AquaSense

AquaSense is a localized digital platform that empowers communities to self-monitor antimicrobial usage and resistance trends. Through crowdsourced data and advanced analytics, it detects hotspots for intervention. Working groups utilize contextual insights to design tailored education programs that foster sustainable behavior change around antibiotic stewardship from the ground up.

Dr. Peace Simeon, a primary care physician and clinical microbiologist, is leading the initiative as Chief Medical Officer and Lead Investigator.

Antimicrobial resistance is a major problem in Tanzania and across Africa. In Tanzania, 50% of bacterial infections are already resistant to first-line antibiotics according to the WHO. This contributes to over 20,000 deaths annually in the country. If no action is taken, resistance could cause23,000 additional deaths and cost the Tanzanian economy over $200 million per year by 2050. 

A key driver of this growing crisis is misuse and overuse of antibiotics in communities. In Africa, up to 80% of antibiotics are sold over the counter without a prescription. Improper usage is also common, with patients often stopping treatment prematurely or taking the wrong dose. As a result, resistant bacteria can spread quickly between community members. 

Our solution targets this problem in 60 rural villages across four regions of Tanzania that have been identified as antimicrobial resistance hotspots by the Ministry of Health. We estimate over 500,000 residents lack access to reliable information and tools for appropriate antibiotic practices. If left unaddressed, resistance in these areas will continue propagating nationally and even globally through travel and trade. Our solution aims to optimize antibiotic use in these high-risk regions to curb resistance for the benefit of millions.

Our solution primarily serves rural communities in Tanzania that are vulnerable to the impacts of antibiotic resistance due to lack of access to reliable health information and resources. 

Within these target areas, we seek to support over 500,000 residents through empowering them with data-driven knowledge about appropriate antibiotic use and resistance trends in their local environment. By crowdsourcing data directly from community members, our solution places priority on understanding things from their perspective - what illnesses they face, which antibiotic treatments are commonly misunderstood or misused, and how local health challenges actually present at the ground level. 

So far, we have conducted in-depth interviews with over 250 households and public forums in several pilot villages to learn about current gaps and design a tool that meets their needs. Residents have helped test early mobile app prototypes and provided feedback to ensure it is intuitive to use. Going forward, we will continue actively engaging end users throughout development and deploying the solution to make sure it delivers maximum value and impact at the community level as behavior change partners.

4 specific public goods our solution provides, with examples of target metrics:

1. Open-access data portal 
   - Provides free online access to aggregate findings from our platform
   - Aims to share anonymized data and insights from 500,000+ community-reported data points annually 
   - Seeks 10,000 monthly users from the global health community accessing our evidence base by 2025

2. Peer-reviewed research publications
   - Publishes results and case studies from our pilots, consorting new research 
   - Targets 5 publications per year in open-access academic journals to disseminate lessons  
   - Aspires to be cited in 50+ external studies by 2027 to advancement AMR surveillance science

3. Policy briefings and toolkits
   - Distributes guidance documents to 50 governments and multilateral orgs annually  
   - Toolkits outline our methods and key indicators to help establish national reporting systems
   - Aims for toolkits to support AMR strategy development or evaluation in 15 new countries by 2024

4. Community knowledge exchange
   - Hosts annual forums for 500+ citizens, experts and leaders to review progress
   - Facilitates peer learning between 50 collaborative projects adapting our approach
   - Envisions these exchanges stimulating grassroots innovations in 20 replicable communities by 2025

Our solution aims to tangibly benefit rural communities in Tanzania vulnerable to rising antimicrobial resistance through:

Activities: Crowdsourcing AMR data and conducting environmental surveillance through our mobile/web platform. 

Outputs: Generating 250,000+ local data points annually on antibiotic usage and local resistance trends.

Outcomes: Our AI-powered analytics will detect emerging hotspots and optimized treatment protocols to curb further development of superbugs. 

Impact: By empowering local health workers and at-risk citizens with these actionable insights, tailored behavior change programs and public health initiatives can be implemented to improve access to effective antibiotics for 500,000 residents over the long run.

Pilot interviews showed us accessing trusted information on antibiotic prescribing is a major need. Research also links participatory monitoring to better health behaviors. By facilitating sustained, collaborative surveillance and response between communities and experts, our approach aims to safeguard these populations' health security against antibiotic-resistant infections spreading further. Independent evaluations will track our impact over time.

Over the next year, we aim to:

- Deploy our platform to 3 additional districts in Tanzania, gaining insights from 20,000 new community members.

- Incorporate routine data extraction and analysis into local public health workflows through training 20 new officers. 

- Publish results from initial pilots to inform at least 2 national strategy documents.

Over the next 3 years, we plan to: 

- Expand nationwide coverage across Tanzania, empowering 500,000 citizens to actively shape resistance solutions.

- Establish regional collaboration clusters in 5+ neighboring countries to pool regional findings through our open platform. 

- Secure partnerships with 3 multinational organizations to support platform localization and beta testing in 10 new developing nation contexts.

- Measure behavioral changes in antibiotic prescribing/usage habits among 50,000+ doctors, nurses and citizens equipped with our insights over time.  

- Contribute findings annually to WHO to support global targets on AMR surveillance system strengthening and rational usage - ultimately helping safeguard lives in underserved communities worldwide.

By systematically scaling both technological reach and partnerships, we aim for transformational population-level impact against a critical threat.

We measure success against our impact goals using both quantitative and qualitative indicators:

Quantitatively:
- Number of community members using the platform monthly (Pilot: 250 members)  
- Percentage of target area enrolled (Pilot: 2 villages/5 targeted)
- Behavior change benchmarks - e.g. reduction in antibiotic misuse reported (Pilot: 12% decrease)

Qualitatively: 
- Surveys and interviews assessing platform usability and user experience (Pilot: 85% found easy to use)
- Focus groups and feedback forms evaluating behavior and knowledge changes (Pilot: 75% learned correct usage) 
- Stakeholder interviews assessing how insights influence policies and programs (Pilot: Informed 2 new health initiatives)

We also track key platform metrics like:
- Rates of active data submission 
- Retention of enrolled members over time
- Accuracy of AI models in identifying risk factors

Both quantitative and qualitative findings are reviewed regularly with community advisors and project officers. Independent evaluations assess broader health and socioeconomic impacts. 

This mixed methods approach provides robust, triangulated evidence of how we are empowering populations and influencing systems change to curb the AMR threat.

Some key barriers we face include:

Financial: Insufficient funds could limit platform development/expansion. We are pursuing impact investment, grants and cooperative agreements. 

Technical: Rural connectivity issues may hamper data collection/sharing. Our platform employs offline data capture and periodic syncs to overcome this. 

Policy: Existing frameworks don't yet support participatory surveillance. We are engaging policymakers to demonstrate value and ensure regulatory compliance. 

Cultural: Communities may hesitate sharing personal health info. Continued community orientation and emphasizing data protection are crucial. Pilots showed this risk can be mitigated.

Partnership: Multi-sector coordination is complex. We formalized steering committees and are cultivating champions within key agencies/organizations. 

To overcome barriers in the next 3 years, minimum requirements include securing £1M in funding, formal buy-in from 1-2 national health agencies, and NGO partnership in 5+ settings abroad. Key to success is adaptive, inclusive engagement with stakeholders and beneficiaries throughout, honoring community priorities as we scale regionally and evolve our models. Pursuing funds/strategic alliances proactively helps ensure viability and sustainability.

We are applying to The Trinity Challenge because it presents a unique opportunity for us to advance our work in a significant way.

The scale of funding available from the Challenge, totalling £1 million over 3 years, will allow us to progress beyond pilot implementations and properly roll out our solution across Tanzania. This directly addresses our largest barrier which is a lack of sufficient financial resources to date. 

The Trinity Challenge also prioritizes supporting African innovators tackling healthcare issues through digital solutions and community empowerment approaches. This ideal fit will boost our credibility and profiles as we seek to engage new implementing partners and policymakers. 

Its focus on evidencing impact will incentivize us to strengthen evaluation plans, critical for attracting future funding and influencing AMR programs on the ground. Challenge outcomes will help verify returns on investment.

Related capacity building services offered could help address technical barriers through mentorship and skills development. Networking opportunities present a chance to identify partnerships that diversify our resources portfolio long term. 

The Challenge's endorsement would validate our solution and team, overcoming cultural doubts around our ability to deliver as young African entrepreneurs. 

Few organizations I would be interested in collaborating with to further develop and scale my AMR solution:

Wellcome: As the anchor funder of the Trinity Challenge on AMR, Wellcome would be a natural partner to help accelerate efforts. Their funding expertise and networks in global health research could help pilot and scale testing of my solution. Wellcome also shares our goal of developing innovative solutions to pressing health challenges like AMR, so collaboration could strengthen both of our impacts. Their guidance navigating regulatory and ethical hurdles would aid real-world implementation. Working together leverages our collective strengths to get results in the fight against drug-resistant superbugs. 

Bill & Melinda Gates Foundation: As a leading funder of AMR R&D, the Gates Foundation brings valuable experience addressing AMR through various approaches. Partnership could open doors to their technical support and trials in developing world contexts where needs are greatest.

WHO: Collaborating with WHO would connect our work to global governance on AMR surveillance and containment. Their endorsement could fast-track adoption in health systems worldwide.