Improving the TRIcycle protocol: upscaling to national Monitoring, detection of CPE and WGS pipelines for One Health Surveillance (TRIuMPH)

Since 2015, under the auspices of WHO, a basic protocol for One Health Surveillance of AMR has been established. This “Tricycle” protocol integrates human, animal and environmental surveillance and focuses on a single indicator for AMR: ESBL-producing E. coli. To our knowledge, this is the first One Health AMR surveillance protocol that has consistently been piloted across six different countries across the world.

Ongoing project

The TRIuMPH project builds on the Tricycle project and on the JPI network “NETESE” by adding new research elements and protocols, thereby extending the application of the Tricycle surveillance. This will be achieved in a collaborative approach with current Tricycle and NETESE partners (PK, MY and MG) and partners that contributed to the Tricycle protocol development (UU, RIVM and INSERM). New One Health protocols will be developed and applied in a one year surveillance campaign for the detection of carbapenemase-producing Enterobacteriaceae (CPE, WP2), and for whole genome sequencing analysis of ESBL / CPE isolates (WP3).

Within one single country, extension of surveillance to a broader scale is needed, as analyses are currently limited to single cities. This will be brought about by two activities: Inclusion of additional sites within participating countries through in-country training (WP4), and integration with existing monitoring campaigns, such as for water samples taken within the Polio Eradication campaign (WP5). These also offer the opportunity to validate the applicability of wastewater sampling as proxy of community prevalence of ESBL and CPE.

Project partners

  • Heike Schmitt, National Institute for Public Health and the Environment (RIVM), Netherlands (Coordinator)
  • Laurence Armand-Lefevre, University Paris-Diderot Medical School, INSERM, France
  • Luc Samison, University of Antananarivo, Madagascar
  • Rohaidah Hashim, Institute for Medical Research, Malaysia
  • Jaap Wagenaar, Utrecht University, Netherlands
  • Muhammad Salman, National Institute of Health (NIH), Pakistan

Project resources


Management of animal diseases and antimicrobial use by information and communication technology to control AMR in East Africa (MAD-tech-AMR)

In low-income countries (LICs), patterns of livestock diseases and antimicrobial use (AMU) are largely unknown, and there are few high-quality laboratory facilities. Robust and actor-centred surveillance systems are needed and surveillance of the dynamics leading to antimicrobial resistance (AMR) should precede more advanced systems.

Ongoing project

The project is designed to provide proof of concept, applying a framework for surveillance of: AMU, diseases that trigger AMU and perceived problems with AMR, in East African poultry production systems. Information and Communication Technology (ICT) will be coupled with veterinary epidemiology and social science methods. The originality lies in using frontline technology particularly suited for challenges in resource-poor settings. The overall objective is to provide an ICT framework for monitoring and control of AMU and AMR in livestock in LICs. The project will assess if veterinary “telemedicine” coupled with ICT systems can change AMU. Baseline data on AMU practices and actors involved will be collected, followed by a Knowledge-Attitudes-Practices study. A platform to register drug purchases and a database to monitor drug sales will be developed along with a mobile application for delivery of animal health advice and information about AMR. The ICT framework will be pilot-tested in selected poultry production systems in Kenya and Uganda. The framework can be expanded in the future to allow inclusion of diagnostic tools, but the initial focus is on clinical diagnosis based on tele-consultation and evidence-based therapeutic strategies.

Project partners

  • Susanna Sternberg Lewerin, Swedish University of Agricultural Sciences, Sweden (Coordinator)
  • Florence Mutua, International Livestock Research Institute, Kenya
  • Lawrence Mugisha, Makerere University, Uganda
  • Joshua Onono, University of Nairobi, Kenya


Call on Diagnostics and Surveillance

The Call on Diagnostics and Surveillance 2019 will fund joint transnational research projects addressing the development of diagnostic and surveillance tools, technologies and methods to detect antimicrobial resistance (AMR). Projects should address the diagnosis of AMR infections in clinical and veterinary settings, or the surveillance of AMR in humans, animals and the environment. The call promotes projects with impact in low and middle income countries (LMICs) in Asia and Africa.

AMR has become one of the major global health and development challenges of the 21st century. The threat of AMR is particularly high in resource-limited and high-risk settings. This is linked to issues such as weak human and animal health systems; diverse means of food production, processing and consumption; food safety and food security; water, hygiene and sanitation challenges; and the global movement of people and goods.

In response to these challenges, the JPIAMR is pleased to launch this joint transnational call for proposals for innovative research projects on new or improved diagnostic and surveillance strategies, tools, technologies and methods.  The call will support research projects that also have the potential for impact in areas where the risk and burden of AMR is greatest, such as in LMIC settings in Asia and Africa. Projects are encouraged to use a One Health approach where relevant.

The projected call budget is approx. 20.06 million Euro.

Scope of the call

Projects should aim to either:

  • Develop strategies, tools, technologies, and methods for the detection, monitoring, profiling and/or surveillance of antimicrobial resistance and dynamics leading to resistance.
  • Study ways to facilitate and implement the uptake and use of existing strategies, tools, technologies, and/or methods for the detection, monitoring, profiling and surveillance of antimicrobial resistance and dynamics leading to resistance.

Expected Outcomes

It is expected that this JPIAMR call will contribute to the urgent need to curb the burden associated with the most prioritised infections in different geographical settings. This topic area is also suitable to reinforce collaborations involving industry and social sciences. Regional LMIC led collaborations are welcomed. The results of the funded projects should contribute to improved understanding, monitoring and detection of AMR where efforts to curb AMR will have a global impact.

Suggested Focal Areas

  • Establish the validity of new or improved diagnostic tools, technologies and methods.
  • Evaluate how new or improved diagnostics can promote more prudent use of antibiotics (e.g. narrow spectrum antibiotics) in human and veterinary use
  • Rapid diagnostics (essential for optimal antimicrobial selection) and point-of-care techniques, to improve personalised or individual therapies
  • Development of new, or more efficient use and accessibility of already existing, tools, technologies and/or methods to detect AMR in multiple reservoirs, for example human, animal and environmental samples

Projects are encouraged to consider the global use of the tools, technologies and methods, including use in low and lower middle income settings (e.g. lack of laboratory facilities, affordable diagnostic tests, unreliable or unavailable electricity supplies or points-of-care-tests).

The following sub-topics are not within the scope of the call:

  • Investigations based on, or involving, clinical trials.
  • Investigations aiming to improve existing commercial technology or products (more details on this will be in the full call text and annexes)

Information & application

This call is closed.

Filmed interviews with some of the project leaders of the funded projects can be found here: Discover the projects of the JPIAMR transnational Joint Call on Diagnostics and Surveillance: Interviews with project leaders February 2019


Canadian Institute of Health Research (CIHR)
Canada’s International Development Research Centre (IDRC)

Czech Republic
Ministry of Education, Youth and Sports of the Czech Republic

Innovation Fund Denmark

Academy of Finland

French National Research Agency (ANR)

The Federal Ministry of Education and Research (BMBF)

Ministry of Health (CSO-MOH)

Italian Ministry of Health
Italian Ministry for Education, University and Research

State Education Development Agency

The Netherlands
The Netherlands Organisation for Health Research and Development (ZonMw)
The Netherlands Organisation for Scientific Research

The Research Council of Norway (RCN)

National Science Center

Ministry of Research and Innovation

South Africa
South African Medical Research Council

Instituto de Salud Carlos III

Swedish International Development Cooperation Agency (Sida)
Swedish Research Council (SRC)

Supported projects

Twelve projects were funded within the JPIAMR 9th transnational call: “Call on Diagnostics and Surveillance 2019”. The total funding amount was 12,1 M€. Click on the project titles in the list below to learn more on each project.