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]]>‘Global research agenda for antimicrobial resistance in human health’ is the World Health Organization’s (WHO) latest research agenda aimed at providing guidance for progress on antimicrobial resistance (AMR). The publication highlights the improvements in water, sanitation and hygiene services (WASH) – along with wastewater management – that will be critical for the prevention of infection and a reduction in the spread of AMR. To address this, the new research agenda states two (out of a total of 40 priorities) for ‘WASH in communities’ and ‘WASH in health care settings’. These are:
Further water related research priorities include the investigation of the factors that are driving colonisation and infection, including sanitation infrastructure, and the identification of optimal surveillance methods to generate reliable data on AMR.
Progressive agenda
A comprehensive work outlining top research priorities for tackling AMR, the agenda focuses on infections caused by drug-resistant bacteria and fungi using robust validated methods from a list of systematically identified research topics.
Grounded in the Global Action Plan on Antimicrobial Resistance, a resolution endorsed by the 68th World Health Assembly in 2015, this research agenda gives particular focus to the Global Action Plan’s objective to strengthen knowledge and evidence through surveillance and research. In addition, it responds to WHO’s mandate to develop a global public health research agenda that fills key gaps in knowledge around AMR.
Global urgency
AMR poses a considerable threat to human health, with an estimated 4.95 million deaths associated with bacterial AMR in 2019 alone. Mortality rates from infections with resistant organisms impact low- and middle-income countries disproportionately. In addition to this serious cost to human health, AMR is also associated with substantial costs to the global economy. This is predicted to reach $100 trillion by 2050 if no action is taken, according to the 2016 report of the Review on Antimicrobial Resistance titled ‘Tackling drug-resistant infections globally: final report and recommendations’. A further report in 2024 titled ‘Towards specific commitments and action in the response to antimicrobial resistance: recommendations for consideration by UN Member States’ states that treating people with resistant bacterial infections may cost $412 billion annually by 2035, with an additional $443 billion per year in productivity losses.
To address these concerns, the WHO AMR report calls for more research, along with the optimisation of current tools to support the implementation of evidence-based policies and interventions for AMR, especially in low- and middle-income countries.
Research agenda goals
The aim of WHO’s AMR research agenda is to identify and give priority to research topics with the greatest impact on mitigating AMR in the human health sector. Critical for the guidance of policymakers, researchers, funders, industry and civil society – and necessary for the generation of new evidence to inform AMR policies and interventions – this report is global in scope and focuses on AMR in the human health sectors. Particular attention is given to infections caused by the WHO bacterial priority pathogens, including drug-resistant Mycobacterium tuberculosis, and the WHO fungal priority pathogens, such as Candida auris, Aspergillus fumigatus and Cryptococcus neoformans.
The research agenda was developed through an adapted Child Health and Nutrition Research Initiative method, in close collaboration with a multidisciplinary Research Agenda Expert Group on AMR. In the first phase, 2340 knowledge gaps were identified through a systematic search of peer-reviewed and grey literature, screening 8409 documents published in the past 10 years. In the second phase, with technical input from a multidisciplinary Research Agenda Expert Group and based on input from a global consultation, these knowledge gaps were further consolidated into 175 research topics.
In the final phase, the Research Agenda Expert Group was invited to assess each of the 175 research topics against five criteria: filling critical knowledge gaps; answerability and feasibility by 2030; potential for translation into policy; impact on mitigating AMR; and promoting health equity. A research priority score accounting for the opinion of all individual experts was calculated to identify the top 40 research priorities, with 33 pertaining to AMR in bacteria and fungi and seven relating to drug-resistant Mycobacterium tuberculosis.
Continuity of learning
Aiming to foster research by 2030 – in accordance with the timeline of the Sustainable Development Goals (SDGs) – and catalyse scientific interest and investment among the scientific community, WHO recommends that the current list of research priorities be further translated into tangible, concrete research proposals that are fundable and implementable in settings with limited resources.
By providing the latest guidance on priorities for research, WHO’s new research agenda plays a critical role in the evolving picture around this serious global health issue. This latest publication on AMR follows the organisation’s 2023 policy brief ‘Global research agenda for antimicrobial resistance in human health’, which became the focus of academic research in the renowned, medical journal, The Lancet, in 2024. It is likely that this new guidance will become a key focus for a range of professionals and drive progress in this growing health concern that is impacting populations across the world.
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]]>The post Water and health – the vital connection appeared first on The Source.
]]>Overplaying the connections risks undermining the case for water – an otherwise well-put argument can seem less than convincing if any weaknesses are apparent.
At the same time, there are aspects of development that do go hand in hand. The vital connection between water and health is one such example. Several of the news articles in this edition underline how evidence of the importance of this connection is still emerging.
One example is the issue of antimicrobial resistance (AMR), with the World Health Organization (WHO) recently having published its research agenda on this theme (see News and Analysis).
At the core of the publication is a set of recommended research priorities that WHO has been working to advance. It includes fuller understanding of the contribution of WASH to, for example, reducing the need for antibiotic use, and strategies for WASH in health-care facilities. (See Analysis).
The research priorities that WHO highlights also include wider cross-cutting concerns, such as the need to gain a better understanding of how, for example, limited access to water and sanitation might contribute to infection with AMR.
In another dimension of the water-health connection, recent research has shed light on the impacts of flooding on human health (see News). The connection with direct impacts, from drowning to electrocution, is intuitively clear. However, this research has taken a broader approach than this.
One study, believed to be the world’s largest and most comprehensive of the long-term health impacts of flooding, looked at post-flood hospitalisations over a 20-year period for almost 750 communities in eight countries around the world. Looking overall and at 10 specific health issues, evidence of wider health impacts emerged.
Another study looked at the impact of floods on death rates over the last 20 years, again revealing evidence of wider impacts.
Faced with concerns around the prospects for more intense flooding due to climate change, such research points to growing relevance of this type of water-health connection on top of the more direct impacts.
Given such widening of the concerns around water-health connections, it is fitting that the recipient of last year’s IWA Global Water Award was Professor Joan Rose. Her views are shared in this issue (p25). She highlights in particular the prospect of a growing global microbial load – of both human and animal origin – on the water environment, as part of wider pressures on water quality.
Her expertise and passion reflect a deep connection within IWA between water and health – seen not least in our Specialist Group and our journal on these entwined themes. It is clear that this is a deep connection that will be of huge relevance in the years ahead.
Keith Hayward, Editor
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]]>The post Excellence, relevance and resonance appeared first on The Source.
]]>The first face-to-face meeting of the newly established Board was held in Kampala, Uganda, in February. While there had been many online meetings last year to address various matters, the Uganda meeting was scheduled immediately prior to the African Water and Sanitation Association’s (AfWASA’s) biennial international congress and exhibition in Kampala, in order to facilitate participation at the African regional event.
The Board meeting was an unprecedented success, with free-flowing engagement by all Board members resulting in a very productive learning experience during the induction of the Directors and unanimous decision-making outcomes for the Association.
Some key decisions were taken after rigorous engagement. Preparations for executing our new five-year strategy were approved after consideration of an operational readiness assessment and operational plan – with a clear roadmap and milestones. The 2025 budget, aligned to the new strategy, was welcomed and approved.
In addition, two exciting new initiatives were approved. Two task groups, each led by a Board member, have been working on important new schemes – one on water utilities and another on sanitation. The two groups were commended for their work and recommendations – both expected to lead to a new IWA event – which were approved unanimously.
Alongside other regular but important business, two new country memberships were approved, meaning we are happy to now be able to include Thailand and Indonesia as part of the IWA General Assembly. We welcome them to the IWA family and look forward to them joining the IWA General Assembly Meeting in the UK this September. We are proud that our total number of General Assembly members now runs to 70 countries.
An important takeaway for me from this meeting was that, during the first six months of the new Board, the Board, management and staff have demonstrated strong capability and commitment to leading our Association and delivering the new strategy for the benefit of all members, partners and stakeholders.
During our time in Kampala, the Board was hosted by the National Water and Sewerage Corporation (NWSC). IWA leaders delivered keynote addresses at the conference, emphasising innovation, digitalisation, utility leadership for sustainable finance, and water security. The conference also featured discussions on scaling up Citywide Inclusive Sanitation across Africa, with IWA showcasing its commitment to advancing water and sanitation solutions on the African continent by working with AfWASA and the newly launched African Water and Sanitation Academy (AWASA).
At the AfWASA event, IWA demonstrated excellence, relevance and resonance with its international and African members. While IWA is a global association, its ability to embrace a diversity of members, appreciate their needs, and add value to help overcome regional challenges is critical – inspiring change and impact for our members across the globe. Our members have long requested support at regional level and from our Specialist Groups. Efforts to advance on both fronts form important parts of our new Strategic Plan.
On behalf of IWA, we are grateful to our hosts, Uganda, NWSC, AfWASA and our own Senior Vice President from Uganda, Dr Rose Kaggwa, for making the Ugandan experience both memorable and impactful.
The hospitality received in Uganda, the opportunity for IWA to contribute to the AfWASA event, and the energy and enthusiasm from the Board members and management combined to form an amazing example of the leading role that our association must play with regional associations and Specialist Groups across the globe, inspiring change and impact through excellence, relevance and resonance.
Hamanth Kasan, President, IWA
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]]>The post UK’s first wastewater monitoring pilot appeared first on The Source.
]]>Researchers at the Excellence Water-Based Early-Warning Systems for Health Protection will track virus and bacterial DNA in wastewater samples to provide an early-warning system for outbreaks of infectious diseases.
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]]>The post Flooded communities found to have long-term health risks appeared first on The Source.
]]>The study, published in the journal Nature Water, analysed more than 300 million hospitalisation records from 747 communities in eight countries (Australia, Vietnam, Brazil, Canada, Chile, Thailand, New Zealand and Taiwan) that had experienced major flood events between the period of 2010 and 2019. Regions included the northeast region of New South Wales, Australia, the Amazon River and the southern region of Brazil, the Mekong Basin in Vietnam, and the southern region of Thailand.
The study found increases in hospitalisation for cardiovascular diseases (35%), respiratory diseases (30%), infectious diseases (26%), digestive diseases (30%), mental health disorders (11%), diabetes (61%), cancer (34%), nervous system disorders (34%), and renal diseases (40%).
While immediate health impacts of flooding, such as drowning, electrocution and hypothermia, would be expected, this study found long-term impacts on health, including an elevated risk of digestive diseases and the spread of infection through the contamination of water supply systems.
Additionally, the study highlights that floods can create environments that are conducive to the growth of fungi, bacteria, viruses, and vectors such as mice and insects, which can trigger outbreaks of respiratory, digestive and infectious diseases, and force mass evacuations, causing displacement, with people living in temporary shelters and having access to limited sanitation facilities – resulting in poor hygiene, with conditions raising the likelihood of respiratory, digestive, and infectious diseases. Access and capacity to healthcare services may also be impaired after floods, leading to delays in medical interventions; and psychological stress from property damage and financial losses can worsen or induce adverse health outcomes.
Adding to this picture, a study by researchers from Columbia University’s Mailman School of Public Health, in partnership with researchers at Arizona State University, Harvard University and the University of Arizona, USA, published in Nature Medicine, analysed the impact of floods on mortality over the past 20 years.
The researchers used a statistical model to calculate how death rates changed in three-month periods following large floods compared with equivalent periods in normal conditions.
The researchers found the largest overall increases in injury death rates among older people (24.9%) and females (21.2%) during the month of tropical storm/hurricane-related flooding, with increases in death rates associated with heavy rain-related flooding for infectious diseases (3.2%) and cardiovascular diseases (2.1%). Snowmelt-related floods were also associated with higher death rates for certain diseases.
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]]>The post UN report finds mountain environments changing at unprecedented rate appeared first on The Source.
]]>This 2025 edition of the United Nations (UN) World Water Development Report highlights the importance of mountain waters and alpine glaciers, which are vital for meeting basic human water supply and sanitation needs.
These water sources are also essential to ensure food and energy security for billions of people living in and around mountain regions and areas downstream, supporting economic growth through various water-reliant industries.
The report highlights that as the ‘water towers’ of the world, mountains are an essential source of freshwater, storing water in the form of ice and snow during cold seasons, and releasing it during warmer seasons as a major source of freshwater for users downstream. They play a unique and critical role in the global water cycle and affect atmospheric circulation, which drives weather and precipitation patterns.
While highlighting the concerning impact that climate change is having on mountain and glacial environments, the report offers solutions to help simultaneously mitigate and adapt to rapid changes in global frozen water resources. It provides a clear overview of current environmental conditions, along with recommendations of necessary response measures, including the urgent need to drastically reduce carbon emissions.
By detailing the connections between mountain freshwater, essential services and the natural world, the report highlights the critical importance of conserving the cryosphere and the potential consequences for the Sustainable Development Goals (SDGs).
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