CATCR

The challenge

Antibiotics have been the mainstay of treatment of bacterial infections for nearly a century, but their use inevitably selects for drug-resistant strains of bacteria. For many pathogens, antimicrobial resistance (AMR) has become widespread, making it increasingly difficult and expensive to treat certain infections. Sub-Saharan Africa, and Central Africa in particular, are badly affected by AMR. It is estimated that more than 4 million lives could be lost to drug-resistant infections in sub-Saharan Africa over the next 30 years.

AMR is a complex issue affected by multiple factors. These include the overuse and misuse of antibiotics, which creates selection pressures favouring the survival and spread of drug-resistant strains, and the potential spread of AMR genes through environmental routes and via livestock. A One Health approach is therefore often adopted, which covers issues such as antimicrobial use in veterinary medicine and animal husbandry, as well as environmental factors affecting transmission of AMR genes. 

AMR is a particular challenge for tuberculosis, with multidrug-resistant TB infections being very hard to treat and of growing concern. A salient issue in TB is detecting cases (of both drug-sensitive and drug-resistant forms) to limit the spread of infection. An estimated 70% of drug-resistant TB cases in Africa are currently not being diagnosed.

With AMR a growing challenge in sub-Saharan Africa, it is important that the region has sufficient researchers to understand local challenges better and to design and evaluate appropriate solutions. However, the region has relatively few researchers with expertise in this area.

The project

The CATCR project is helping to address this shortfall through a new research training programme focused on developing research capacity in antimicrobial resistance (AMR) in Central Africa.

It is focused on three key areas:

• Antimicrobial usage in patients with parasite infections (including malaria), including understanding prescribing, dispensing and utilisation, and ways to promote good practice.
• The prevalence and spread of carbapenemase-producing Enterobacterales, a key class of drug-resistant gut bacteria, in humans and livestock, with a One Health focus.
• The epidemiology of drug-resistant tuberculosis, characterising drug-resistance genes, and determining their implications for treatment.

The project is delivering technical training in these areas to up to 5,000 researchers and health workers from Cameroon, the Republic of Congo, the Democratic Republic of the Congo (DRC) and Gabon, drawing on existing South–North and South–South networks, training opportunities and resources. Other training activities will include laboratory attachments and seminars/workshops.

In addition, a fellowship programme is being organised that will provide research training opportunities for seven PhD students and three mid-career (postdoctoral) researchers. This will leverage the existing EDCTP-funding Central African Network of Excellence (CANTAM) and link trainees with expert mentors from across the region. GSK will also provide input to increase fellows’ understanding of translation and commercialisation of health research.

Impact

The CATCR project is building capacity in an area of growing public health importance in sub-Saharan Africa. It will:

• Advance scientific understanding in several key areas of AMR relevant to Central Africa.
• Build a cohort of researchers with a wide-ranging understanding of AMR and local challenges.
• Strengthen the research and leadership skills of African-based researchers.

Through these routes, the project will strengthen AMR research capacity in Central Africa, creating research leaders able to lead the battle against multiple key AMR challenges.