Like cancer, antimicrobial resistance (AMR) has a shared aetiology and diversity of underlying mechanisms, drivers and solutions across disease areas. The recent intensified global focus on AMR is timely, but fundamental knowledge gaps hinder prioritisation of research efforts. The Centre has considerable expertise in this area of genomics, evolutionary analysis, modelling, and burden estimation.

Recent years have seen a worrying increase in AMR, that is the ability of many pathogens to survive the treatments usually applied against the infections they cause. This includes the resistance of bacteria to antibiotics, of viruses to antivirals, of fungi to antifungals, and of parasites to antiparasitics.

Some infectious pathogens are getting dangerously close to resisting all known methods of treatment and effectively tackling this problem requires the development of a better understanding of the epidemiological and evolutionary factors causing AMR to emerge and spread in pathogen populations.

Our research focusses on:

• Estimation of the burden of disease due to AMR – through the integration of genomic, disease surveillance and clinical outcome data;
• Characterising the relationship between the frequency of resistance and drug use – using prescribing data, population surveys (e.g. Demo-graphic Health Surveys) and drugs sales data;
• Developing mechanistic models of the evolution and spread of resistance – integrating the outputs of (a) and (b) with pathogen-specific representations of the underlying genomic mechanisms of resistance, accounting for population structure and other major selection pressures (e.g. antigenic);
• Modelling the potential impact of interventions – examining the potential impact of new diagnostics and drugs plus novel use of existing drugs (e.g. combination therapy, drug cycling).