Federal Project Grant Award Summary

The National Institute of Allergy and Infectious Diseases (NIAID) awarded a $597,421 Project Grant to the University of California, San Francisco (UCSF) effective July 1, 2026, through June 30, 2031, under the Allergy and Infectious Diseases Research program (CFDA 93.855). This award supports research examining antimicrobial resistance (AMR) monitoring in the context of azithromycin mass drug administration to children in Niger. The project leverages a large biorepository of nasopharyngeal and rectal samples collected through the Gates Foundation-funded AVENIR II cluster-randomized adaptive platform trial to investigate how antibiotic resistance emerges, persists, and potentially declines following cessation of mass drug administration in pediatric populations.

The research deliverables include quantitative assessments of antibiotic effectiveness once resistance has emerged, evaluation of whether azithromycin mass drug administration selects for AMR in colonizing and pathogenic organisms, and determination of whether resistance declines post-intervention and the fitness costs associated with resistant pathogens. The study integrates culture-based microbiological approaches, susceptibility testing, short-read metagenomic sequencing, long-read whole genome sequencing, and clinical outcomes analysis. Findings from this research are intended to inform evidence-based policy decisions regarding the implementation of mass drug administration programs by balancing potential mortality benefits against antimicrobial resistance risks in high-mortality settings.