EPSRC Digital Health Hub for Antimicrobial Resistance

抗菌素耐药性数字健康中心(AMR)旨在利用创新的数字技术，最终改变抗菌素单一健康监测和抗菌素管理，承认AMR在人类、动物和环境之间的相互联系。世界卫生组织宣布AMR-也被称为“沉默的大流行”-人类面临的十大全球公共健康威胁。AMR也在英国内阁府风险登记册上排名，然而，尽管得到了这一承认，但对AMR预防的关注和资金水平仍然低得惊人。2016年奥尼尔关于抗菌素耐药性的审查强调，到2050年，除非采取行动减少抗菌素耐药性，否则每年1000万人的生命和累计100万亿美元的经济产出将面临风险。来自动物、人类和食物的抗药性病原体可以交叉传播，环境水库是一个潜在的重要领域，在这个领域中发生了抗药性基因的动员和转移。因此，需要对AMR监测和公共卫生行动采取综合的One Health方法。此外，人们越来越担心气候变化可能会增加新出现和再次出现的传染病的风险。人们越来越多地认识到数据科学和数字卫生技术在抗击AMR方面的重要性，尽管该领域仍处于初级阶段。在前所未有的需求的推动下，新冠肺炎大流行极大地加快了数字卫生技术的进步，而利用这些进步对AMR来说是一个巨大的机会。然而，仍然存在许多挑战：对一次性保健需求了解不足；数据链接、孤岛和差距阻碍监测；缺乏快速检测，公众缺乏对AMR的认识；数字干预措施往往没有优先考虑用户主导的设计，也没有以行为改变为基础；汇集大数据集的数据隐私、安全和道德问题；健康不平等和数字鸿沟；早期研究和AMR需求之间的脱节，以及缺乏对如何将数字技术商业化、监管并整合到医疗系统和患者路径中的理解。AMR的数字健康中心汇集了来自五所大学、NHS、英国健康安全局、生态和水文学中心、慈善机构和行业合作伙伴的大量合作伙伴，他们跨越传统学科为AMR工作，包括计算机科学、生物医学工程、行为社会科学、环境科学、数据可视化以及临床和公共卫生研究。我们的中心愿景将通过五个目标实现：1.系统层面的需求：培育跨部门参与的新文化，以加快为AMR One-Health监测和抗菌管理创造和采用数字健康创新。2.技能和能力：提高跨学科技能、能力、知识共享和领导力，以便为抗击AMR制定世界领先的数字卫生战略。重大挑战：共同为AMR的两个重大挑战创建数字健康解决方案：i)数字One-抗生素使用和AMR的健康监测，将人类、动物和环境数据联系起来；ii)通过决策支持算法、数字诊断可穿戴设备和传感器进行数字抗菌素管理4)。伙伴关系基金：通过在产业界、学术界、卫生和社会保健之间开展跨学科试点研究，扩大临界质量和创新中心。影响和参与：通过我们的沟通战略、耐心和公众参与、一年两次的会议和活动，最大限度地提高中心的影响力和EPSRC的投资。

The Digital Health Hub for Antimicrobial Resistance (AMR) aims to harness innovative digital technologies to ultimately transform antimicrobial one-health surveillance and antimicrobial stewardship, recognising the interconnectedness of AMR between humans, animals and the environment.The World Health Organization declared AMR - also known as the 'silent pandemic' - a top 10 global public health threat facing humanity. AMR also ranks on the UK Cabinet Office Risk Register and yet despite this recognition, there remains alarmingly low levels of attention and funding for AMR prevention. The 2016 O'Neill Review on Antimicrobial Resistance highlights that by 2050, 10 million lives a year and a cumulative US$100 trillion of economic output are at risk unless action is taken to reduce AMR. Resistant pathogens from animals, humans and food can be cross-transmitted and environmental reservoirs are a potentially important domain in which the mobilisation and transfer of resistant genes occur. Thus, an integrated One Health approach to AMR surveillance and public health action is needed. Moreover, there is growing concern that climate change could increase the risk of emerging and re-emerging infectious diseases.There is growing recognition of the importance of data science and digital health technologies in the fight against AMR, though the field remains in its infancy. The COVID-19 pandemic has dramatically accelerated advances in digital health technologies, driven by unprecedented need, and there is a huge opportunity to leverage these advances for AMR. However, there remain many challenges: poor understanding of one-health needs; data linkage, silos and gaps hinder surveillance; the lack of rapid tests, the lack of public awareness of AMR; digital interventions often do not prioritise user-led design and are not grounded in behaviour change; data privacy, security and ethical issues of bringing together large datasets; health inequalities and the digital divide; the disconnect between early stage research and AMR needs, and lack of understanding of how digital technologies can be commercialised, regulated and integrated into health systems and patient pathways.The Digital Health Hub for AMR brings together a critical mass of Co-Is working across traditional disciplines for AMR, including computer science, biomedical engineering, behavioural social science, environmental science, data visualisation, and clinical and public health research, from five universities, NHS, UK Health Security Agency, Centre for Ecology and Hydrology, charities and industry partners. Our hub vision will be achieved through five objectives:1. Systems-level needs: To nurture a new culture of cross-sector engagement to accelerate the creation and adoption of digital health innovations for AMR one-health surveillance and antimicrobial stewardship. 2. Skills and Capacity: To grow interdisciplinary skills, capacity, knowledge sharing and leadership needed to deliver a world-leading digital health strategy for combatting AMR.3. Grand Challenges: To co-create digital health solutions for two AMR grand challenges: i) Digital one-health surveillance of antibiotic use and AMR, linking human, animal and environmental data ii) Digital antimicrobial stewardship via decision support algorithms, digital diagnostics wearables and sensors4. Partnership Fund: To grow critical mass and a hub of innovation by seeding interdisciplinary pilot studies between industry, academia, health and social care.5. Impact and Engagement: To maximise hub impact and EPSRC's investment through our communications strategy, patient and public engagement, biannual conferences and events.