The ICARS strategy is based on four interconnected pillars:
- Partnering with LMICs to develop and test solutions to tackle AMR, using implementation research to generate new evidence
- Supporting the translation of existing evidence into policies, programmes and practice
- Advocating globally and nationally for Intervention and Implementation Research as an important area to tackle AMR
- Supporting targeted capacity and capability building through training and nurturing AMR champions in LMICs.
Antimicrobial resistance is a complex issue. The spread of infection between animals, humans and in the environment means that we must move away from isolated interventions in a single sector.
Through our activities, we enter into partnerships with low- and middle-income countries (LMICs) to advance the implementation of their NAPs. Specifically, ICARS partners with LMICs to develop and test new solutions for AMR mitigation, translate existing evidence into action and, as part of these activities, support capacity and capability building in the country.
We further advocate for the need for Implementation Research as a means to deliver on the NAPs. Our work is supported by implementation partners and builds on existing national and international initiatives to expand the scale and scope of the AMR response, and boost investment and collaboration across sectors.
Pillar 1: Develop and test context-specific solutions for AMR mitigation
Each country is different both in its approach to tackling AMR and in the type of issues that accelerate AMR at a local level.
ICARS simultaneously uses top-down and bottom-up approaches, engaging with government ministries while involving scientists and practitioners throughout the process. Through visits, workshops, frequent discussions and reviewing existing evidence, ICARS and the country partners gain a deep understanding of the context surrounding the issue at country-level and understand the key challenges. By working with ministries and local-level stakeholders to understand the context, ICARS ensures that the implementation research projects are tailored to respond to each country’s individual needs and challenges, and that activities are guided by the problems that countries are committed to solve rather than one-size-fits-all programmes.
Feasible solutions must furthermore be cost-effective, especially in an LMIC setting where resources are scarce. They should provide an incentive for stakeholders to implement them in practice. Thirdly, and perhaps most importantly, sustainable solutions require close attention to the enablers of behaviour change in the specific context. Only with actual behaviour change can solutions become sustainable and have true impact. Implementation Research is as such an important tool for increasing the effectiveness of solutions in the long-term. The ministries are responsible for the development and implementation of the project, with support and advice from ICARS. At the same time, a wide range of stakeholders are involved in the process from the beginning, be they practitioners, researchers or the private sector, to ensure buy-in and maximize the commitment for action from country partners. This results in a project plan that is co-developed with the country partners, and an effective implementation phase with efforts from all stakeholders.
While bringing together multiple stakeholders to tackle AMR together is not easy, it is the belief of ICARS that such a comprehensive approach is essential for bringing evidence into action and leading to sustainable, long-lasting behavior change.
Are you a government official from a low- or middle-income country that is committed to fighting AMR, who could use support from ICARS to implement its National Action Plan?
Pillar 2: Translate existing evidence into action
ICARS supports the translation of existing evidence into country policies, programmes and practice to close the knowledge gap between evidence-based interventions and solutions and their practical implementation in LMICs.
There is a wealth of research evidence as well as tools and methodologies that have shown impact on AMR, reducing drug-resistant infections. However, such evidence has been produced by academic researchers with very little input from ministries
and policymakers and is often primarily developed in high income settings, thereby not being directly applicable to LMICs. This pillar covers our actions to support the translation of existing evidence on AMR into country policies, programmes and
practices in LMICs.
At ICARS we are currently identifying areas of opportunity to translate evidence into action, in partnership with LMIC ministries. We do this by analysing and reviewing reports of previous efforts, completed research and scientific publications, while evaluating which solutions could be potentially suitable for a specific LMIC. There is no one-size fits all. Where appropriate, we will engage with and facilitate dialogue between the research community and the relevant government ministries to identify barriers and enablers for the implementation of such existing, evidence-based solutions.
Pillar 3: Advocate for intervention and Implementation Research as an important tool to tackle AMR
ICARS engages with national and international partners to raise awareness and promote the need for Implementation Research in AMR as a means to deliver on NAPs, as well as advocate for more investment in this area of research.
We aim to influence more funders and policymakers, at a national and international level, to prioritise this area of research and increase their investment. In addition, our goal is to become the ‘go to’ partner for AMR Implementation Research and intervention development in LMICs. This pillar covers our efforts to raise awareness of and promote the need for and mobilise national and international commitment for intervention and implementation research as a means to deliver on AMR National Action Plans, while advocating for more investment in this area of research.
We are advocating nationally and internationally for intervention and implementation research to alleviate AMR globally, and especially in LMICs. Due to the COVID-19 pandemic, most of our advocacy activities are now taking place online, through social media or participation in virtual events such as conferences and webinars. We are pleased to see the interest in our approach grow and our online network expand both in size and diversity, now including LinkedIn followers from over 30 countries.
Pillar 4: Support targeted capacity and capability of AMR champions in LMICs
Capacity-building is essential to the process of creating sustainable behaviour change to address AMR. This pillar covers activities meant to support policy-makers and professionals in LMICs in their efforts to tackle AMR. We work with partners to nurture a critical mass of researchers and local stakeholders, sharing knowledge and skills that help them use intervention and implementation research in their efforts to reduce drug-resistant infections.
In the future we aim to extend access to information and training on intervention and implementation research through multimedia means such as certified MOOCs and online workshops. This would allow more researchers from LMICs to participate and improve their skills while being inspired to use this methodology in tackling AMR in their own country.