Most of the antibiotics used to manage diseases in humans and livestock end up in the environment. Antibiotics (ATBs), Antibiotic Resistant Bacteria (ARB), and Antibiotic Resistance (ARGs) have spread in almost all habitats globally. The Food and Agricultural Organization (FAO), World Health Organization (WHO), and the World Organization for Animal Health (OIE) recognize the problem of Antimicrobial Resistance (AMR), and thus recommend: Prudent use of antimicrobials; and a “One Health Approach” to mitigate the problem. Antimicrobial Resistance (AMR) is a situation where bacteria develop resistance against antibiotics intended to destroy them.

Antibiotics in the environment may induce AMR in bacteria, hence the risk of transfer to humans and wildlife. AMR reduces effectiveness of antibiotics, leading to higher costs of treatment, severe illnesses, and deaths. Globally, about 1.2 million people died in 2019 due to complications of AMR; Sub-Saharan African region alone had 255,000 deaths (Murray et al., 2022, The Lancet, https://doi.org/10.1016/S0140-6736(21)02724-0).

The Strategic Research Agenda by the Joint Programming Initiatives (JPI) calls for transnational studies on AMR in both terrestrial and aquatic environments. Indeed, the role of livestock, wildlife and migratory birds in the spread of AMR has previously been under-emphasized, yet they are major reservoirs of ARB and ARG.

The PAIRWISE Project is being implemented in three countries in Europe, and two in Africa. PAIRWISE is investigating the risks posed to human health and the environment by pollutants and pathogens present in water resources. The project also aims to investigate the dispersal of ATB, ARB and ARG downstream Wastewater Treatment Plants (WWTPs) by comparing different geographical/climatic regions, wastewater management practices and types of water bodies.

Project partners include; National Veterinary Institute (SVA), Sweden; Norwegian Institute for Water Research (NIVA), Norway; Linköping University (LiU), Sweden; Doñana Biological Station, Higher Council for Scientific Research, Spain; National Research Institute for Rural Engineering, Water, and Forestry, Tunisia; Faculty of Medicine Ibn Al-Jazzar Sousse, Tunisia; and the College of Natural Sciences,  Makerere University, Uganda.

This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 869178-AquaticPollutants, Joint Programming Initiative on Anti-microbial Resistance (JPIAMR), www.waterjpi.eu; and JPI Oceans, www.jpi-oceans.eu. For Uganda, the three-year project is funded by the Swedish International Development Agency (Sida). The African Population and Health Research Center, Nairobi, www.aphrc.org coordinates the funding in Uganda.

In Uganda, the research activities are being conducted by researchers from the College of Natural Sciences, Makerere University including: Prof. Charles Masembe (Principal Investigator), Dr. Robinson Odong, Dr. Peter Akoll, Mr. Mayega Johnson (Department of Zoology, Entomology and Fisheries Sciences) and Mr. John Omara (Department of Biochemistry and Sports Sciences) as team members. The study area in Uganda includes the catchment of River Rwizi, Lake Mburo National Park, and River Aswa.  

The research will contribute towards better understanding of the factors which influence the occurrence and spread of AMR in water systems, livestock farms, and birds. It will also contribute towards the Government of Uganda’s framework to combat the threat of AMR, through the National AMR Action Plan; design policies to reduce the risks of AMR, and the costs incurred for animal and human disease management.

Makerere University PAIRWISE Consultative Meeting in Mbarara

On 31^st May 2022, the project team from the Department of Zoology, Entomology and Fisheries Sciences led by Prof. Charles Masembe (Principal Investigator) held a consultative meeting to get buy-in and introduce the PAIRWISE Project to the key stakeholders in Greater Mbarara and River Rwizi catchment. The meeting also aimed to receive input from key stakeholders regarding the use of antibiotics in Greater Mbarara district and River Rwizi catchment, to document challenges of Antimicrobial Resistance and identify potential sites for fieldwork.  

The meeting was attended by administrators, senior health, water and environmental officers in Mbarara City and District including:

1. The District Chief Administration Officer represented by Mr Bakashaba Innocent
2. Mr David Nuwagaba, the District Natural Resources Officer
3. Mr Tumwebaze Herbert, Environment Officer, Mbarara City
4. Dr Oriokot Francis, Deputy Director, Mbarara Regional Referral Hospital
5. Dr Akashaba Andrew, Mbarara District Veterinary Officer
6. Mr Mwesigye Joseph, Environment Officer, Mbarara District
7. Mr Katongole Joseph, a farmer in Mbarara District

Mr Ayebare Calist, Fisheries Officer, Isingiro District, and a fresh graduate (May 2022, Makerere University 72^nd Graduation) assisted in organizing the Stakeholders meeting. During the meeting, Dr Robinson Odong on behalf of Prof. Charles Masembe shared the project overview with participants, outlining the challenges of AMR, and expectations from the research. Stakeholders brainstormed and listed the commonly used antibiotics and the potential sites for sample collection. The research will take the One Health Approach, encompassing aspects of human, animal and environmental health.

Capacity Building under PAIRWISE Project

As part of the PAIRWISE capacity building component, the project is supporting research activities of two graduate students: Ms. Ndinawe Ruth Pamela (Master of Science in Molecular Biology) studying “The dispersal of antimicrobial resistance bacteria and genes through aquatic birds under different climatic and geographical conditions”; and Mr. George Katende (Master of Science in Immunology and Clinical Microbiology), studying “Characterization of clinically important antibiotic resistant bacteria and genes in river waters upstream and downstream of WWTPs and hospital effluent” https://cns.mak.ac.ug/blog/call-applications-msc-scholarship-under-pairwise-project.

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