Designing One Health Governance for Antimicrobial Stewardship Interventions (DESIGN)

AMR is a problem of the global commons, whose resolution depends on coordination of collective global strategy. Addressing the challenges posed by AMR through a One Health approach relies on inter-sectoral policy coordination – across public health, agricultural, and environmental sectors – internationally, making stewardship complex, necessitating new approaches to policy development.

Our research seeks to address these issues through a comparative analysis that will identify innovative international policy, legal and regulatory approaches in high-, medium- and low-income case study countries. We will apply systems analysis to understand the complex contingencies inherent in local and international contexts in order to clarify the manner in which national systems could better support the coordinated efforts of public health, agricultural, environmental sectors, professional groups, public and private sectors, and civil society to secure their cooperation.

Design thinking workshops will leverage evidence emerging from the systems analysis by engaging governments and local stakeholders. Workshops will identify the incentives that foster a One Health approach to the governance of AB stewardship, including innovative governance approaches that support the development of regional and national policies, regulations and laws to improve the global commons. The findings will be used to advise government, industry, public health and environmental agencies on solutions that foster implementation of a One Health approach to reduce AMR.

Project partners

  • Mary E. Wiktorowicz, York University, Canada (Coordinator)
  • John Paget, Netherlands Institute for Health Care Research, Netherlands
  • Marion Bordier, Agricultural Research for Development, France
  • Alpha Amadou Diallo, Institut Sénégalais de Recherches Agricoles, Senegal
  • Marilen Balolong, University of the Philippines, Philippines
  • Ria Benko, University of Szeged, Hungary


COMplex Biofilms and AMR Transmission (COMBAT)

Antimicrobial resistant microorganisms are difficult to treat and lead to increased death and treatment costs.

Antibiotic resistance is recognised as a critical threat in both human and animal medicine. Addressing this threat can be challenging when bacteria exist in complicated communities called biofilms. Biofilms form naturally and allow bacteria to survive and persist in diverse environments. Surviving bacteria facilitates the spread of antibiotic resistance genes contributing to the spread of antimicrobial resistance.

The COMBAT (COMplex Biofilms and AMR Transmission) project will identify interventions that can actually control complex biofilms in three different environments, thereby decreasing the threat of antimicrobial resistance spreading. COMBAT’s approach is based on solid novel laboratory-based biofilm study but also on the application of interventions in the domestic, healthcare and animal environments, providing a direct application to control real “One Health” antibiotic resistance problem.

Project partners

  • Jean-Yves Maillard, Cardiff University, United Kingdom (Coordinator)
  • Dirk Bockmühl, Rhein-Waal-University of Applied Sciences, Germany
  • Mark Fielder, Kingston University London, United Kingdom
  • Noora Perkola, Finnish Environment Institute SYKE, Finland
  • Veljo Kisand, University of Tartu, Estonia
  • Seamus Fanning, University College Dublin, Ireland


Optimising community antibiotic use and environmental infection control with behavioural interventions in rural Burkina Faso and DR Congo (CABU-EICO)

Incorrect use of antibiotics is a major cause of antibiotic resistance. In rural Africa, people often receive antibiotics without prescription from local pharmacy shops, increasing the risk of resistance.

Substandard sanitation and hygiene practices result in frequent exchange of bacteria between humans’ guts, and their environment. How important these different sources are for the acquisition of antimicrobial resistant (AMR) bacteria in humans is still unclear, but contacts between humans and animals, in particular rodents, are frequent in much of Africa.

We will develop and evaluate a behavioural intervention for community pharmacy staff and their communities, to improve antibiotic use and hygiene practices, to ultimately reduce AMR. The intervention will be implemented over 12 months in Burkina Faso and DR Congo. We’ll measure as primary result changes in the use of specific AMR-prone and clinically vital antibiotics at community pharmacies throughout the intervention period. We will compare antibiotic use in pharmacies and surrounding communities where the intervention was implemented, and where the intervention did not take place. Also, we will assess changes in hygiene practices by surveying members of the surrounding communities. Then, we will determine how frequent AMR bacteria are transmitted by repeatedly analysing stool samples of those populations, and of rodents living in the surroundings, for bacteria and specific AMR genes. Through mathematical modelling we will quantify how changes in antibiotic use and hygiene practices will impact AMR transmission.

Project partners

  • Marianne van der Sande, Institute of Tropical Medicine, Belgium (Coordinator)
  • Halidou Tinto, Institut de Recherche en Science de la Santé, Burkina Faso, Philippines
  • Delphin Phanzu Mavinga, Institut Médical Evangélique de Kimpese, The Democratic Republic Of The Congo
  • Edwin Wouters, University of Antwerp, Belgium
  • Tamara Giles-Vernick, Institut Pasteur, France
  • Stephen Baker, University of Cambridge, United Kingdom
  • Ben Cooper, University of Oxford, United Kingdom


Combating Antibiotic Resistance in Philippine Lakes: One Health upstream interventions to reduce the burden (ARPHILAKE)

Antimicrobial resistance (AMR) may lead to more deaths than cancer by 2050. Action is required now to avert this disaster.

This study aims to implement key interventions in Greater Manila, The Philippines to reduce AMR. Interventions will focus on hospitals, small farms, and the Laguna Lake, one of the largest freshwater lakes in Asia. Better antibiotic use, point of care testing in hospitals and farms, and novel solar-powered wastewater cleaning technologies will be implemented. Their impact will be assessed by state-of-the-art molecular surveillance for antibiotic resistance genes and bacteria in the water before and after interventions. The study will be the most comprehensive and systematic interventions to be introduced in Asia to reduce AMR in lakes.

Project partners

  • Dylan Pillai, University of Calgary, Canada (Coordinator)
  • Maria Pythias Espino, University of the Philippines Diliman, Philippines
  • Stefanos Giannakis, Polytechnic University of Madrid, Spain
  • Ana Pereira do Vale, University College Dublin, Ireland
  • Paul Wigley, University of Liverpool, United Kingdom


Knowledge transfer strategies, networking and public engagement for a successful mitigation of risks induced by aquatic pollutants (AquaticPollutantsTransNet)

This transfer project is part of the AquaticPollutants projects’ family and accompany its research and innovation projects. It will support the funded projects in scientific communication and in the uptake of research results with the aim to increase their impact.

Ongoing project

Protecting all our water resources from pollutant inputs and the spread of pathogens is essential for a healthy environment, ecosystems, and our life! “Strengthen the European Research Area (ERA) in the field of clean and healthy aquatic ecosystems and to leverage untapped potential in the collaboration between the freshwater, marine and health research areas.” – That is the goal within the ERA-NET Cofund AquaticPollutants where the Joint Programming Initiatives (JPIs) on Water, Oceans and Antimicrobial Resistance (AMR) are working closely together. To support the achievement of this goal is in the focus of the upcoming transfer project AquaticPollutantsTransNet.


The project aims to:

  • Improve stakeholders’ & citizens’ perception through active involvement in the reduction of aquatic pollutants in the water cycle,
  • bring aquatic pollutants to the public’s attention and improve social impact awareness and understanding of the advantages in their reduction,
  • realise the above by using innovative tools and by implementing engagement activities around the AquaticPollutants projects to foster societal embedding.

Key objectives

To support knowledge transfer, scientific networking, and public engagement on aquatic pollutants,the key objectives are:

  • identification of key stakeholders and their knowledge gaps,
  • development of innovative approaches for enhanced knowledge transfer and exchange,
  • create synergies amongst the AquaticPollutants projects and strengthen stakeholder collaboration,
  • foster the knowledge transfer from the research projects to stakeholders and its uptake,
  • implementation of multiple dissemination and exploitation routes with thematic (non-scientific) groups, political fora, scientific networks and citizens.

Project phases

The transfer project consists of two interacting phases:

  • Phase one aims (a) to identify key stakeholders and knowledge demands relevant to aquatic pollutants (CEC, AMR and pathogens) and (b) to develop innovative methods/strategies/tools to improve the transfer of scientific knowledge on aquatic pollutants to policy makers, the public, the health, agricultural and industrial sectors.
  • The aim of phase two is (a) to create added value by cooperation among the AquaticPollutants projects, (b) to strengthen collaboration with stakeholders and (c) implement innovative methods and channels for strategic transfer exploitation and uptake of results by communication to reach the relevant identified stakeholder groups.

Thus, AquaticPollutantsTransNet will follow a tailored dissemination, exploitation and knowledge transfer strategy with multiple dissemination and exploitation routes integrating standardisation, thematic expert groups, political fora, scientific networks and the public.

Once the project has started, we will keep you updated on our website and communication channels. The entire AquaticPollutantsTransNet team looks forward to cooperate and interact with you as funded projects, stakeholders, interested parties or individuals!

Contact: Thomas Track, Head of Water Management, DECHEMA e.V., Frankfurt/Main, Germany, thomas.track[at]

Project partners

  • Dennis Becker, DECHEMA Gesellschaft fuer Chemische Technik und Biotechnologie e.V., Germany (Coordinator)
  • Gunnar Thorsén, IVL Swedish Evironmental Research Institute, Sweden
  • Nicole Baran, BRGM , the French geological survey, France
  • Pierre Strosser, ACTeon, France


Marine Plasmids Driving the Spread of Antibiotic Resistances (MAPMAR)

Antibiotic resistance genes (ARGs) are one of the most challenging contaminants of emerging concern (CECs). Instead of being directly produced by human activity, ARGs emerge as consequence of antibiotic use in clinical settings, and residual antibiotic contamination.

Ongoing project

ARGs spread through horizontal gene transfer and conjugative plasmids, because their ability to cross inter-species barriers, are key in this process. Recent findings revealed the existence of marine plasmids (MAPS) of global distribution and broad host range. These MAPS can transmit ARGs across oceanic distances, and may reintroduce them to human food chains via marine products. They are, however, different to classical plasmids from clinical settings.

MAPMAR uses metagenomics, data science and single-cell sequencing to obtain a catalog of most prevalent and transmissible MAPs. By testing methods to block their transmission, MAPMAR explores strategies to curtail the risk of oceans acting as highways for ARG propagation.

Project partners

  • Fernando de la Cruz, University of Cantabria, Spain (Coordinator)
  • Anne-Kristin Kaster, Karlsruhe Institute of Technology (KIT), Germany
  • Shay Tal, Israel Oceanographic and Limnological Research (IOLR), Israel


Consequences of antimicrobials and antiparasitics administration in fish farming for aquatic ecosystems (CONTACT)

Aquaculture is an important source for food, nutrition, income and livelihoods for millions of people around the globe. Intensive fish farming is often associated with pathogen outbreaks and therefore high amounts of veterinary drugs are used worldwide.

Ongoing project

As in many other environments, mostly application of antimicrobials triggers the development of (multi)resistant microbiota. This process might be fostered by co-selection as a consequence of the additional use of antiparasitics. Usage of antimicrobials in aquaculture does not only affect the cultured fish species, but – to a so far unknown extent – also aquatic ecosystems connected to fish farms including microbiota from water and sediment as well as its eukaryotes. Effects include increases in the number of (multi)resistant microbes, as well as complete shifts in microbial community structure and function. This dysbiosis might have pronounced consequences for the functioning of aquatic ecosystems.

Thus in the frame of this project we want to study consequences of antimicrobial/-parastic application in aquaculture for the cultured fish species as well as for the aquatic environments. To consider the variability of aquaculture practices worldwide four showcases representing typical systems from the tropics, the Mediterranean and the temperate zone will be studied including freshwater and marine environments. For one showcase a targeted mitigation approach to reduce the impact on aquatic ecosystems will be tested.

Project partners

  • Michael Schloter, Helmholtz Zentrum Muenchen – German Research Center for Environmental Health (GmbH), Germany (Coordinator)
  • Gisle Vestergaard, Technical University of Denmark, Denmark
  • Timothy M. Vogel, Ecole Centrale de Lyon / Université de Lyon, France
  • Lior Guttman, Israel Oceanographic & Limnological Research, Israel
  • Susanne Rath, University of Campinas, Brazil


CECs and AMR bacteria pre-concentration by ultra-nano filtration and Abatement by ThermoCatalytic Nano-powders implementing circular economy solution. (NanoTheC-Aba)

This project will deliver an energy efficient new integrated prototype system for water purification, composed of three different components.

Ongoing project

The components are:

  • The first-to-be realised ultra-stable silicon carbide (SiC) UltraFiltration/NanoFiltration (UF/NF) membrane
  • An innovative nano-enabled Thermocatalytic energy efficient Packed-Bed Reactor (TPBR)
  • A nano-enabled antimicrobial MicroFiltration (MF) membrane.

The TPBR beads are obtained by recycling SiC membranes scraps deriving from the ordinary production process and will be coated with thermocatalytic perovskite-nano powders allowing full abatement of CECs and of AMR pathogens at mild temperatures without need of chemicals and light sources. The MF membrane is coated with antibacterial titania-silica-core shell nanoparticles for inactivating AMRbacteria, while removing suspended solids. The UF/NF membrane separates the clean permeate stream, ready to be recycled or reused from the toxic concentrate, which is purified by the TPBR, thus preventing discharge of CECs and pathogens in rivers and oceans.

The new system is compact, amenable to scale-up, and ease to integrate in mariculture, aquaculture, tannery, hospital, and other industrial wastewaters treatment facilities, providing safe and efficient operation. The integration of the three components allows the optimization of each system unit both alone and in combination, boosting the efficiency of the process and ensuring high water quality and safety, by enabling a water and SiC recycling multi-circular model.

Project partners

  • Giuliana Magnacca, Torino University, Italy (Coordinator)
  • Victor Candelario, LiqTech International A/S, Denmark
  • Vittorio Boffa, Aalborg University, Denmark
  • Francesca Deganello, Italian National Research Council (CNR) – Institute for the Study of Nanostructured Materials (ISMN), Italy
  • Mariana Ornelas, CeNTI – Centre for Nanotechnology and Smart Materials, Portugal


Potential of decentralized wastewater treatment for preventing the spread of antibiotic resistance, organic micropollutants, pathogens and viruses (PRESAGE)

New approaches are needed to reduce the emission of contaminants of emerging concern (CECs). Some sources contribute strongly to suchemissions, which has driven the focus of PRESAGE on innovative decentralized wastewater treatment (WWT), based on anaerobic andaerobic compact systems.Ongoing project

An integrated analysis of the behaviour of organic micropollutants (OMPs), antibiotic resistant microorganisms and genes (ARMs/ARGs) and pathogens (viruses and bacteria) will be carried out. This will allow better understanding the relation betweenthe operational parameters of reactors, the microbiological evolution in the system, the removal of OMPs and pathogens, and thedevelopment of ARMs and ARGs. The contribution of such a complex mixture on the final effluent ecotoxicity will be assessed.The technologies will be validated at 4 demosites treating black and grey water, and effluents from hospitals and an antibiotic industry, inclose collaboration with the industrial sector. This high readiness level anticipates a good impact of project results on wastewater innovation. Experts in the field of advanced WWT, microbiology and ecotoxicology will strongly cooperate and participate in a mobility plan focusing oncomplementary skills.

PRESAGE impacts society and economy, boosting the water industry and protecting the environment from effluent discharges containing CECs. In the proposed treatment strategy a minimum global impact is targeted, preferentially promoting the onsite water reuse.

Project partners

  • Francisco Omil, Universidade de Santiago de Compostela (USC), Spain (Coordinator)
  • Marcelo Zaiat, University of São Paulo (USP), Brasil
  • Henrik Rasmus Andersen, Technical University of Denmark, Denmark
  • Eric Pinelli, CNRS/Institut National polytechnique de Toulouse (INP Toulouse), France
  • Thomas Ulrich Berendonk, TU Dresden, Germany
  • Luis Melo, Faculty of Engineering of Univ Porto (UP), Portugal


Development a smart forewarning system to assess the occurrence, fate and behaviour of contaminants of emerging concern and pathogens, in waters (FOREWARN)

This project will assess the occurrence, fate and behaviour of contaminants of emerging concern (CECs) and pathogens, and develop machine-learning methods to model their transfer and behaviour and build a decision support system (DSS) for predicting risks and propose mitigation strategies.

Ongoing project

FOREWARN will be focussed on CECs such as antibiotics and pathogens such as antibiotic-resistant bacteria (ARB), antibiotic resistance genes (ARG) and emerging viruses, such as SARS-CoV-2. The project will consider 2 types of case studies: 1) In-silico case studies will be selected from previous results, and dataset obtained in past or ongoing EU projects. Data will be used to develop the models and algorithms to feed and develop the DSS system to better understanding the sources, transport, degradation of CECs and pathogens and modelling their behaviour. 2) The adaptive DSS system will be refined and tested under real environmental conditions (6 months) to achieve TRL5 in real environment case studies.

Project partners

  • Esteban Abad, CSIC, Spain (Coordinator)
  • Leena Maunula, University of Helsinki, Finland
  • Sandra Martin-Latil, ANSES, France
  • Spyros Pournaras, Attikon University Hospital, Greece
  • Kevin McGuinness, Dublin City University, Ireland