Fleming Fund: Tackling AMR

Fleming Fund: Tackling Antimicrobial Resistance


Our work contributes to Global Actions to address the global challenge of rising drug resistance by providing and testing educational approaches to Antimicrobial Resistance (AMR) Education.


The Fleming Fund is a UK Government Aid programme to help low and middle-income countries (LMICs) address priorities in tackling antimicrobial resistance (AMR), through a diverse range of projects that are delivered through a number of key partners. We are exploring how professional learning can strengthen surveillance of drug resistance and laboratory capacity. The Open University UK is working with Mott MacDonald to identify needs and to design, implement and test a series of learning events to support capacity building. This work takes place over the period 2018-2022 in Low-Middle Income Countries worldwide.

The work of this project contributes to Global Actions to address the global challenge of rising drug resistance by providing and testing educational approaches to Antimicrobial Resistance (AMR) Education.

Antibiotics have transformed the lives of people who have access to them. In the UK alone the number of people who die from infectious diseases has reduced from 40% to 7% over the past century due to a combination of factors including improved public health and sanitation as well as antibiotic treatments. However, bacteria have proved highly adaptable and resistant and, as new forms of antibiotics are developed, microbes are responding through a broad range of resistance strategies. As bacteria become more resistant to treatments, more people are at risk. 1.5 million people worldwide die each year from forms of infection that are resistant to antibiotic treatments. This problem is getting worse at an alarming rate and immediate global action is needed to minimise the impact of AMR.

Antimicrobial resistance can be described through biological terms and mechanisms, but it is shaped by social, cultural, political and economic drivers. Understanding how healthcare professionals understand, value and use antimicrobials, as well as the context in which health professionals develop work practices related to AMR are key to our research. We view learning for work as a critical component of innovation and the adoption of new and contemporary work practices. We are also interested in developments in technologies and digital networks and how these are stimulating the evolution of systemic new work practices while automating others, especially by examining changes in the professional practice of people who work in areas relevant to AMR.

The research questions are as following:

  • RQ1: What are the major influencers that shape antimicrobial resistance in LMICs? (Phase 1, April – June 2018). This work is based on interviews with over 20 international experts in AMR and desk-based review.
  • RQ2: How do the influencers (identified in RQ1) impact on ways of working within primary care workplaces in LMICs? (Phase 2, June-Sept 2018)

In Phase 3 (Oct 2018 – March 2019) we will design, implement and test a range of interventions as learning events and examine:

  • RQ3: How do outcomes from Phase 1 Phase 2 inform the design of learning events supported by technology that strengthen AMR surveillance?
  • RQ4: To what extent do learning events from Phase 3 improve awareness, attitudes and practices regarding AMR in LMICs?
  • RQ5: Do these learning events engender or reinforce positive organisational culture to strengthen AMR surveillance?

The role of IET

A team of Open University researchers are working in partnership with Mott MacDonald over a four-year period (2018-2022) to identify educational approaches to support capacity building. The project will deliver AMR Education as a series of learning events to ensure appropriate use of the Global AMR Surveillance System (GLASS) guidelines, developed by the World Health Organisation (WHO).

Professionals in LMICs are required to adopt the GLASS procedures urgently to reduce Anti-Microbial Resistance. Our research is examining changes in the ways health professionals work that will contribute to strengthening the AMR surveillance system and the reduction of AMR. Change could take the form of improvement in awareness, attitudes and practices regarding AMR engendering or reinforcing positive organisational culture. Given that little is known about how to offer AMR education to different groups of people in ways that will trigger effective change, our research is also exploring the major drivers that shape antimicrobial resistance in LMICs and how these drivers impact on ways of working within primary care workplaces in LMICs. This research is informing the design of online learning events that aim to strengthen AMR surveillance. These learning events will be co-designed with individuals and teams at local workplace level using the latest know-how in blended professional learning while, at the same time, paying attention to accessibility issues for healthcare and agriculture professionals working within in the country contexts.


  • Department for International Development (DfiD)
  • Department of Health


  • Department of Health and Social Care (DHSC)
  • International Development Office (IDO)
  • Mott MacDonald