A blog by Dr Yu Wan, David Price Evans Research Fellow at the University of Liverpool, who recently travelled to CAMO-Net South Africa.
Thinking outside the box: my reflections on ICID 2024 and CAMO-Net meeting in Cape Town
Thanks to CAMO-Net’s travel grant, I had the opportunity to present at the 20th International Congress on Infectious Diseases (ICID) and attend the subsequent CAMO-Net meeting in December 2024 in Cape Town, South Africa, where I joined my colleagues from the University of Liverpool and met many international CAMO-Net colleagues in-person for the first time. This fruitful journey was filled with excitement in learning, networking, and knowledge sharing.
As a bioinformatician based at the CAMO-Net Liverpool Centre in the UK, my research focuses on mechanisms, epidemiology, and evolution of antimicrobial resistance (AMR) in hospital-acquired bacterial infections. Attending ICID 2024 and the CAMO-Net meeting provided me with fresh and thought-provoking perspectives that I had not often considered before.
Regional approaches to AMR
On the third day of ICID, Professor Anna Levin, co-lead of CAMO-Net’s Brazil Hub at the University of São Paulo, delivered a fascinating plenary talk titled “Updates on AMR”, which attracted a wide audience. She began by referencing the 77th World Health Assembly in June 2024 and forecasts of the global AMR burden by 2050. Her presentation covered WHO’s 40 AMR research priorities (2023) and highlighted the spread of antimicrobial-resistant bacteria in hospitals, including the transmission between colonised patients and healthcare workers. She also discussed the use of AMR prevalence as an indicator for evaluating infection prevention and control (IPC).
Professor Levin emphasised the urgent need for rapid diagnostic tests to detect bacterial colonisation and explored key drivers of AMR in the community, presenting Brazil Hub’s extensive research on AMR in natural water and wastewater. In addition, she introduced emerging technologies for addressing AMR, such as monoclonal antibodies, antimicrobial peptides, bacteriophages, genetic editing, and artificial intelligence. In the final section of her talk, she underscored the importance of standardising sterilisation practices and improving the education for healthcare workers, using the example of unregulated use of antiseptic liquid Savlon in South America.
Professor Levin giving a plenary presentation at ICID 2024 (photo credit: Chris Deputy)
Equity in AMR
On the second day of ICID, I attended a scientific session on equity in AMR, which was chaired by CAMO-Net South Africa Hub’s co-lead, Professor Esmita Charani from the University of Cape Town (UCT). This session featured three presentations, followed by a panel discussion:
- “Power and representation in global health research and infectious diseases” by Professor Sipho Dlamini from the UCT;
- “Science communication and community engagement in AMR and the need for co-design” by Dr Anastasia Koch (Tasha) from the UCT;
- “Gender and antimicrobial stewardship and infection prevention and control practices” by Dr Vrinda Nampoothiri from the Amrita Institute of Medical Sciences in India.
Professor Dlamini emphasised the critical role of vaccination in reducing antibiotic prescribing and addressing health inequalities. He also advocated for a co-creation approach in research, where stakeholders, including the public, are involved from the beginning. His presentation ended with a powerful message: “Think globally and act locally”.
Dr Koch introduced the EH!Woza programme, a nonprofit initiative in South Africa that exemplifies the co-design approach to community engagement and public health, particularly, in disadvantaged regions. She showcased videos produced by the EH!Woza team, including an animated explainer on AMR and interviews capturing local perspectives on drug-resistant tuberculosis. This initiative’s impressive work was further discussed on the third day of the CAMO-Net in-person meeting by Dr Koch and media producer Sam Flans.
Finally, Dr Nampoothiri discussed health seeking behaviours among females and dynamic roles of bystanders (patients’ relatives, mostly females, as auxiliary healthcare givers) in the IPC in Indian hospitals. She also examined gender differences in IPC practices and antibiotic prescribing behaviours, power and hierarchy in healthcare, as well as sociocultural imbalances and their impacts on AMR. Her presentation concluded with a call to empowering people who are already doing correct things.
CAMO-Net delegates at ICID 2024 (photo credit: Chris Deputy)
Social and economic context of AMR
During the two-day CAMO-Net meeting, participants engaged in presentations and workshops under the theme “context, culture, and behaviour”. There were five workshops altogether:
- Outbreak Response Case Studies: Examining AMR and behavioural factors in social and climate contexts.
- Communications in AMR: Exploring effective messaging strategies.
- Implementing changes through dashboards and data: Demonstration of Western Cape Provincial Health Data Centre’s AMR dashboard by Dr Chris Kelly.
- Contextualising social engagement in public health: Example from PROTEA’s partnership with EH!Woza.
- Strengthening and transforming human capacity: Community, partnership, ethics, and key lessons.
Discussions in these workshops centred on containing an outbreak of a life-threatening, multidrug-resistant, respiratory bacterium in a deprived community and under an adverse climate through coordination across social sectors, evidence generation, and technical innovations. By engaging in roundtable discussions and analysing the problem from various perspectives — hospital administrators, community members, WHO, NGOs, and government officials — I gained a deeper understanding of how socioeconomic factors and pathogen characteristics shape outbreak responses.
The meeting also heightened my awareness of how national strategies for tackling AMR vary across country-specific contexts, including different funding mechanisms. One of the most fascinating takeaways was the culturally tailored communications about AMR. For instance, South Africa has 12 official languages, yet fewer than one in ten people speak English at home, according to the country’s 2022 census. During the meeting, participants shared translations of “drug-resistant bacteria” in their native languages — for example, “small animals that cannot be killed by drugs”. This exchange underscored the need to standardise the concept of AMR and improve community-engagement strategies.
Participants exchanging the meanings of their names during an icebreaker session at the CAMO-Net meeting (photo credit: Professor Marc Mendelson)
Conclusions
My participation in ICID 2024 and the CAMO-Net meeting was an eye-opening experience that broadened my perspectives on AMR, equity in healthcare, and the intersection of social and economic contexts in public health interventions. The insights I gained from these events have reinforced my commitment to applying a multidisciplinary approach to AMR research and strengthening collaborations across sectors.
As I return to Liverpool, I carry with me not only new knowledge but also a renewed dedication to contributing to the global combat against AMR. As Professor Dlamini stated in his closing remarks at the CAMO-Net meeting: “Transformation is intentional.” Addressing global health challenges requires interdisciplinary solutions that integrate context, culture, and behaviour as fundamental components.
