SAMRC invests in a new Extramural Research Unit to tackle Antimicrobial Resistance

Cape Town | The South African Medical Research Council (SAMRC), in response to the emerging antimicrobial resistance (AMR) crisis, has established the Centre for the Study of Antimicrobial Resistance (CAMRA) at the University of Cape Town (UCT) in South Africa.

Directed by UCT Professor of Respiratory Medicine, Professor Keertan Dheda, CAMRA is the first South African unit dedicated to studying the origin, development and fundamental drivers of antimicrobial resistance (AMR) and multidrug-resistant pathogens.

AMR has essentially rendered some critical drugs ineffective and has contributed to 700,000 deaths globally each year. Tuberculosis, now the foremost infectious disease killer worldwide and the most common cause of death in South Africa is known to have 25% of its strains resistant to at least one major TB drug.

“Resistance to antibiotics threatens the gains that we have made in health in South Africa – particularly in TB,” says President of the SAMRC Professor Glenda Gray. “Bold efforts are required to tackle drug resistance at a global level and the SAMRC is committed to funding research that will endevour to find solutions that make a global impact.”

The establishment of the SAMRC’s Extramural Unit, CAMRA, forms a part of the SAMRC’s response strategy to existing and emerging disease burdens and will strengthen the World Health Organization’s (WHO) critical call for attention to the crisis of drug resistance – which has been prioritised alongside global warming.

“The proposed work on AMR funded by the SAMRC at CAMRA is noteworthy in that it will also study non-TB AMR, which is a burgeoning health problem in South Africa,” says Vice President of research for the SAMRC, Professor Jeffrey Mphahlele. “Preventative strategies, antibiotics, vaccination, economic and psychosocial issues, and promotion of the appropriate use of antibiotics – also known as antibiotic stewardship – are among the many aspects of antimicrobial resistance that demand attention.”

The SAMRC has recently invested in similar research projects including collaborative research with the African Academy of Sciences (AAS) into the scope of antimicrobial resistance (AMR) in Africa where, although resistance to commonly prescribed antibiotics has been witnessed, the full scope of the burden is not yet understood as 40% of African countries do not have sufficient data on AMR.

“Substantial morbidity and mortality due to multidrug-resistant infections, major health cost implications, and wider impact on society and the economy will not only retard economic growth, but there are also serious risks that it will undo the gains made under the United Nations’ Millennium Development Goals,” says CAMRA’s new Director, Professor Keertan Dheda.

The deficiency of new antibiotics entering the commercial pipeline is also cause for concern according to Professor Dheda. He proposes that the emerging  classes of antibiotics be protected but adds that  this cannot be done without an understanding of the key drivers of antibiotic resistance.

“We know that exposing bacteria to levels of antibiotics below what is required to be effective is a key driver of antibiotic resistance. What is not known, however, is to what extent this occurs in specific clinical contexts; how resistance evolves and how it will be possible to prevent or at least minimise the development and evolution of resistance using better strategies for dosage and administration,” says Professor Dheda.

CAMRA will combine the efforts of several multi-disciplinary national and international authorities in the fields of TB and antimicrobial resistance to study the movement and distribution of drugs in the body, molecular sequencing and the development of inhaled drugs. The Unit includes members and collaborators from the University of KwaZulu-Natal (UKZN), University of Pretoria (UP), Stellenbosch University (SUN), Walter Sisulu University (WSU), Sefako Makgatho Health Sciences University (SMU), SA National Institute of Communicable Diseases (NICD), London School of Hygiene and Tropical Medicine, University of Parma (Italy), and the Baylor Scott & White Research Institute in Dallas (Texas), in addition to those from UCT.  

“There are also important capacity development aspects of the project, including uplifting promising academic centres, and championing transformation and gender equality in efforts to build the next generation of scientists,” adds Dheda.

CAMRA is expected to span 10 to 15 years and hopes to generate data to leverage further research.