Uganda Fleming Fellowships in AMR surveillance at the University of Edinburgh

The University of Edinburgh is hosting six fellows from Uganda to help build capacity in the surveillance of antimicrobial resistance and antibiotic use.

The Fleming Fund is funded by the Department for Health and Social Care in the UK government to give support to low and middle income countries addressing AMR.

As part of this work, the Fleming Fund is funding a range of initiatives in low and middle income countries with the aim of increasing the quantity and quality of data available to allow better understand the scale and scope of AMR.

The aim is to get data relevant to AMR in the hands of decision makers to inform policies and practices which will optimise the use of antimicrobial medicines.

Fleming Fund Fellowship Scheme in Uganda

As part of this scheme the University of Edinburgh has been selected as a Host Institution for Fleming Fund fellows from Uganda.

In Edinburgh, the scheme is being directed by Ross Fitzgerald (head of Edinburgh Infectious Diseases), with Adrian Muwonge as co-director.

Six fellows were appointed at the end of 2018 and over the past 7 months they have been working with the mentors at the University of Edinburgh to gain relevant knowledge and skills which will help them make an impact on improving the surveillance of AMR and antibiotic use in their country.

The six fellows have a wide range of experience in addressing AMR in both humans and animals.

Uganda Fleming fellows

Merab Acham – Veterinary Inspector, Ministry of Agriculture, Animal Industry and Fisheries

Joel Bazira – Senior Lecturer, Mbarara University of Science and Technology (MUST)

Joseph Kungu – Lecturer, Makerere University, College of Veterinary Medicine Animal Resources and Biosecurity (COVAB)

Ibrahimm Mugerwa – National Coordinator for AMR Surveillance, Uganda National Health Laboratory Services (UNHLS)

William Olum – Senior Pharmacist, Jinja Regional Referral Hospital

Michael Omodo – Laboratory Manager, National Animal Disease Diagnostics and Epidemiology Centre (NADDEC)

Getting started in Uganda

The Edinburgh mentors, fellows and representatives from the fellows' home institutions met at a workshop in Kampala early in January to start devleping workplans for the fellowships.

Some of the Edinburgh team returned to Kampala in April 2019 to start delivery of the epidemiology and statistics training that will underpin much of the new work the fellows want to develop in their professional posts.

In addition to to the practical training in epidemiology and statistics, a key part of the the fellowships is a collaborative project for all six fellows and mentors which takes a One Health approach to the problem of AMR.

In preparation for this project, some of the team travelled to sites in Jinja and Mbarara where some fieldwork will be carried out later this year.

Fleming fund fellows in Uganda January 2019 — The opening workshop for the Fleming Fund fellows and mentors took place in Kampala, Uganda in January 2019, with representatives from the Infectious Diseases Institute at Makerere University and Mott MacDonald, the fellowship scheme coordinator, also attending.

Uganda Fleming fellows in Kampala — The six Fleming Fellows with staff from the University of Edinburgh outside the Infectious Diseases Institute at Makerere University in Kampala, April 2019.

Uganda Fleming fellows and mentors on Equator — Some of the fellows and mentors went to visit field sites for the collaborative project in April 2019, and found themselves split between north and south!

Pig farm near Jinja, Uganda — These young pigs were on a farm near one of the potential field sites, near Jinja.

Lady pig farmer in Jinja, Uganda — This pig, in a farm outside Jinja, was particuarly photogenic.

Visit to Edinburgh

In June 2019, the fellows travelled to Edinburgh. They spent a busy four weeks engaged in a variety of key activities to help them devleop effective approaches for surveillance of antimicrobial resistance and antibiotic use in humans and animals.

They met with a wide variety of clinicans, vets, epidemiologists, and social scientists working in relevant fields.

They also attended a microbiology lab course, toured the microbiology diagnostics labs at the Royal Infirmary of Edinburgh, and developed plans for the collaborative research project.

Uganda Fleming fellows in Edinburgh — The sun shone for the fellows on their visit to Edinburgh in June 2019. Here, with University of Edinburgh mentors and Eileen Chappell, the Fleming Fund Fellowship scheme coordinator, outside the Royal (Dick) School of Veterinary Studies at Easter Bush.

Flmeing fellows at EID20219 symposium — The fellows also attended the annual Edinburgh Infectious Diseases at the Royal College of Physicians (Edinburgh). L to R: Ross Fitzgerald (director of the Fleming Fellowship scheme at the University of Edinburgh), Merab Acham, Joel Bazira, William Olum, Jospeh Kungu, Michael Omodo and Ibrahimm Mugerwa.

Next steps

Over the next 12 months of the fellowship, carry out a pilot study to assess the logistics of the main collabroative project which will be starting at the end of the year. The fellows will returning to Edinburgh in January 2020 to start the analysis of data obtained in this project.

The Edinburgh mentors will continue to input into the new projects, giving fellows practical on-the-ground support and contributing to training and capacity building in Uganda.