the use of novel regimens for patients with extensively drug-resistant tuberculosis.
Supporting researchers, health professionals and other stakeholders to expand their capacity to conduct and manage implementation research to mitigate resistance to treatment and control agents.

2024 updates

Seventy-nine percent (79%) of the 75 research studies conducted through the AMR-SORT IT project in Africa, Asia and Latin America led to tangible changes in policy and practice.

TDR-supported studies have led to national policy changes in the Dominican Republic and Ecuador, which have adopted short all-oral regimens for drug-resistant TB patients. (See Spotlight story below.)

A 20-year-old patient diagnosed with Rifampicin-resistant TB receiving certification of “cured” after 9 months of all-oral treatment accompanied by health personnel from the specialized TB center, Santo Domingo, Dominican Republic.

Credit: Aline De Cima

The Impact Grants initiative is supporting a study on “Bacteriophage-based control of transmission and emergence of carbapenem-resistant pathotypes of Escherichia coli and Klebsiella pneumoniae in Uganda.”

A research team in the Philippines has investigated gender dimensions and other social inequities associated with AMR. A research team from South Africa conducted a literature review exploring the intersection of gender and other sociocultural determinants of health and AMR in a changing climate.

To address the challenge of mosquito resistance to insecticides, TDR has supported several networks and LMIC-based young scientists to attend scientific meetings organized by the West African Aedes Surveillance Network, the International Conference on Advances in Surveillance and Control Methods for Aedes-Borne Diseases and Urban Vectors, and the International Conference for Tropical Medicine and Malaria. All events were opportunities to discuss, exchange and develop collaborations to fight insecticide resistance.

Relevant training activities

TDR’s postgraduate training scheme, in collaboration with eight universities in LMICs, focuses on building capacity on implementation research on major global health challenges, including resistance to treatment and control agents.
TDR-supported regional training centres (RTCs) trained individuals on implementation research to mitigate resistance to treatment and control agents.

RTCs trained
more than

7000

individuals online

345

individuals in-person

Spotlight

Supporting policy-makers tackling drug-resistant TB

TDR-supported studies on short, all-oral regimens for drug-resistant tuberculosis have shown high treatment success rates and prompted national policy changes in the Dominican Republic and Ecuador, who have integrated the novel regimens into routine care for drug-resistant TB patients.

TDR annual report 2024: Building local research solutions to improve global health

TDR
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ISBN 978-92-4-010930-8 (electronic version)
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Cover caption: Angel Michael (centre) delivers her child’s urine and stool sample to Ngw’ashi Dotto Haga (left), a community health care worker, as part of the baseline parasitological assessment study.

Credit: UNDP/Kumi Media