Building global surveillance with local data: a sustainable response to antimicrobial resistance


The rise of drug-resistant infections is one of the biggest problems that modern medicine faces and, left unaddressed, antimicrobial resistance (AMR) will undermine sustainable development. The global AMR response is currently ill-equipped to deal with this challenge because it is based largely on data from high-income countries. For effective and sustainable solutions in low- and middle-income countries, we need to know more about the local burden of AMR, and we need to understand better how such knowledge is produced. To this end, the project tracks the 'life-cycle' of AMR data that is produced in routine clinical practice and follows its trajectory in local healthcare facilities, the health system and the policy level.

  • Sustainable Development Goals

    This project examined the following SDGs:

    SDG 1 – No Poverty
    SDG 3 – Good Health and Well-being
    SDG 8 – Decent Work and Economic Growth
    SDG 10  Reduced Inequalities
    SDG 12  Responsible Consumption and Production

    Find out more about the UN Sustainable Development Goals.

Project description

The research pursued two objectives:

  • generate data on the molecular mechanisms of AMR in a lower-middle income country (Egypt)
  • gather information on how this data is taken up in the hospital and wider health system to build surveillance systems.

This 'lifecycle' approach to studying AMR data piloted a bottom-up, local perspective on AMR surveillance that complements the top-down, global perspective from which surveillance systems are usually planned, implemented and studied. Furthermore, the project piloted a 'bio-social' approach, based on interdisciplinary collaboration spanning the social and biological sciences. At a local hospital in Cairo, we investigated what AMR-relevant data is generated as part of routine clinical practice and collect biological samples and associated patient data for further genomic analysis. Furthermore, we tracked how the clinical data is managed and shared within the hospital through interviews and participant observation, how it is managed in the national health system, and whether/how it feeds into the policy process.

Timeline and funding


April 2017-December 2020



The team

  • Principle Investigator (PI) and Co-Investigators

    Principal Investigator


  • Project team
    • Dr James Price,  Brighton and Sussex Medical School
    • Professor Hadir El-Mahallawy, National Cancer Institute, Egypt
    • Mostafa El Yamani, PhD candidate, School for Public Health and Primary Care, Maastricht University, The Netherlands
    • Amira Hussein, Consultant and Lecturer in Clinical Microbiology, Cairo University, Department of Clinical Pathology and Kasr alainy hospitals
    • Sheri Saleeb, Masters Student, Biotechnology, the American University in Cairo

Where we worked