1. ICARS International Centre for Antimicrobial Resistance Solutions
Based on slides prepared by professor kåre mølbak
Vice-president and director of Division of infectious diseases preparedness
Statens Serum Institut, denmark
Heading ICARS interim steering committee

2. This presentation
What
Why
When, how & where
JPIAMR ↔ ICARS

3. What is ICARS
A Danish inter-ministerial initiative, suggested in 2017 by World Bank and CGIAR, on solutions for AMR mainly in LMIC. ICARS is under development in 2019
ICARS conduct, commission and participate in research to support the development of interventions to contain and mitigate AMR in LMICs
Translational research transforms national action plans and policies into practice
Bottom-up participatory research and complex intervention studies
Top-down risk assessments and economic analyses to aid risk management, and setting of governmental priorities and intervention research
Combination of top-down and bottom-up: ICARS as a policy interface
Independent open resource to public and private bodies

4. Mode of operation Focus on solutions and interventions
Intervention and implementation science - social science, development experts and related disciplines
Complex interventions aiming at implementation in ”real life” – not only clinical trials - the devil is in the context
One Health, including human public health
Long-term commitments and partnerships
Knowledge node – assist on technical matters with relevant partners

5. Direct + indirect focus
AMR specific and AMR sensitive interventions
Too much emphasis on antimicrobial use ?
Indirect drivers to be addressed:
Environment – domestic and the public domain
WASH (water, sanitation, hygiene)
Better use of existing vaccines (a.o. flu for pregnant, childhood vaccines)
Management practices in health care and in agriculture
Infection control
The ”AMR lens” on such interventions

6. Why ICARS: AMR is a ”wicked problem”
Difficult to clearly define – cannot first understand and then solve
Multi-causal with many interdependencies
Unforeseen consequences of addressing them
Solutions are not right or wrong – they are better-worse; good enough-not good enough
Are socially complex, context matters making each one unique
Responsibility of multiple organizations
Solutions involve changes in behavior
Often characterized by chronic policy failure

7. Re-focus
Bias in research towards presenting challenges rather than working on solutions and interventions
When solutions are addressed, it is often addressed with a single or few disciplines
Although there is a concensus on One Health, there is a lot of silo thinking and focus on antimicrobial use
Focus on publishing rather than making a change

8. Why LMIC
MIC are home to 5 of the world’s 7 billion people and 73% of the world’s poor people.
MICs also represent about one-third of global GDP and are major engines of global growth
Need to be working with NGO’s, private partners and local governments

9. When, how & where Workshop, Interim SC, MoU DK↔CGIAR
2018
Workshop, Interim SC, MoU DK↔CGIAR
DK financial commitment (€6M annually)
2019
Secretariat (DK)
Organizational fabric: Legal status – MB - AB-Policy - AB-Science - Partner network
First projects with LMIC (Kenya, Ghana, Vietnam)
Fundraising - foundations
2020
Role of ICARS is defined in relation to international agencies and organizations
DK financial commitment geared x 3-4
Implementing legal structure and organization
Further financial gearing. CGIAR centre?
scientists working at ICARS new-built centre in CPH
affiliated scientists working locally mainly at LMICs hubs

10. JPIAMR ↔ ICARS Meeting JPIAMR – ICARS 27 March: JM update JPIAMR MB
Once the roadmap and secretariat of ICARS becomes ready, ICARS will visit JPIAMR’s secretariat for mutual information and coordination
ICARS will include JPIAMR in ICARS’ scientific advisory board
ICARS will sign up as member of the JPIAMR VRI