 My name is Abila Shakarki and I am a medical microbiologist by training and I work at the Oxford Research Unit based in Nepal in Kathmandu. In Nepal we have a lot of burden of infectious diseases like typhoid, TB, pneumonia, etc. And the increase in antimicrobial resistance in these infections has been a huge burden on an already very poor healthcare system. So my research in Nepal focuses on looking at how these infections are spread particularly in hospital settings and finding out about what we call nosocomial infections. So if you look at hospital settings, it's a very complex setting. You have people who already carry resistant bacteria and then you have people who are very weak because of various reasons. And because it's a very resource limited hospital, we don't have infection controls and proper guidelines in place. So there's a lot of infection, so people come in to treat, say a simple cold, but then they pick up a resistant infection when they're weak and then that develops into a resistant infection that you can't treat anymore or you treat with very expensive medicine which the local population can't support. In developed countries, it's about 7% of all infections in hospitals are from resistant pathogens. And they say about 10% in developing countries are from resistant pathogens. But in my hospital, from our data, we see that about 40% of all infections that happen in the hospital are with resistant pathogens. And in those 40%, more than half have been hospital acquired. And we see a huge burden of that. It's almost more than 25% of all positive infections that we see. I started working on antimicrobial resistance 15 years ago and when I started I used to say, this will become a big problem. That's what everyone used to say. If we're not careful, it will be a big problem. Two weeks ago, I attended a conference and I reported 700,000 people die because of resistant pathogens. According to WHO, at the rate at it's going will go up to 10 million by 2050. And that means more people will die of resistant pathogen infections than what cancer kills today. So because it's such a multifaceted problem, there's lots going on. I think the one that really got my attention was the discovery of what they call a patch. So you don't need to take the medicines orally like you do most of the antibiotics that you do now. It's you just put it on and it goes directly into the bloodstream. So how that helps resistance is the antibiotic does not go to the gut where we think because there are lots of bacteria there. You put antibiotics in there and that's what gives rise to resistance. So the whole idea is if you wear the patch, it goes directly into the bloodstream and you somehow delay resistance developing in an individual. So the hospital lacks resources. There's absolutely limited resources. And what our research does is so I take a particular population in a hospital. For example, I do one study in just with the neonates, just with the pediatric group. Find out the main risk factors for them and then inform the hospitals. But if I give them the top two risk factors, then they will use their infection control just for those top two. And that is that will bring down the infection rate in the hospital. And so like we've been doing this with neonates, with adult ICU, the hospital, the wards in the hospital that are most affected by resistant pathogens. And for Nepal, it's a huge problem because 70% of revenues for Nepal comes from tourism. And tourism, travel, it plays a huge role in spreading infectious diseases and resistance as well. So controlling it locally actually helps the global picture a lot. In Kathmandu for the last 13 years, we've done a lot of studies on typhoid fever, which is very endemic. And a lot of people die actually because of complications from typhoid. But recently we've had a lot of increase in the resistance for typhoid, which is very worrying. Because from every five patients that come into the hospital, four of them have typhoid fever, which is a huge burden. And one of the things our study has shown, because we saw resistance rising up so quickly, is we got in touch with the IVG group, the Oxford Vaccine Group. And they have started massive vaccination campaigns. And our study has been able to show which population to target. And I think that shows a very nice collaboration of how we can do research. And then it goes on to intervention. And the number of typhoid cases has gone down in the last year. Happy to say.