A world where minor infections become deadly and routine surgeries perilous isn’t science fiction: it’s the looming reality of rising antimicrobial resistance (AMR). Microbes, including bacteria and fungi, are evolving and adapting to the medicines we use to combat them.
By 2050, it’s predicted that deaths by infections that were previously treatable with antibiotics and other antimicrobials could exceed 10 million every year. Other impacts, including decreased livestock production and skyrocketing healthcare costs, will only compound the problem.
AMR has been earmarked by the World Health Organisation as a top global-health threat. And while Australia on average is considered a ‘low-AMR’ region, we have hotspots of resistance in remote northern Australia that are among the worst in the world.
At the forefront of the battle to prevent the loss of decades of medical advancements is Professor Branwen Morgan, who is leading the ‘Minimising AMR Mission’ at the CSIRO.
Morgan grew up in Hamilton, in northern New Zealand, where her introduction to science came from her microbiologist father, who studied thermophiles – organisms that thrive in super-hot environments. Morgan recalls her childhood trips tagging along with him to the hot springs of Rotorua, a city in New Zealand renowned for its geothermal activity, to “help” with his research.
Her career path ultimately returned her to the resilient world of microbes – and a more ominous manifestation of them, at that. But it wasn’t from following in her father’s footsteps. After earning her PhD in neurobiology from UNSW, Sydney, Morgan realised that an academic career wasn’t her calling.
Instead, she was drawn to the world of research translation and science communication. “I love connecting people, ideas and projects,” she says.
From corporate comms to AMR frontlines
Morgan has amassed an impressive CV in corporate affairs and research management. She spent several years in communications roles and as a science journalist, including a three-year stint in London (and raising a young family along the way), before a pivotal opportunity in project management opened up in Sydney with pharmaceutical giant, AstraZeneca.
She says the decision to move into corporate affairs, especially the pharma sector, wasn’t one she took lightly. But the experience she gained proved invaluable. “That really set me up with many of the skills and digital and business knowledge that I still use today.”
AstraZeneca was the first of a string of consulting roles, but Morgan was eventually drawn back to the world of research and science engagement. In 2017, she joined AusGEM – a joint venture between the University of Technology, Sydney (UTS) and the NSW Department of Primary Industries – as general manager. AusGEM uses genomic technology such as DNA sequencing and bioinformatics to tackle biosecurity threats, and it was there that Morgan first got the chance to deep-dive into the challenge of AMR.
One day, a press release from a research institution in the United States piqued her interest: it was about a project that tracked AMR “like weather patterns”. Inspired, Morgan thought, “We could do more than that – we could bring in genomics and have all of these different types of data [to inform our research].” A person’s susceptibility to AMR changes depending on what they eat and where they live, work, and play, says Morgan. “Imagine if you could track that at a person-specific and location-specific level.”
She joined forces with UTS infectious disease researcher Professor Steven Djordevic to apply for a AU$1 million medical research grant, which they used to launch OUTBREAK, a research-based network that aims to develop an artificial intelligence (AI)-powered AMR surveillance system.
The journey hasn’t always been smooth sailing. With funding drying up at the onset of the COVID-19 pandemic, and an unsuccessful second grant application, the project risked derailment. But the CSIRO provided a lifeline and invited Morgan to include OUTBREAK into one of their ‘Missions’ – large-scale research collaborations that focus on Australia’s unique strengths and advantages in tackling some of our biggest challenges. The Minimising AMR Mission was launched in February this year.
Morgan’s mission: Targeting AMR in Australia
A future without effective antibiotics is enough to keep anyone awake at night – Morgan included. “We’re absolutely not doing enough,” she says. “We’re not connected, we’re inefficient, we don’t have critical mass on particular projects. We need a more focused approach and collective effort.”
As the Minimising AMR Mission lead, Morgan says the focus will not be on the development of a new drug. Instead, it will advise on where Australia’s efforts and funding will be most effectively spent, as well as gathering the necessary resources to accelerate delivery of that solution.
She stresses the importance of looking at the big picture when addressing the challenge of AMR. For example, understanding the regulations that are in place and who is responsible for funding is crucial, especially considering how many sectors will be impacted by AMR, including healthcare, agriculture, water management and environmental conservation.
“There are many researchers and organisations that are undertaking antimicrobial discovery-based research,” says Morgan. “Rather than us saying, ‘We’re doing that too,’ we decided that the mission could best help and support these groups by developing platform technologies to accelerate that process.”
A recent example of this is the development of AI-powered tools that help to accelerate the process from drug discovery to market approval, which usually takes about 15 years and costs more than AU$1 billion. Machine-learning technology, for example, can be used to screen vast amounts of data quickly, identifying potential drug compounds or even entirely new classes of antibiotics.
The Minimising AMR Mission will also focus on approaches to ‘upstream’ prevention. This could mean investing in the development of vaccines to stave off infections that might otherwise need antibiotic treatment, or removing antimicrobial pollution from the environment, such as in agricultural run-off or human wastewater, which can create hotspots of resistance.
Capturing enough high-quality data is also a challenge that Morgan hopes to address, especially when the impact of AMR can often be “hidden” behind other conditions. For example, infections are a major cause of death for people with cancer due to their compromised immune systems.
Morgan stresses that AMR is a collective challenge that will require collective action – from policy-makers who regulate antimicrobial usage and direct research funding, to members of the public being more mindful about our own antibiotic use and the bigger-picture risks at play. “I’m concerned that if we don’t take collective action and responsibility, we’re not going to solve it.”
She champions the “influence, inclusion and inertia” approach: “We have to have influencers who talk about antimicrobial resistance in the context of shared responsibility and joint action,” she says. “Then, there’s inclusion: drug-resistant infections are far higher in our remote and regional communities. [That brings] inertia to keep things moving – including with funding – in both the public and private sector.”
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Story by Gemma Chilton
Image: Joseph Byford