About
About the NIAMR project
The challenge, the gap, and our response
Antimicrobial resistance (AMR) is an urgent global public health threat that complicates treatment of infectious diseases. It is responsible for an estimated 1.3 million deaths worldwide each year. The burden is disproportionately high in low- and medium-income countries (LMICs) including Uganda, where AMR-associated mortality surpassed deaths due to malaria, HIV, and tuberculosis in 2019 (Murray et al., 2022).
AMR-associated mortality surpassed deaths due to malaria, HIV, and tuberculosis in Uganda in 2019
Recognising this threat, the Global Action plan on AMR (2015) and Uganda's National Action Plans on AMR (2018–2023; 2024–2029) identify surveillance – particularly the systematic collection and use of data on AMR and antimicrobial use as a core intervention. Such data are essential for effective clinical management, public health surveillance and design and implementation of AMR control strategies.
However, as highlighted at the United Nations General Assembly High-Level Meeting on AMR, the Africa CDC Landmark Report and Uganda NAP (2024–2029), AMR data in many LMICs including Uganda, remain fragmented, incomplete, and underutilised for decision-making, despite investments in microbiology laboratory capacity. Key challenges include shortage of skilled personnel at facility and national levels, disjointed data systems, and limited clarity regarding national AMR data needs.
AMR data in many LMICs including Uganda, remain fragmented, incomplete, and underutilised for decision-making.
We aim to develop and evaluate a national interoperable integrated digital AMR data capture, processing and sharing platform (NIAMR) at national level, bringing together human health AMR data from multiple existing AMR data capture systems, to support timely AMR detection, monitoring and evidence-based decision-making for improved surveillance and response in Uganda, with a scalable architecture for extension to other One Health sectors (i.e., animal health, water, wildlife and environment). This retrospective, three-year project will be implemented in five sequential phases.
Referenced frameworks
Research roadmap · 36 months · Feb 2026 – Jan 2029
Our five phases
Situation analysis & Baseline Assessment
National situation analysis and baseline assessment of AMR data generation, management and dissemination in Uganda.
Development and Implementation
Development and implementation of the integrated NIAMR platform in AMR high-burden districts.
Functionality Testing
Testing the functionality and performance of the NIAMR platform for AMR surveillance and data use.
Piloting
Piloting the NIAMR platform to assess data quality, system performance and user uptake for national roll-out.
Impact Evaluation and Costing for scaling
Evaluating the impact of NIAMR and conducting a micro-costing study to support integration across One Health sectors.
Phase 1
National situation analysis and baseline assessment
Phase 1 involves a national situation analysis and baseline assessment of AMR data generation, management, and dissemination in Uganda, using desk reviews and community engagement and involvement (CEI).
Phase 2
Development and pilot implementation
Phase 2 focuses on the development and pilot implementation of the integrated NIAMR platform in selected districts identified as AMR high-burden (red zones) heat maps, to assess feasibility, acceptability and ethical considerations.
Phase 3
Impact evaluation at scale
Phase 3 involves evaluation of the impact of the NIAMR platform at scale on AMR surveillance performance and data use.
Phase 4
System performance assessment
Phase 4 involves assessing system performance, data quality, and user uptake to inform optimisation and national roll-out.
Phase 5
Costing for One Health scaling
Phase 5 involves estimating the costs of scaling the NIAMR platform using a micro-costing approach to support integration across all One Health sectors (humans, animals, water and environment).
Results chain
Outputs, outcomes & impact
Outputs — what we produce
The Key project outputs include:
i. NIAMR platform
An interoperable and integrated digital AMR data capture, processing and sharing platform (NIAMR).
ii. Situation analysis report
A national AMR data management situation analysis report for Uganda.
iii. Clearly defined national AMR data needs
Clearly defined national AMR data needs and standardised AMR datasets.
iv. AMR data governance structures
Clarified and documented AMR data governance structures.
v. NIAMR user and training guides
NIAMR user and training guides supporting platform adoption and use.
Outcomes
The Key project outcomes include: enhanced availability and use of integrated AMR data to support timely, evidence-based decision-making for AMR surveillance and response.
Impact
Early detection of AMR · Improved AMR surveillance and management · Integrated AMR data capture and sharing · Shared results for all One Health sectors for shared learning in combating AMR effectively.
Intended impact: reduced AMR burden across human, animal, and environmental health in Uganda.
Our team
A multidisciplinary research team
Our multidisciplinary research team includes microbiologists, biostatisticians, epidemiologists, public health scientists, health economists, data scientists and informaticians from Makerere University (https://www.mak.ac.ug/). We have substantial experience and expertise in health systems research, AMR / antimicrobial measurement and surveillance, statistical modelling, health informatics, digital health, information systems, data science and analytics, and AI/machine learning. Across our team, we have developed and implemented new methods and digital tools that have strengthened AMR measurement and surveillance as well as health infrastructure at the local, national and global level.
Governance
How NIAMR is governed
Project Advisory Board
Steering Committee · Oversight
National AMR CEIs Committee
Community engagement oversight
Project Advisory Board / Steering Committee
The Project Steering Committee / Advisory Board comprises a multi-disciplinary team of experts including Ministry of Agriculture, Animal Industry and Fisheries (MAAIF), World Health Organisation-Uganda (WHO-Uganda), Parliamentary AMR forum, Infectious Diseases Institute-CHS, East African Health Research Commission (EAHRC), Uganda Health Federation (UHF), and National Information Technology Authority (NITA-U). These oversee the work performed by the project implementing team, CEI-CAB team and meet monthly to discuss the project progress with NIHR and the project team.
National AMR CEIs Committee
The National AMR CEIs Committee facilitates community engagement and involvement (CEI) across the partner institutions — the Ministry of Health (MoH), Uganda's National Health Laboratories and Diagnostics Services (NHLDS), Baylor College of Medicine Children's Foundation-Uganda (BCMCF-Uganda), and Mbarara University of Science and Technology (MUST) — ensuring NIAMR meets real-world data capture, sharing and surveillance needs.
Project Lead and Research Team
The Project Lead – Prof. Josephine Nabukenya – will supervise the project implementation team. She will coordinate all project activities together with the project team.
The Project Implementing Team constitutes the research team (2 Project Co-leads, Co-investigators and the CEIs representatives from the MoH, NHLDS, BCMCF-Uganda and MUST) as well as Health Systems Research Assistants and PhD students.
Our partners
Working with the community and stakeholders
The project is following the WHO "co-design with the user" principles in designing and implementation of the NIAMR intervention; as such the Mak research team is engaging and working with the community (CEIs) including the Ministry of Health (MoH), Uganda's National Health Laboratories and Diagnostics Services (NHLDS), the Baylor College of Medicine Children's Foundation-Uganda (BCMCF-Uganda), and Mbarara University of Science and Technology (MUST). The CEIs representation are led by the Director General of Health Services Dr. Charles Olaro for MoH, and assisted by the Commissioner for NHLDS Dr. Susan Nabadda, and the Programme Manager of BCMCF-Uganda Mr. Roger Kisame.
UK International Development
UK's international development funding, backing global health research and capacity strengthening across partner countries.
DHSC
UK government department that underwrites the NIHR programme funding the NIAMR project.
NIHR
Funder of NIAMR under the Global Health Policy and Systems Research programme — award NIHR168786, over 36 months.
Makerere University
Lead research institution hosting the NIAMR project and coordinating the multidisciplinary research team.
MoH
Leads policy and governance of health data in Uganda; approves deployment of the NIAMR platform.
NHLDS
Provides stewardship for Uganda's AMR surveillance network and coordinates NIAMR's integration with national systems.
BCMCF-Uganda
Coordinates UK Fleming Fund Phase II investments and multisectoral AMR surveillance in Uganda.
MUST
Represents AMR academia and scientists; Uganda's second public university, with a community-impact mandate.
