CHNUK: Integrated platforms from science to policy in response to antibacterial resistance

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Combating Antimicrobial Resistance (AMR) in China requires a multi-pronged approach that includes the need for new effective antimicrobials. Traditionally, China has been a major producer of generic antibiotics rather than a developer, but times are changing with new government policies that are beginning to help drive innovation in drug discovery. This includes the structured revitalization of Traditional Chinese Medicines (TCM), which, along with other natural products are known to possess antibacterial activities. It is very clear that effective antimicrobials, both those as monotherapy or in combination therapy, are those that hit multiple targets. Traditional Chinese Medicines (TCM) are by nature combinatorial in their activities and present a golden opportunity for China to take a strategic lead in the development of new effective therapeutics to combat AMR in China.Here we bring together interdisciplinary teams to deliver state of the art scientific advances and policy expertise across the UK and China; that will help train the next generation of researchers, develop innovative research platforms, and an environment from which (given the support and incentives) antibiotic R&D in China could grow and flourish into a new 'golden age' of discovery. This is potentially achievable, and we will determine the critical pathways and drivers that will influence and enable the discovery, development and delivery of new antibiotics in China.Six technology, policy, and training platforms provide the framework and foundation for future delivery, and a pipeline for China UK exchange and interaction. 1.Target validation and mechanisms. 2.Assays and screening. 3. Lead development 4. Industry translation 5. Policy. 6. Training and exchange. Exchange will be an important component of the hub enabling interchange of up to 15-20 researchers into the UK or China. This includes cultural orientation, crash course language training and a broad AMR training program at Sheffield for incoming China researchers, plus specialist research training for up to 12 months at hub partners. Our focus will be on 'old' and 'new' targets encompassing our breadth of existing expertise in essential processes, virulence and resistance mechanisms. Our targets will be those within multi-drug resistance in 'ESKAPE' and WHO priority bacteria including Escherichia coli, Helicobacter pylori, Pseudomonas aeruginosa, Salmonella sp. and Staphylococcus aureus. These pathogens are responsible for life-threatening infections in most Chinese hospitals and communities. New topical, gastric and systemic therapeutic interventions are urgently required to reduce transmission and disease. This CHN UK hub of activity is built from strong university and institute partnerships across Chinese Academy of Sciences (CAS) Shanghai Institue Materia Medica (SIMM), Jilin, Royal Botanic Gardens at Kew, Sheffield, Oxford, Peking, Warwick, Xiamen. These are cornerstoned by national infrastructure support in the UK from the Diamond Light Source synchrotron, Protein Production UK (PPUK) and the Research Complex at Harwell (RCaH), and in China by the Shanghai Synchrotron (SINAP) and national compound collection at SIMM. Furthermore, these will be supported by an international panel of experts from academia and industry. This expertise includes individuals with more than 250 years combined experience in antibiotic discovery, the de novo establishment of a drug discovery institute (H3D) in South Africa, and global AMR industry and policy perspectives from PwC (with significant China expertise) and The Economist Group, both of whom are heavily committed to help encourage the development of global AMR solutions. The Economist Group have already planned a major international AMR workshop (London, Jan 2019) that we will engage with.A senior management group supported by English and Chinese speaking administrators in Warwick and Sheffield will enable effective program delivery.