Data Challenge: Africa_AMR

‎In African clinical settings, carbapenems are the antibiotics doctors reach for, the last resort, when medication failure is no longer an option. Infections caused by carbapenem-resistant Klebsiella pneumoniae and Escherichia coli carry mortality exceeding 50% even under aggressive treatment, the ceiling of what medicine can currently offer. ‎ ‎Our research question is precise: does rising ESBL prevalence in African clinical isolates predict carbapenem resistance emergence, and if so, over what time interval and does that interval differ across African sub regions? ‎ ‎The biological mechanism is established. Bacteria acquire Extended Spectrum Beta-Lactamase production, rendering them resistant to third-generation cephalosporins. Clinicians treating these ESBL infections with carbapenems create selection pressure that accelerates last-resort resistance emergence. ESBL prevalence is therefore a leading indicator, it is measurable, trackable, and actionable. We hypothesize that this ESBL-to-carbapenem transition operates on a region-specific African timeline that differs from European and North American estimates, and is predictable using available surveillance data. ‎ ‎This analysis has never been performed for Africa. Of 54 African nations, fewer than 15 appear in ATLAS. Three-quarters of the continent are absent when WHO guidelines are written, when stewardship resources are allocated, and when resistance trajectories are modeled. No early warning system currently exists for what is coming. ‎ ‎Using Pfizer-ATLAS, GSK-SOAR 201910, and SPIDAAR, from the Vivli AMR register datasets with the broadest African and West African isolate coverage, supplemented by publicly available antibiotic consumption and health system capacity data, we will model the ESBL-to-carbapenem transition, map surveillance gaps across all 54 African nations, build a causal AI prediction engine using a directed acyclic graph framework, and deploy an openly accessible early warning dashboard. ‎ ‎This tool is built for the infection control pharmacist at a tertiary hospital in Lagos or Accra who needs to know what is coming, not what happened elsewhere. ‎ ‎