This month, researchers from the Drivers of Resistance in Uganda and Malawi (DRUM) Consortium held a side event at the UNC Water and Health Conference on the role of water, sanitation, and hygiene (WASH) in AMR. Alongside this side event - which included a review of the literature and a panel discussion with experts on AMR, WASH, environmental, and One Health research and policy – DRUM also published a commentary on the role of WASH in AMR.

The conference event outlined the potential drivers of AMR transmission, including the role of WASH as both a driving and mitigating factor. As part of the event, DRUM presented preliminary results from work in Malawi showing widespread detection of ESBL-producing bacteria across a range of environmental and clinical samples. During the panel discussion, panellists highlighted gaps in the literature base, including the need to better understand how WASH interventions affect AMR burden, as well as the need for collective, multisectoral action given the diffuse global effects of AMR. Panellists also noted how national AMR action plans often do not address the role of the environment, potentially due to a lack of adequate evidence. New guidance documents from the WHO encourage countries to use a One Health approach in their AMR action plans to ensure the roles of WASH and the environment are considered.

DRUM’s work adds to the mounting calls for additional research into the environmental and WASH-related drivers of AMR and for more robust and standardized environmental surveillance for AMR, including in wastewaters.

A recording of the event will be posted on the conference website.