Community Research and Development Information Service - CORDIS

FP7

JPIAMR Report Summary

Project ID: 323209
Funded under: FP7-HEALTH
Country: Sweden

Final Report Summary - JPIAMR (Coordination Action for the early implementation of the Joint Programming Initiative on Antimicrobial Resistance)

Executive Summary:
Executive Summary

Joint Programming is a concept developed to address both fragmentation and need for alignment of policy and research among EU member states and associated countries in which participating countries define, develop and implement a common Strategic Research Agenda. This agenda is the foundation for the agreed vision on how to address the major societal challenges like antimicrobial resistance (AMR). For JPIAMR this includes the alignment of national, European and international policies and programs and issuing calls and a large spectrum of joint activities in the field of AMR as well as updating the SRA. The JPIAMR thus promotes transnational cooperation to combine the resources, infrastructures and research strengths in order to overcome the challenge of antimicrobial resistance.

Objectives

• JPIAMR will develop a scientific program aiming towards sustainable use of antibiotics and a decrease in the number of patients with resistant infections in Europe.
• JPIAMR aims to integrate relevant scientific fields across national borders and to create a common Strategic Research Agenda with a shared common vision where available resources and capabilities are coordinated to maximise their use and impact.
• JPIAMR provides the forum and platform for initiating and coordinating joint actions with Stakeholders beyond issuing joint calls.

Achievements and Impact

During the period of the CSA, the governance structure of JPIAMR was established, a Strategic Research Agenda and an Implementation Plan were launched. A Terms of Reference document, a Vision Document, an Alignment Plan, an AMR research funding mapping and other strategic and governance documents such as evaluation and monitoring framework, peer review guidelines, IPR and Open Access policy, foresight guidelines and a communication strategy were developed. A self-evaluation was also undertaken in 2015.

Three international conferences ,ten strategic workshops, several high level events with related initiatives and a variety of workshops have been organised. The commitment of up to 43 million euro of funding for four joint transnational calls during the period of 2014-2016 was secured, which is in addition to funds already being spent by national funding organizations. A mapping exercise of antibacterial resistance research and associated investment in participating countries was performed and results are available in a research funding database on the JPIAMR website.

The research supported through JPIAMR is expected to increase our understanding of the risk for un-controlled spread of resistance genes among bacteria and the spread of resistant microbes between humans, animals and the environment, and will allow for the identification of preventive measures or interventions. Meanwhile, research to support the development of new antibiotics and diagnostics will be necessary until we, by translating into a lower and smarter use of antibiotics in veterinary and clinical settings globally, obtain sustainable health economics and a significant reduction of the risk that antibiotic resistance poses to public health.

With the support of the JPIAMR a significant number of Member States, Associated Countries, and Third countries like Canada, Japan and Argentina, will have expanded the European Research Area in the field of Antimicrobial Resistance into a Global Research Area within the next fifteen years.

Project Context and Objectives:
What is JPIAMR?

Antibiotics have saved millions of lives from once deadly infectious diseases. But, misuse of antibiotics and other antimicrobials in humans and animals has led to bacteria evolving resistance. To progress towards tackling Antimicrobial Resistance (AMR), the Joint Programme Initiative on Antimicrobial Resistance (JPIAMR) coordinates national funding and supports collaborative action to fill knowledge gaps in this field. By mobilising existing and new resources the initiative can create a greater critical mass and attract new researchers into the AMR field. A Strategic Research Agenda (SRA), which outlines key [neglected] areas to tackle, guides JPIAMR and focuses research actions. The SRA also serves as a guidance documents for nations to align their AMR research agenda.

Antimicrobial Resistance, the Societal Challenge

In the past seventy years since their discovery, antibiotics have saved millions of lives from once-deadly infectious diseases, and continue to be crucial for the success of ordinary treatments and medical interventions. Many recent developments in modern medicine (e.g. neo-natal surgery, organ transplants or advanced cancer treatments) would again become impossible without the use of antibiotics to prevent infections due to surgical treatment or immunosuppression.

The more antibiotics that are used (even when this use is medically justified), the higher the risk that pathogenic bacteria will evolve resistance to antibiotics. Through use and misuse, bacterial resistance is spreading, and continues to spread, rendering antimicrobial drugs (including antibiotics) close to useless. The millions of metric tons of antibiotics that have been produced and used over the last decades have now led to a situation in which multi-drug resistant bacteria have become a major threat to human health. Correct antibiotic therapy may not be started in time, or there are simply no (or very few) antibiotics available that can be used for the successful treatment of infections with these bacteria.

Besides morbidity and mortality, Antimicrobial Resistance (AMR) also has an economic impact on individuals, healthcare systems, and societies, though this cost has proven difficult to accurately quantify. A British AMR Review Committee, on behalf of the UK Government, found that today in the US and Europe alone, 50,000 deaths per year can be connected to resistant antibiotics. And these figures are set to rise. The prediction is that in 2050, only 35 years in the future, 10 million people will die each year to an astronomical cost of 100 billion dollars to society.The World Health Organization (WHO) currently considers antibiotic resistance one of the three greatest threats to human health for the next decades.

Antibiotic resistance is a global problem that concerns all countries and levels of society. Resistance leads to infections that does not respond to treatment with available antibiotics. A global reduction of the burden of microbial infections resistant to treatment with antimicrobials will lead to reduced health costs and saved lives. Research of antimicrobial resistance in Europe is fragmented and few countries have specific programs dedicated to this field of research. To tackle this challenge, 22 countries have joined forces in the Joint Programming Initiative on Antimicrobial Resistance (JPIAMR) with the aim to coordinate research efforts to have greater impact and to avoid duplication. Only by bringing together industry, public health bodies and academic bodies to share experience and resources across scientific disciplines will it be possible to create long-term reduction of AMR in Europe.

Joint Programming Initiatives were set up to pool national research efforts in order to make better use of Europe’s public R&D resources and to tackle common European societal challenges more effectively in a few key areas. They are designed to overcome the fragmentation of national research programmes to address global challenges.

Why JPIAMR?

• Research of AMR in Europe is fragmented and few countries have specific programs dedicated to this field of research.
• To coordinate the AMR research, in order to allow greater impact and avoid duplication.
• Only by bringing together industry, public health bodies and academic bodies to share experience and resources across scientific disciplines will we be able to create long-term reduction of antimicrobial resistance in Europe.

Objectives

• JPIAMR will develop a scientific program aiming towards sustainable use of antibiotics and a decrease in the number of patients with resistant infections in Europe.
• JPIAMR aims to integrate relevant scientific fields across national borders and to create a common Strategic Research Agenda with a shared common vision where available resources and capabilities are coordinated to maximise their use and impact.
• JPIAMR provides the forum and platform for initiating and coordinating joint actions with Stakeholders beyond issuing joint calls.

Aims

• Find routes for novel antibiotics and new anti-infectious strategies.
• Scientifically validate means to increase the number of patients treated early with the appropriate antimicrobial.
• Provide scientific evidence on ways to reduce the spread of resistant strains.
• Provide scientific evidence for the efficacy of strategies to reduce the number of patients with multidrug resistant strains.
• Reduce the consumption of antibiotics.

Project Results:
JPIAMR Achievements and Impact

During the period of this CSA, JPIAMR governance structure has been implemented, including a Management Board (MB), a Steering Committee, a Scientific Advisory Board (SAB), a Stakeholders Advisory Board (SHAB), a Core Call Steering Group, and a Central Secretariat based in Stockholm. National Expert Panels have been appointed in each participating country.

The Management Board has adopted a Terms of Reference document, a Vision Document, a Strategic Research Agenda (SRA), an Implementation plan 2014-2018, an Alignment Plan, an AMR research funding mapping and other strategic and governance documents such as evaluation and monitoring framework, peer review guidelines, IPR and Open Access policy, foresight guidelines or a communication strategy. A self-evaluation was also undertaken in 2015.

In order to organise the portfolio of joint activities the JPIAMR MB has developed an “Implementation Plan 2014-2018” and set up 4 strategic Working Groups on SRA Implementation, Alignment, Evaluation and Internationalisation, and 1 Task Force on Industry Relations that deploy the implementation of the initiative.

Several joint calls (4), international conferences (3), strategic workshops (10), several high level events, AMR national alignments, collaboration with key international stakeholders, among other activities have been set up.

The research supported through JPIAMR is expected to increase our understanding of the risk for un-controlled spread of resistance genes among bacteria and the spread of resistant microbes between humans, animals and the environment, and will allow for the identification of preventive measures or interventions. Meanwhile, research to support the development of new antibiotics, alternative therapies and diagnostics will be necessary until we, by translating into a lower and smarter use of antibiotics in veterinary and clinical settings globally, obtain sustainable health economics and a significant reduction of the risk that antibiotic resistance poses to public health. The global and multifaceted problem of antimicrobial resistance will demand vast and versatile solutions. A comprehensive solution to the problem requires measures from many sectors of society, including but not limited to: policy makers; health care; education; industry; environmental agencies; agriculture; veterinary medicine; and research. The coordination of the best European research resources and capabilities will be necessary to form critical mass and develop the most advanced scientific approaches to tackle the problem of AMR. Turning back the increasing trend towards AMR by sustainable use of antibiotics and the implementation of new treatment options for infectious diseases are major goals.

With the support of the JPIAMR a significant number of Member States, Associated Countries, and Third countries like Canada, Japan and Argentina, will have expanded the European Research Area in the field of Antimicrobial Resistance into a Global Research Area within the next fifteen years.

The JPIAMR coordination and support action (CSA1.0), granted by the European Commission, has played a pivotal role since 2012 in establishing the JPIAMR initiative and in the early successes of the collaboration. Until now, the CSA1.0 financial support has enabled JPIAMR to operate effectively and efficiently. The continuation of a JPIAMR sustainable organisational structure that can address the multiple (scientific) objectives of the JPIAMR Strategic Research Agenda and support actions of the JPIAMR Implementation Plan is going to be supported on a voluntary basis, from each participating country, both in-kind (by fees) and in-cash. Additional engagement in partnerships with the European Commission are also sought.

Developing the Strategic Research Agenda

The JPIAMR Scientific Advisory Board (SAB) consists of international top researchers in the AMR field that were proposed by the participant member states. The composition was arranged to cover different aspects of AMR research and has subsequently been complemented to cover also certain additional identified areas of expertise, primarily veterinary AMR medicine and behavioural science.

The prime task of the SAB has been to develop the SRA, during 2013 with extended expert consultations, national consultations and stakeholders’ consultations, and to provide advice to the Management Board regarding scientific priorities, workshops and calls.
The JPIAMR SRA, launched in 2014, defines the strategic and scientific priorities benefiting from co-ordination and co-operation at the European level with the aim to reduce antimicrobial resistance and thus improving public health and wellbeing of populations and deliver economic and societal benefits.

Through a series of Scientific Advisory Board workshops and national expert panels, stakeholder, and public consultations, six strategic research priorities have been identified:

• Therapeutics: The improvement of current antibiotics and the development of new antibiotics and alternatives for antibiotics.
• Diagnostics: New and improved diagnostics to stimulate better use of current antibiotics and support the development and use of new antibiotics and alternatives to antibiotics.
• Surveillance: An international, standardised surveillance programme for AMR and antibiotic use in human and agricultural settings.
• Transmission: A comprehensive, multi-disciplinary understanding of the transmission mechanisms.
• Environment: The assessment of the contribution of pollution of the environment and the development of strategies to minimize environmental contamination.
• Interventions: The study of preventative and control interventions.

The SRA is not just supported and recognised by the initiative’s member states but also by other international players, such as WHO. This became apparent once more at the launch of the JPIAMR Strategic Research Agenda “Joining forces globally against drug resistant bacteria” on 3rd April 2014, in Brussels.

The SRA has adopted a ‘One Health’ approach including research on animals and the environment as well as humans, which should lead to:

• More prudent use of antibiotics in people and animals.
• Incentives for the development of new antibiotics, and alternatives for antibiotics such as vaccines, and better diagnostics. In addition, novel good diagnostic tools are needed to promote the efficacious use of these (new) medications.
• A warning system is needed to enable better risk assessments to support effective policy measures to contain resistance in hospital, community and agricultural settings. To achieve this, surveillance systems on antibiotic use and on resistance (in humans, animals, foods and the larger environment) should be standardised, improved and extended, with the final aim to foster a global surveillance system for AMR.
• Interventions are needed to prevent colonisation, infection and transmission of resistant bacteria by hospitalised patients. A better, quantitative understanding of the transmission routes of AMR between bacterial populations and between different (animal, human, food, environment) reservoirs is needed to support the development of strategies and interventions to minimize the spread of resistance. Research on the effectiveness of intervention strategies and how they can most effectively be implemented is also required.
• Political and societal awareness on the threat of AMR is crucial to stimulate the implementation of measures to fight the misuse of antibiotics and to stimulate innovation.
• Knowledge transfer and intensive collaborations between scientists and policy makers is important for the successful adaptation or adoption of measures that positively impact on AMR, have social support and are cost effective.

The SRA is a living document and the Scientific Advisory Board is already working on updating some sections by adding new elements especially in the environment and behavioural areas.

Additionally, we have also developed a foresight report that summarises our definition of foresight, the foresight activities undertaken during the development of the SRA and the future action plan for the update of the SRA. A full foresight exercise will be developed when starting the new version of the SRA in 1-2 years.

Alignment of national Plans – the influence of the JPIAMR SRA

Alignment for JPIAMR is the strategic approach taken by the Member States to modify their national programmes, priorities or activities as a consequence of the adoption of joint research priorities in the context of Joint Programming with a view to implement changes to improve efficiency of investment in research at the level of Member States and the European Research Area. The state of alignment will be modified and will develop further over time to reflect the changing priorities and needs. National Mirror Groups have started to be set up within members (e.g. France, UK)

JPIAMR has a dedicated Working Group that has developed an “Alignment Plan”. Alignment of national research programmes and activities occurs around a common Strategic Research Agenda (SRA). In practical terms, it requires changes to the content of national research programmes, the volume of research and the way the national programme or activity is executed (e.g., in its degree of collaboration with third parties).

An “Intergovernmental Workshop” held in Paris on the 17th November 2015 brought together ministries, agencies and funding bodies to discuss the current situation of AMR funding in each country and to discuss ways to add value to new and existing programmes of work, through cooperation and coordination within and between countries and discuss the challenges associated with transnational funding.

JPIAMR member countries are invited to take into account the JPIAMR ‘One Health’ perspective on AMR when designing and updating their own national research and innovation strategies and programmes. In addition, they are encouraged to improve the inter-operability between their national programmes and to use JPIAMR’s Strategic Research Agenda as guidance. For example, Sweden or Spain, have copied the SRA directly into the national plans and France used a major part of it in its own plan for research.

Before 2011 few countries even had AMR national plans. In the last years, especially in 2015 many countries have started to develop their national plans. In the dedicated section on research of those plans the JPIAMR SRA is referred to as the basis on how the research elements should be addressed.

The JPIAMR (phase 2) mapping exercise, ‘AMR activities beyond funding of research projects’ (October 2014-March 2015), has identified 12/18 countries providing data now having an AMR strategy in place, while an additional 3 countries are in the process of developing a strategy. The JPIAMR should work across all countries to promote the research themes within the SRA and assist those countries currently developing a strategy or those who do not have one.

JPIAMR also helps national countries to find the right tools for internal coordination and alignment (e.g. creation of mirror groups on the one health approach, development of funders’ forums etc) like in the case of UK or France.

• The JPIAMR SRA provides a science-based template for nations to incorporate AMR into their national research plans to tackle resistance through central transversal programmes.
• JPIAMR facilitates synergies, add value to programmes and combine different investments in AMR to avoid small scale efforts and increase awareness.
• JPIAMR actively collaborate and coordinate alignment actions with the European Commission, acknowledging its active partner role and strong support by responding to calls for new funding instruments.

Mapping AMR research funding, identifying gaps

JPIAMR mapped out antibacterial resistance research undertaken across 19 countries from 2007-2013, identifying 1,243 projects with a total public investment of €1.3 billion. We looked at national investments and European Union organisations investments, including the European Commission’s investment in the Innovative Medicines Initiative (IMI) and found that funding varies considerably across countries and within the different research areas.

With the mapping of Antibacterial Resistance research funding in the countries Belgium, Canada, Czech Republic, Denmark, Finland, France, Germany, Greece, Ireland, Israel, Italy, the Netherlands, Norway, Poland, Portugal, Romania, Spain, Sweden, Switzerland, Turkey, the United Kingdom, and the EU, we have a detailed overview of the scale and scope of AMR research and associated investment in Europe. The mapping exercise was used in conjunction with the SRA to develop the implementation plan and for the prioritisation of particular research areas identified in the SRA. It identified gaps and opportunities for the JPI and Member States to exploit. This information was also used in the working group on alignment to identify areas for improved co-ordination, and to align research efforts and avoid duplication across Member States. Finally, this exercise forms the baseline for AMR research and associated investment which will help to evaluate the work of the JPI over time.

The report on the JPI AMR mapping exercise was published in the journal Lancet Infectious Diseases: http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)00350-3/fulltext?rss=yes

National and European research funding in the field of antibacterial resistance is unbalanced and underfunded was the key find of the study.

The JPIAMR mapping study has shown that 66% of funding was awarded to projects in the field of therapeutics. This is a stark contrast to the other fields such as transmission, which received 9% of the funding, 14% of funding went to diagnostics, 5% to interventions and only 2% awarded to projects on antimicrobial resistance in the environment and 4% in surveillance. 91% (1,129/1,243) of projects identified in this study were funded at national level. However, they only accounted for 49% of total investment, suggesting that these are relatively small awards and highly focussed projects.

In addition to the mapping exercise we have provided an updateable, publically accessible, database as a resource for the scientific community and other interested parties. Individual projects and programmes are identifiable within this database hosted on the JPIAMR website.

Implementing the Strategic Research Agenda, the JPIAMR joint actions

The “JPIAMR Implementation Plan 2014-2018” has been developed by a series of workshops and consultations of the Management Board and it covers both the implementation of the SRA itself, and the implementation of strategic policy issues. Four Working Groups were initially created to carry out the action plan through selected joint actions: WG1 SRA implementation (Chair: Germany); WG2 Alignment (Chair: UK); WG3 Evaluation (Chair: Spain); WG4 Internationalisation (Chair: Sweden). Later on a Task Force on industry relations was added (Chair: France).

EU funding currently accounts for approximately 10% of all European research financing; the majority of funding being provided by national organisations. AMR research is a prioritised area by the EC and its relative impact is higher in this area. EU and national funding has been identified in the JPIAMR mapping of AMR research.

The Strategic Research Agenda (SRA) provides a framework of opportunities for countries involved in the JPI AMR and those who are willing to participate in joint actions. Joint actions will be implemented through co-operative activities that realign or link national investments in order to achieve increased impact and the provision of new funding.

The JPIAMR calls and other activities will be instrumental in producing new innovative approaches and advancing existing research in order to create the foundation for the development of cost-effective prevention and intervention strategies to decrease the transmission of AMR in society. Outcomes from this research could improve public health and wellbeing of populations while boosting research advances and innovations, increasing the competitiveness of the European Union. However, it is expected that the results will lead to economic and societal benefits not only in Europe but also globally.

The Implementation Plan is already being deployed with a series of ongoing, past and planned joint activities.

Strategic workshops

JPIAMR organises workshops to identify future joint actions. By bringing together experts from all relevant fields relating to a specific topic, the workshops can map the landscape and identify knowledge gaps. The added value of JPIAMR is that through its funding mechanisms and collaborative actions, the initiative can set in motion activities to fill these knowledge gaps.

• JPIAMR's role in EP resolution 'Safer healthcare in Europe', 16 February 2016, Brussels
• New Frontiers in Antibacterial Resistance Research, 20-21 January 2016, Stockholm
• Trans-Atlantic Workshop on AMR Clinical Trial Networks (JPIAMR-EC-IMI-NIH), Stockholm, January 22, 2015
• Intergovernmental Workshop 17 November 2015, Paris
• Research Infrastructures Workshop 28 October 2015, Amsterdam
• Transmission Dynamics Workshop 12 October 2015, Berlin
• Diagnostics Workshop 11 May 2015, London
• Information Systems Workshop 5 February 2015, Madrid
• Brainstorming workshop, 9-10 October 2014, Brussels
• Joint AMR workshop EC-JPIAMR-EPFIA-IMI, “Antibiotics and their Alternatives: Fixing and feeding the Pipeline”, April 4, 2014, BrusselsLaunch event of the JPIAMR Strategic Research Agenda “Joining forces globally against drug resistant bacteria”, 3 April 2014, Brussels
• Workshop on the veterinarian perspective of AMR, 31 July 2013, Amsterdam
• A stakeholders workshop: Geneva Invitational Conference, 27-28 May 2013, Geneva

Joint transnational calls for proposals

JPIAMR has launched four joint transnational calls for research proposals since 2014 including the ongoing JPI-EC-AMR Cofund call 2016, representing a total budget of approximately €42.3 million. The overall aim of the calls is to combine the resources, infrastructures, and research strengths of multiple countries in order to overcome antibiotic resistance. The goal is to foster multinational translational research collaborations that can accomplish more than individual countries working independently, leading to improved control of bacterial infections.

The first two calls are finalised and in total ten projects have been financed involving 40 of research groups from 14 countries. The projects are receiving 12.6 M€ in total over 3 years. The third call, JPI-EC-AMR Cofund call is supported by 18 countries and the EC with a budget of almost 30 M€ is ongoing and the fourth call with 10 countries involved has just been published. Both of them will have final decisions at the end of 2016 or beginning of 2017. A Fellowship programme will be also initiated in 2016.

Research infrastructure

JPI AMR aims to develop integrated approaches to pursue unique world-class research in the AMR-field. It strives to promote open-access to data, research results, and materials. Thus, JPI AMR aims to reduce research duplication, enhance coordination of research efforts, and advance collaboration between parties, e.g. between scientists and Research Infrastructures (RIs).

Research infrastructures related activities within JPIAMR:

• Spring 2015: survey on AMR related research infrastructures.
• Autumn 2015: survey on amounts of strains and samples collected in research funded by the Framework Programmes.
• October 28, 2015: Strategy meeting on Research Infrastructures, data sharing and data re-use
• January 25-26, 2016: first Medical Infrastructures/Users Forum (MIUF) meeting organized by ECRIN.

Evaluation Activities

JPIAMR has a specific working group on Evaluation that has developed a framework for monitoring and evaluating (2014). It is accompanied by an Open Access and IPR policy (2016). This exercise intends to assess whether the JPIAMR is achieving its goals with relation to its objectives. For that, a comprehensive understanding of the information provided by different national research systems is desirable so as to determine whether or not the JPI instrument adds value at European level.

Specific actions:

• A workshop regarding the different national evaluation systems (Madrid, February 2015)
• A mapping exercise of antibacterial resistance research and associated investment in participating countries from 2007-2013published in “The Lancet” (Dec. 2015) and an AMR funded projects database (Dec. 2015).
• A mapping of national European SMEs in the area of AMR (March 2015)
• A mapping of national policies looked into variables like infrastructure, research networks, national policies, political and societal awareness, training and career development, and industrial research activity (March 2015).

Internationalisation Activities

The AMR challenge needs a global approach. Consequently, this internationalisation JPIAMR working group has been working in expanding the basis of the joint programming activities including new members outside Europe. A specific Membership Policy has been developed. Currently Canada, Japan, Israel, Turkey and Argentina have joined the initiative, and there are discussions of collaboration with other countries outside Europe, for example India. For such JPIAMR developed a “membership policy”: http://www.jpiamr.eu/about/how-to-become-a-member/

JPIAMR is proving to be an international platform by engaging with non-European countries and internationally with WHO and G7. In January 2016, JPIAMR co-organised a workshop with the US National Institute of Health (NIH) and the US National Institute of Allergy and Infectious Diseases (NIAID), which brought together scientists in the field of antibacterial resistance. The aim was to increase the trans-Atlantic dialogue and encourage scientific collaboration to enhance research addressing antibacterial resistance.

Specific actions:

• Key collaboration with the US through TATFAR and by holding a joint symposium: 2016 EUROPE – NORDIC – U.S. SYMPOSIUM ‘New Frontiers in Antibacterial Resistance Research’ in Stockholm on 20-21 January, 2016
• Strategic Workshops 2016: Alternative Therapies (January), US-EU Clinical trials – in collaboration with NIH -IMI-EC (January)
• Observatory on AMR and on the WHO Global AMR Research Agenda
• Collaboration with TAFTAR
• G7 AMR statements reference JPIAMR
• Collaboration exchange with ASEAN
• Collaboration with DG Santé in a Joint Action (upcoming 2016)

External communication and dissemination

Communication, dissemination and general advocacy is critical to the success of the JPIAMR. A guide for JPIAMR Members on “Communicating the Joint Programming Initiative on Antimicrobial Resistance” was developed in 2016. It relates communication challenges for the JPIAMR with the goals for reaching out to our target groups. It provides tools and examples on how to work with our corporate identity in presentations, communication materials, events, website and other channels. All members should report their communication efforts to the Secretariat. This includes events taken part in, what type of audience, any media coverage, articles written, interviews that they have been involved in. Data will be used to better evaluate our outreach and impact.

JPIAMR has developed materials and tools to strengthen and promote a common JPIAMR corporate identity comprising infographics, slide templates for oral presentations, templates for meeting documents (invitations, agendas, list of participants, practical information, etc), as well as a generic corporate slide presentation to be used when presenting the JPIAMR. Member of the MB, SAB, and Secretariat can also use common templates for business cards, posters, brochures, and flyers.

A fully functional website has been developed that features a professional platform for information sharing, news feeds, stakeholder forum member recruitment, document library, individual member country pages, collecting of public consulting input, and call online submission. The website went public in late 2012 and a new upgraded version went online in fall 2015.

The Document Library section contains public strategic documents and JPIAMR material as well as internal pages with specific access for the different JPIAMR units. This includes group-specific login-protected access to all MB, SAB and SHAB meeting documents, in the form of an intranet. The website also features interactive elements such as a Stakeholder Forum registration form, conference registrations, call partnering tool, and call submission form (managed by the CSA Jülich partner).

Communicating and disseminating the activities, results of calls, funded projects, and policy documents is a core objective of the JPIAMR. The main channels being used are the website, a series of videos, podcasts, webinars, newsletters (8 during 2013-2016, reaching more than 1000 recipients), Twitter (www.twitter.com/JPIonAMR @JPIonAMR), and Facebook (www.facebook.com/JPIAMR) securing a wide reach towards all target groups.

Stakeholders’ relations

Scientific and policy-oriented meetings and symposia are also effective forums for communicating and discussing JPIAMR objectives, activities, and priorities with the scientific community, policymakers, industry, and other stakeholders.

The Stakeholder Advisory Board (SHAB) was formed in early 2013. Their participation was key in developing the Strategic Research Agenda. Continues bilateral meetings and teleconference are perform regularly.

SHAB members:

• Action on Antibiotic Resistance (ReAct)
• European Centre for Disease Prevention and Control (ECDC)
• European Society of Clinical Microbiology and Infectious Diseases (ESCMID)
• European Diagnostic Manufacturers Association (EDMA)
• European Federation of Pharmaceutical Industries and Associations (EFPIA)
• European Food Safety Authority (EFSA)
• European Medicines Agency (EMA)
• European Patients’ Forum (EPF)
• Federation of European Microbiological Societies (FEMS)
• Federation of Veterinarians of Europe (FVE)
• Standing Committee of European Doctors (CPME)
• World Health Organization – Regional Office for Europe (WHO)

A Stakeholder Forum for public involvement in JPIAMR has also been created where organizations and individuals having an interest in JPIAMR activities are invited to join through an online registration form . This forum currently has over 900 members.

Industry relations

A JPIAMR industry relations task force has been established to enable an environment for information exchange with large pharmaceutical companies and small and medium-size enterprises with interest in antibiotics, diagnostics, and infection prevention. Discussions with Innovative Medicines Initiative (IMI), the European Federation of Pharmaceutical Industries and Associations (EFPIA), BEAM, as well as with individual companies are well underway through the IMI2 Strategic Group on Infectious Diseases. We also have a joint strategic group comprising EPFIA, IMI, EC, and JPIAMR. JPIAMR also contributed to the international antibiotic pipeline by co-organising the first “Transatlantic Clinical Trials Workshop in the area of AMR” (Jan. 2016)

External Events with JPIAMR Participation

2013

• EAAD “AMR awareness day Press Event” (Brussels, Belgium, 15 November 2013)
• EMA Workshop: “Regulatory options in fight against antimicrobial resistance” (London, UK, 8 November, 2013
• World Health Summit 2013 with a dedicated symposium on “Current Challenges in Combating Antimictobial Resistances”. (Berlin, Germany, 20-22 October 2013)
• Workshop: ESFRI infrastructure, joint programming initiative or ERA-Net in the joint workshop for ESFRI Biological & Biomedical (BMS) research infrastructures, JPIs & ERA-Nets, (Brussels, Belgium, 17-18 October 2013)
• Global Research Collaboration for Infectious Disease Preparedness (Annecy, France, 9-10 October 2013)
• Chatham House Conference: “Antimicrobial Resistance: Incentivizing Change towards a Global Solution” (London, 3-4 October 2013)
• Joint Programming Conference 2013 (Dublin, Ireland, 28 February to 1 March 2013)

2014

• March 12 Brussels JPIs Chairs meeting
• April 3 Brussels, De Warande, SRA Launch Conference
• April 4 Brussels Antibiotics workshop
• June 6 Luxembourg DG Sanco meeting
• June 22-24 Copenhagen ESOF conference session
• July 15 Bari, Med – Jpis meeting
• October 9-11 Brussels SRA Prioritisation workshop
• October 13 Paris JPND visit
• October 22 Brussels Alignment workshop by JPIs
• November 3 Tallinn AMR workshop day in Estonia
• November 20-22 Brussels ERC workshop on multi-lateral funding
• December London Chapman house AMR event

2015

• January 8 Geneva WHO meeting
• January 14 Brussels EFPIA meeting
• January 15 Brussels SAB meeting
• February 10 Madrid Evaluation workshop
• March 25-27 Brazil WHO workshop
• April 25-28 Copenhagen ECCMID conference
• May 5 Stockholm Swedish AMR seminar
• May 11 London Diagnostics workshop
• May 12 Riga EU presidency AMR event
• June 1-3 Uppsala AMR Conference
• June 7-11 Maastricht 6th Congress of European Microbiologists
• October 12 Berlin Transmission Workshop
• October 22-23 Luxembourg, TATFAR meeting
• October 28 Amsterdam Research Infrastructure Workshop
• November 16 Brussels Antibiotic Awareness day
• November 17 Paris Intergovernmental Workshop
• November 18 Stockholm, Antibiotikaforum
• December 1 Brussels IMI-EFPIA meeting
• December 4 Lund Lund Conference
• December 14 Gothenburg, IMI meeting

2016

• January 14-15 Brussels JPIs Joint Conference
• January 20-22 Vienna ERA-LEARN 2020 training course on foresight processes
• January 20-21 Stockholm 2016 Europe – Nordic – U.S. SYMPOSIUM “ New Frontiers in Antibacterial Resistance Research”
• January 21 Brussels Better health better research
• January 22 Stockholm NIAID Grants day
• January 22 Stockholm Clinical Trial Workshop
• January 26 Brussels Dutch Presidancy prep meeting
• January 26 Paris ECRIN MIUF
• February 9 Amsterdam Ministerial AMR Conference
• February 10 Japan Bilateral meeting
• February 12 Brussels EJP meeting
• February 12 Paris BEAM meeting
• February 12 Brussels GPC-JPIs meeting
• February 16 Brussels EU Parliament meeting

GPC Engagement

• Participation in the Dublin Joint Programming Conference of the Irish EU presidency on February 28 to March 1, 2013
• Feedback on the questionnaire investigating the relationships among European research infrastructures and research projects
• Feedback on the JPIs Framework Conditions questionnaire
• Feedback on the questionnaire on GPC-EC-JPIs communication
• 1st JPIs Chair meeting, December 4, 2013
• GPC – JPIs Alignment Workshop, Brussels, March 2014
• JPIs Chairs meeting, Brussels, March 2014
• Feedback on the questionnaire of the “GPC Biennial Report 2014 – JPI Self-Assessment”, August 2014
• Continuous engagement with the project JPIs TO CO-WORK
• GPC – JPIs meeting, Brussels, February 2016

Potential Impact:
Potential impact (including the socioeconomic impact and the wider societal implications of the project so far) and the main dissemination activities and exploitation of results

The global burden of infections resistant to existing antimicrobial medicines is now growing at an alarming pace. Drug-resistant infections are already responsible for more than half a million deaths globally each year. Research commissioned by the British AMR Review suggests that if the world fails to act to control resistance, this toll will exceed 10 million each year by 2050 and will cost the world over 100 trillion USD in lost output. The World Health Organization (WHO) currently considers antibiotic resistance one of the three greatest threats to human health for the next decades.

The global and multifaceted problem of antimicrobial resistance (AMR) demands comprehensive and creative solutions that require action from many sectors of society. To avoid outbreaks and epidemics caused by multidrug-resistant strains, costly control and prevention measures need to be taken. Joint collaborative actions, maximising research efforts and benefiting from the exchange of best practice and multi-disciplinary collaboration of different scientific disciplines and groups within society, are crucial to tackle this problem. The approach of Joint Programming has been developed for this purpose to align resources by creating a collaborative platformto maximise existing and future efforts to combat AMR.

JPIAMR was formed in the end of 2011 and has now 19 member countries, 2 observers, and Japan as partner (http://www.jpiamr.eu/about/participating-members/ ). The EC (DG Research), being a non-voting member, has been a JPIAMR Partner from its establishment and has provided strong support for the JPIAMR structure and activities in the form of a Framework Programme Coordination and Support Action and by taking part in joint collaborative activities.

Potential Impact

JPIAMR coordinates national funding and supports collaborative action to fill knowledge gaps in this field. By mobilising existing and new resources the initiative can create a greater critical mass and attract new researchers into the AMR field. Thus, JPIAMR does not only include joint transnational research funding but, furthermore, the alignment of national strategies, the internationalisation of the consortium participating in this JPI as well as fostering the agreement of common or similar policies on the common problem of AMR. A Strategic Research Agenda (SRA) was developed in 2013, which outlines key [neglected] areas to tackle, guides JPIAMR and focuses research actions. The SRA also serves as a guidance documents for nations to align their AMR research agenda.

By working together in a JPI, we could achieve:

• New preventative and therapeutic approaches
• AMR relevant research elements more embedded in health service and care infrastructure
• A reduction of inappropriate consumption of antibiotics in humans and animals
• A positive impact on treatment, care and quality of life
• Increased visibility of the burden of AMR and the benefits of research
• A catalytic effect on the development on national and international strategies

JPIAMR helped build a new integrated way of collaboration within European countries. It is extending the European Research Area by mobilising national and European resources toward common scientific goals. It fights fragmentation, and improves integration and coordination on national research programmes in the field of antimicrobial resistance. One expected impact is to increase the critical mass of researchers working on these fields to speed up discovery of new treatments and avoid redundancies. The ultimate goal of JPIAMR is to lead to new initiatives around research excellence intended to offer a competitive and attractive image of European research prosecuted for the greatest benefit of Europe’s populations and economies.

JPIAMR is an efficient tool for enlarging the ERA in the field of AMR and additional support for transnationally coordinated research. JPIAMR represents an efficient and inclusive way of conducting AMR research by promoting and supporting trans-national collaborations leading to increased mobility and new and stronger international research networks. Moreover, JPIAMR can provide guidance and share best practises in case barriers (i.e. social, economic, cultural, legislative, and inter-sectorial) are encountered by or between JPIAMR member countries.

JPIAMR is achieving coordination and integration of national research and innovation programmes with the JPIAMR research strategy in coherence with Horizon 2020 objectives. It is increasing the efficiency of research and innovation investments by European Member States by avoiding duplication of research and infrastructure investment at national level, and by updating the JPIAMR Strategic Research Agenda and keeping it aligned with global efforts. The JPIAMR SRA has by virtue of providing a common roadmap for JPIAMR members become a standard template for national research and innovation programmes. Updated mapping of nationally and internationally funded AMR projects categorized in SRA language and presented in a searchable database by JPIAMR provides joint knowledge of gaps and under-funded areas.

The coordination of research priorities directly impacts the Health theme by proposing instruments and domains reflecting needs with the potential of outputs with high impact. The implementation of the SRA in a One Health Approach should also improve the integration of disciplines and fields of research to develop linkages between basic, clinical and public health and social research. The third expected impact is the pooling and the coordination of national resources and efforts to reach the critical mass necessary to better understand, detect and prevent and combat AMR. JPIAMR support the development of National AMR strategies, plans and research programmes. The SRA also provides a base-line for the development of a Global AMR Strategic Research Agenda that the WHO has taken on board.

Impact on the European AMR Research community

The impact on the European AMR research community will be huge, as it will benefit from increased resources through pooling of resources from several member states. The strategy used to build the SRA is a bottom up one where the SAB was crucial to identify the fields to develop and the gaps to bridge. The community will benefit also from the coordination at a European level of themes and topics to be addressed as a priority and also avoiding overlapped effort.

During the period 2012 to 2016 four joint transactional calls were launched. We have already achieved coordination of AMR funding by prioritizing jointly key areas to be addressed, by attracting the research community to this field, by encouraging interdisciplinary approaches with a specific call on this and also by connecting, better the research community globally with a series of strategic workshops and a specific call to build networks / working groups.

All-in-all the impact of JPIAMR on the European Health and Veterinarian Research Community can therefore be described as a faster international progress for research and innovation on antimicrobial resistance through the development of novel research tools and infrastructures by further establishing the JPIAMR as a reference for European and global knowledge and innovation platform in the area of antimicrobial resistance.

Impact on the European Research Area (ERA)

The idea of a European Research Area grew out of the realisation that research in Europe suffers from three weaknesses: insufficient funding, lack of an environment to stimulate research and exploit results, and the fragmented nature of activities and the dispersal of resources. To tackle this problem, the Commission proposed, in January 2000, the creation of a European Research Area, including the development of a European research policy which not only addresses the funding of research activities, but also takes account of all relevant aspects of other EU and national policies.

Despite this strong declaration of intent, only 10-15% of the total public funding of research is used in common among European countries through the Horizon 2020 Framework Programme for Research, and about 10% to support intergovernmental schemes or organisations. AMR funding is low compare with other Health areas. This is an effort to mobilize more resources in this field and to coordinate national agencies in a more efficient way in funding more strategic research. Thus, JPIAMR will be an efficient tool for enlarging the ERA in the field of AMR and an additional contribution to the share of transnationally coordinated research. JPIAMR represent a different way of conducting AMR research by promoting and supporting trans-national collaborations leading to increased mobility and new and stronger international research networks.

This is why following the Commission's Communication on Joint Programming to tackle Europe's major societal challenges, the Competitiveness Council, called for a common commitment of EU Member States to fight AMR. This coordination action helped build the ERA by fighting fragmentation, and improve integration and coordination on national research programmes in the field of AMR.

Added value in undertaking the work at a European level

As in most fields of research, it is very difficult today for an isolated country to control at a very high level of skills and competences the wide variety of approaches required to tackle a multifactorial issue such as antimicrobial resistance and more specific antibiotic resistance.

The development of a new antibiotic, new therapies or new diagnostics tools require large sums of funding and a critical mass of researchers in different scientific fields. Coordination of One Health plans and actors are key to articulate priority joint actions that can provide an impact in the reduction of resistance.

Today most funding agencies working in their own countries are mostly based on a bottom-up approach. Specific top-down programmes to tackle this societal challenge should be established. The Framework Programme has in recent years established a public-private partnership with IMI to support the development of therapies with a focus on clinical research and development. It is important that the national agencies come together to fund those more fundamental knowledge gaps and pre-clinical research through the JPIAMR.

JPIAMR has started to improve this situation. Thus only a structured European approach can address this major challenge by pooling and coordinating the efforts of basic and clinical researchers in this field. Obviously, joint programming should be done at Global level.

Few years ago, most JPIAMR member countries did not have AMR national plans or identified priority actions in the field. By 2016 most of our members have now one. Those member countries who do, take different approaches:

• Specific research programmes
• National plans targeted to the health side of AMR
• National plans comprising the full One Health Approach
• National AMR strategies

JPIAMR is engaging the members in developing AMR plans and is also working to align specific areas of existing strategies relevant to AMR, specifically in the sections dedicated to research that refers to the SRA, and also has a programme of actions aimed at encouraging countries to develop new research strategies. Several countries are now including the SRA in their new national plans (e.g. Spain, Sweden) or developing specific AMR research programmes (e.g. UK, NL, Switzerland).

Internationally JPIAMR has supported WHO in developing a Global Strategic Research Agenda with the SRA base line, is instrumental in the US relations in the research field working together in several actions with NIH and more in the science policy area through TAFTAR. In addition, JPIAMR has attracted several non-European countries (e.g. Canada, Argentina, Japan) that are also working towards alignment.

List of Websites:
www.jpiamr.eu

Vetenskapsrådet/Swedish Research Council
JPIAMR Secretariat
Box 1035
SE101 38 Stockholm
Sweden

+46854644000
secretariat.jpiamr@vr.se

Contact

Jan-Ingvar Jönsson, (Secretary General Medicine and Health)
Tel.: +46 8 54644128
E-mail
Record Number: 189264 / Last updated on: 2016-09-16