One Health interventions to combat antimicrobial resistance

Antimicrobial resistance can be viewed through a One Health lens across humans, animals and the environment. Focussing on primary care, tests offered at point-of-care in Vietnam to curb antibiotic overuse yielded promising but nuanced results. The Just Transition initiative, examining justice implications of AMR policies globally, aims to align efforts with climate change mitigations for mutual benefits.

Sonia is an epidemiologist working at the Oxford University Clinical Research Unit in Hanoi. She uses population-based studies to evaluate the coverage, equity, and impact of public health interventions and programmes. She is interested in the application of social learning and collective action approaches to improve health behaviours. She previously used Participatory Learning and Action and peer-led interventions to improve maternal and child survival in Malawi, and is currently applying similar approaches to behaviour change interventions to tackle inappropriate antibiotic use and antibiotic resistance in Vietnam. She leads the Collective Action Against AMR (Co-ACT) study, a whole system intervention that combines education-based and engagement-based approaches to address unnecessary antibiotic use and antimicrobial resistance (AMR) across healthcare, community, and farm settings.

Sonia’s other implementation research related to AMR includes a pragmatic trial of point-of-care diagnostics to reduce inappropriate antibiotic use at primary healthcare level (ICAT), and a pilot study to explore the feasibility and acceptability of point-of-care testing in community pharmacies to target over-the-counter antibiotic sales. Alongside this, she is using population datasets to analyse global distributions and determinants of antibiotic use. By linking these population-datasets with climate data, she is building geospatial models to look at the relationship between climate and AMR, as well as mathematical models to identify intervention points with the largest potential for impact on antibiotic use and resistance.

Sonia is also interested in social determinants of health and health inequalities, and was an advisor to UNICEF/GAVI on evaluating missed opportunities for vaccination and trends in vaccination coverage equity in low and middle income countries. Sonia maintains strong connections with the University of Auckland and AUT in New Zealand, where she worked on population-based research in child, youth, and family health, and continues to collaborate on research related to indigenous and migrant health inequalities.

Sonia co-leads the SPEAR (Social Public Engagement and Action Research) Project about understanding the socio-cultural impact of the Covid-19 pandemic in Indonesia, Nepal, and Vietnam. She has also led community engagement projects related to AMR, including Photovoice stories about antibiotic use, and Antibioship, a serious game about AMR.