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SEAOHUN is pleased to share the final report from the One Health Workforce – Next Generation (OHW-NG) project, marking six years of global collaboration, innovation, and impact supported by USAID. With over 66,000 learners trained and participation from more than 90 countries, OHW-NG has helped shape a transdisciplinary workforce ready to respond to today’s complex health threats. 📥 Download the Year 6 Report and explore the project legacy: https://drive.google.com/drive/u/2/folders/1LaofpTBPjlhyun06AuVFzX_cPjqhaOl9

By Dr. Ngo Thi Thuy Huong and Team   Editor: Anti Rismayanti, SEAOHUN Regional Program Manager   Antimicrobial resistance (AMR) has emerged as one of the most pressing threats to global health, with repercussions that ripple through hospitals, farms, communities, and natural ecosystems. In low- and middle-income countries like Vietnam, the challenge is compounded by overuse of antibiotics in human and veterinary medicine, poor waste management, and an evolving cast of emerging contaminants—including microplastics (MiPs). These tiny fragments of plastic not only persist in the environment but, as new evidence suggests, may act as vehicles for AMR dissemination. Backed by the SEAOHUN 2024 One Health Research and Training (OHRT) Awards Program and rooted in the One Health framework, our team at Phenikaa University, in collaboration with the National Institute of Hygiene and Epidemiology (NIHE), set out to understand and mitigate the potential link between MiPs and AMR. Our project did not merely generate scientific findings—it mobilized students, engaged communities, and piloted a model for integrated environmental surveillance and action. Implementing a One Health Vision: From Rivers to Reports Our project was strategically designed around three major objectives: evaluating the presence of AMR and pollutants associated with microplastics, developing intervention tools based on wastewater-based epidemiology (WBE), and raising public awareness through education and citizen science. Over six months, we collected 72 samples from high-risk sites in Hanoi—including areas near hospital discharges, wastewater treatment plant inflows, and small rivers receiving mixed urban waste. Field sampling was complemented by questionnaire-based surveys to assess public perception and behavior related to antibiotic use and pollution. Analytical methods such as FTIR spectroscopy revealed that polyethylene terephthalate (PET) and nylon were the dominant microplastics. These were not inert pollutants: we detected multiple resistance genes (blaTEM, blaCTX-M, SHV) and multidrug-resistant (MDR) organisms like Aeromonas spp., which thrive in contaminated water bodies and are known reservoirs of resistance. Our metagenomic analysis revealed a disturbing trend—resistance genes were not isolated events but part of a pattern involving fluoroquinolone, beta-lactam, and elfamycin groups. Simultaneously, we documented elevated levels of cadmium (Cd) and lead (Pb), elements previously implicated in co-selecting for resistant strains. These insights supported our hypothesis that environmental stressors—including heavy metals and MiPs—create conditions conducive to AMR propagation. Student-Centered Research, Experiential Learning, and Capacity Building A key pillar of our implementation strategy was the empowerment of young scholars. Members of the One Health Student Club at Phenikaa University (OH.PU) played a central role throughout. These students weren’t mere observers—they were researchers, communicators, and change agents. Field trips were conducted biweekly, giving students hands-on experience in using sampling equipment, collecting water and sediment samples, and conducting basic analysis under supervision. Three graduate students integrated project data into their theses, benefiting from access to cross-sectoral mentorship and advanced laboratory techniques. We also trained over 70 undergraduate students on survey design, data interpretation, and science communication skills. They practiced these skills by organizing and moderating public workshops, developing educational materials, and participating in podcast competitions that challenged them to explain AMR in creative, relatable ways. This dual-track approach—strengthening technical capabilities while building confidence in public engagement—was central to our success. Students learned to translate scientific findings into real-world impact, fostering a generation of leaders who understand the interconnectedness of environmental, human, and animal health. Engaging Communities in AMR Prevention and Environmental Stewardship Beyond academia, the project’s influence extended deep into communities. A training workshop in Tien Tan Commune, Ha Nam province brought together over 140 participants—farmers, retirees, housewives, students, and public officials—to explore the implications of AMR and pollution on their health and livelihoods. Pre- and post-workshop surveys demonstrated increased awareness of antibiotic misuse, improved understanding of microplastic risks, and a shift toward more cautious health practices, including reduced self-medication. Participants engaged in interactive sessions led by project scientists, who presented case studies, facilitated discussions, and introduced One Health concepts in accessible language. Meanwhile, a parallel campaign targeting students used podcasts and digital media to reach younger audiences across Hanoi. This initiative attracted participation from high schoolers and undergraduates, whose entries ranged from dramatized stories to interview-style narratives about AMR, reflecting both creativity and critical thinking. By embedding scientific literacy into public discourse, the project created a feedback loop where knowledge generation and behavior change reinforced each other. This model is now being refined for replication in other provinces. Bridging Research and Policy Through Wastewater-Based Epidemiology At the heart of our research intervention is a proposed wastewater-based epidemiology (WBE) model. This data-driven tool analyzes patterns in AMR gene prevalence across water systems, using geospatial mapping to visualize hotspots and inform policy. Such a tool could become instrumental in early warning systems for AMR and potentially other emerging infectious diseases. We are currently building a GIS-integrated dashboard that incorporates sampling data, resistance gene prevalence, metal concentrations, and population density. This system can be updated in real-time as more data become available, providing local authorities with actionable intelligence for environmental management and public health planning. We envision future iterations of this model being linked with hospital and veterinary data to create a truly integrated AMR monitoring system—something Vietnam sorely needs as it strengthens its national response strategies. Outcomes, Impact, and Sustainability The outcomes of our project reveal a dynamic interplay between scientific discovery, behavioral transformation, and institutional strengthening. From a scientific standpoint, our investigations confirmed that microplastics (MiPs) can serve as carriers for antibiotic resistance genes, particularly in environments subjected to intense human activity. This finding reinforces the urgency of considering environmental contributors in national AMR strategies. On a behavioral level, the project successfully influenced public perception and practices. Participants in our workshops—ranging from local community members to university students—demonstrated increased awareness of the risks associated with antibiotic misuse and environmental contamination. Follow-up surveys indicated tangible behavioral shifts, including reduced reliance on self-medication and more responsible attitudes toward antibiotic consumption. Institutionally, the project strengthened the foundation for sustained One Health engagement at Phenikaa University. The One Health Student Club was revitalized as an active platform for student-led research, communication, and community outreach. Faculty members also benefited, using project outputs to develop new teaching tools and integrate AMR-related case studies into their curricula. These efforts have laid the groundwork for longitudinal research and the development of more comprehensive educational modules. Looking to the future, the project is poised for wider impact. Plans are in motion to expand our workshop format to other provinces, targeting new communities and student groups across different academic disciplines. We also aim to launch an “AMR Roadshow” that will bring interactive, science-based education to high schools throughout Hanoi. At the same time, we are preparing a series of peer-reviewed journal articles and policy briefs to ensure our findings reach the broader scientific and policy-making community. One of our most ambitious goals is to further develop and scale our wastewater-based epidemiology (WBE) model. With support from national agencies and networks such as VOHUN, we hope to refine this tool into a practical, real-time surveillance system that can inform public health decision-making far beyond this project's original scope. Ultimately, this project affirms that AMR cannot be tackled in isolation. It is a challenge that transcends disciplines and sectors. But through collaborative, interdisciplinary efforts and sustained community engagement, we can begin to build resilient systems that safeguard both human and environmental health for the long term. Reflections and Lessons Learned Perhaps the most enduring lesson is this: real change begins when science meets storytelling. Our project was most impactful when data were shared through human voices—whether it was a farmer realizing the link between pig feed and antibiotic runoff or a student confidently explaining AMR to their peers. Flexibility, local relevance, and sustained follow-up proved essential to maintaining momentum and building trust. Timing also played a critical role. Delays caused by exam periods and budget disbursement challenges reminded us to design projects that are both rigorous and adaptable. Yet despite these hurdles, our team’s dedication and the resilience of our community partners turned obstacles into opportunities. In reflecting on this journey, we are reminded that AMR is not just a microbial issue—it is a systems issue. And solving it requires every tool at our disposal: science, education, policy, and above all, collaboration. Conclusion With the support of the SEAOHUN OHRT Awards Program and funding from USAID, our project has achieved more than its scientific goals. It has built bridges between disciplines, created new educational models, and planted the seeds for sustained community change. By addressing AMR at its environmental roots and involving young people in the solution, we are not only protecting ecosystems but empowering a generation to lead the fight against one of the 21st century’s most daunting public health threats. Vietnam’s waterways may carry microscopic threats, but through integrated One Health action, they now also carry hope—and the momentum of a movement that is just beginning. Team Leader : Dr. Ngo Thi Thuy Huong – Phenikaa University Team Members: Dr. Le Thanh Thao – Phenikaa University Assoc. Prof. Dr. Hoang Thi Thu Ha – National Institute of Hygiene and Epidemiology (NIHE) Dr. Nguyen Thuy Tram – NIHE Dr. Nguyen Thi Hanh Tien – Phenikaa University Dr. Nguyen Quoc Dinh – Phenikaa University Ms. Pham My Dung – Phenikaa University Mr. Vo Hoai Hieu – Phenikaa University

By Dr. Vu Thi Quynh Chi and Team   Editor: Anti Rismayanti, SEAOHUN Regional Program Manager   Antimicrobial resistance (AMR) is one of the most pressing health threats of our time—complex, multidimensional, and deeply rooted in human behavior. In Vietnam, AMR is particularly concerning among pediatric populations due to high rates of infectious disease and frequent antibiotic misuse. Recognizing this challenge, our team at The University of Danang launched a focused intervention under the SEAOHUN 2024 One Health Research and Training (OHRT) Awards Program, aimed at improving antibiotic knowledge and usage practices among caregivers of children under five years old. The project, titled "Knowledge and Use of Antibiotics among Pediatric Caregivers: Comparing Two Educational Interventions," was designed to evaluate the effectiveness of one-on-one versus group education in promoting antibiotic stewardship through a One Health lens. The findings not only shed light on behavioral change potential but also demonstrate how tailored education at the community level can become a frontline defense against AMR. Implementation Journey: Bridging Research, Education, and Community Needs The intervention was implemented over five months at Da Nang Hospital for Women and Children. Sixty caregivers were enrolled and randomly divided into two groups: one receiving individualized education, and the other participating in group sessions. Educational content was informed by literature reviews and local needs, and covered proper antibiotic use, risks of resistance, and hygiene-based infection prevention. These sessions were complemented by pre- and post-training assessments using structured Vietnamese-language questionnaires to evaluate knowledge and behavior change. Logistically, the project faced hurdles. Coordinating with caregivers whose time was constrained by family and work obligations proved difficult. In response, the team provided transportation stipends and scheduled training on weekends. Additionally, administrative bottlenecks at the hospital were alleviated through collaborative engagement with hospital leadership, easing access and data collection. These experiences underscore the importance of community-centric, flexible programming in public health initiatives. Educational Interventions: Insights into Learning Dynamics The comparative analysis between educational formats revealed a significant overall improvement across all participants. Knowledge scores jumped from a mean of 39.9 to 54.0 out of 60, while correct practices improved from 32.4 to 40.7 out of 45—both with statistical significance (p < 0.001). However, the depth of learning was notably different between formats. Participants who received one-on-one education not only showed higher post-training scores, but also demonstrated more nuanced understanding. For example, they were significantly more likely to correctly state that antibiotics are ineffective for viral infections and that hot water can degrade reconstituted antibiotic suspensions. They also expressed greater confidence in safely administering pediatric medications. In contrast, group sessions allowed for broader outreach and peer exchange but lacked the individualized attention needed to dismantle deep-rooted misconceptions. These insights affirm that while group education is practical for scale, one-on-one engagement is indispensable for lasting behavior change—especially in contexts where traditional beliefs and limited medical literacy influence health practices. The One Health Perspective: Shifting Paradigms at the Grassroots Level A central achievement of this project was translating the abstract concept of One Health into everyday relevance for caregivers. Many participants initially perceived antibiotic misuse as a personal or family issue. Through interactive sessions and tailored examples—such as how antibiotic-resistant bacteria can emerge from livestock and contaminate food or water—caregivers began to understand the interconnectedness of human, animal, and environmental health. The project also introduced a Handbook on the Use of Antibiotics for Children, a practical resource developed by the team to reinforce lessons and serve as a reference for safe medication practices at home. With easy-to-read visuals and culturally appropriate language, the handbook has already begun to gain traction as a communication tool among local health workers. Contributions to Faculty and One Health Education The project also yielded transformative outcomes for the faculty involved. As educators at OHUN member universities, we gained firsthand experience in designing participatory learning tools, applying real-world scenarios, and measuring impact through rigorous evaluation. These insights have inspired curriculum reforms that integrate practical, community-based case studies and simulation exercises that mirror the realities of AMR and antibiotic misuse. Beyond academia, the project has strengthened our network with hospital administrators, pharmacists, and public health officials—laying the groundwork for future cross-sector collaborations in One Health advocacy and training. Envisioning Long-Term Impact and Scaling Up Looking ahead, we anticipate the project will catalyze long-term change both in household health behaviors and institutional practices. The improved knowledge and skills of caregivers are expected to reduce unnecessary antibiotic use, leading to better child health outcomes and helping slow the spread of resistance. We are currently exploring opportunities to integrate this model into routine pediatric care, leveraging hospital and local government support. Challenges remain: sustained funding, maintaining caregiver engagement, and translating educational success into systemic change. To address these, we aim to pursue support from governmental health agencies and international donors, while developing scalable, tech-enabled versions of the training, such as mobile health applications for caregiver education. Advancing One Health in Vietnam: A Scalable, Sustainable Model This initiative stands as a replicable model for One Health education in resource-constrained settings. By combining behavior change science, locally adapted materials, and flexible delivery methods, the project directly addresses one of the root causes of AMR: lack of public understanding and improper use of antibiotics. As Vietnam continues to battle high rates of resistance in pediatric and general populations, community-based interventions like this are essential complements to clinical and policy efforts. Lessons Learned: Education with Empathy and Evidence Throughout the course of the project, several key insights surfaced that can inform future initiatives aiming to foster behavior change through One Health education. One of the most important realizations was that behavioral change is deeply personal. The one-on-one interactions provided a safe, judgment-free space for caregivers to voice their concerns and clarify misconceptions—something that group settings often do not allow. This personalized approach fostered trust and encouraged honest dialogue, resulting in a deeper understanding of antibiotic use and resistance. Another valuable lesson was the power of simplicity. Visual aids, relatable examples, and straightforward language proved highly effective in bridging the gap between complex scientific concepts and everyday caregiving practices. Many participants, previously unaware of the consequences of misuse, found clarity through these accessible tools. Equally important was the recognition that health systems must prioritize listening. Caregivers consistently expressed appreciation for being seen and heard, especially when the training content was adapted to their schedules, responsibilities, and prior knowledge. This responsiveness made them more open to learning and adopting new practices. Lastly, the project reinforced that change cannot be a one-time event. Sustained progress requires continuous engagement—through follow-up sessions, accessible resources, and community-level reinforcement of One Health messages. Only through repeated, consistent exposure can new habits be nurtured and old misconceptions dismantled. Together, these lessons highlight the necessity of empathy, adaptability, and persistence in educational interventions. They offer a roadmap for educators, health professionals, and policymakers committed to advancing One Health in ways that are not only scientifically sound but also human-centered and culturally attuned. Conclusion The SEAOHUN OHRT Awards Program has empowered us to transform an abstract, global health challenge into a locally actionable program. Our journey with pediatric caregivers in Danang demonstrates that meaningful change starts with informed individuals—and that with the right tools, trust, and training, even small-scale interventions can ripple into systemic impact. Through a One Health lens, we have not only improved antibiotic stewardship in one community but helped lay the foundation for a healthier, more resilient Vietnam. Team Leader: Dr. Vu Thi Quynh Chi, The University of Danang Team Members : Van Pham Kim Thuong, Tran Thi Van, The University of Danang

By Dr. Saharuetai Jeamsripong and Team   Editor: Anti Rismayanti, SEAOHUN Regional Program Manager   In the global fight against antimicrobial resistance (AMR), novel surveillance strategies are critical—particularly in agricultural environments where antibiotic use is widespread, and risks of AMR spread are high. In this context, the project "Capacity Building for AMR Research: Bioaerosol Sampling Practical Training Modules" , supported by the SEAOHUN One Health Research and Training (OHRT) Awards Program, marks a groundbreaking step in Thailand’s One Health efforts. Led by Dr. Saharuetai Jeamsripong of Chulalongkorn University, the project addresses the absence of localized technical tools and trained personnel for AMR monitoring through airborne bioaerosols—an often overlooked pathway for resistance gene dissemination. By developing training modules and practical guides, and delivering immersive workshops, the initiative not only deepens technical capacity but also embeds sustainability into AMR surveillance education. From Vision to Impact: The Implementation Experience The project was launched in May 2024 with a focused ambition: to democratize access to bioaerosol sampling expertise, particularly in settings with limited resources. Early in the implementation, the team recognized the importance of hands-on learning. Rather than solely relying on remote consultations, Ms. Thanaporn Thongthum undertook a summer internship at Laval University in Canada, where she was trained directly in sample collection, DNA extraction, and microbial analysis by global experts. This immersive experience informed the content and structure of both the Field Guide and Facilitator Guide, grounding them in practical application rather than abstract theory. In parallel, the team conducted a needs assessment among registered workshop participants to tailor the training content. This ensured that the curriculum addressed existing knowledge gaps and aligned with real-world challenges. The guides, rich with diagrams, case studies, and context-specific protocols, were later translated into Thai to ensure wide accessibility and relevance. The capstone of the project was the two-day training workshop held on July 18–19, 2024, involving classroom lectures, hands-on field sampling at a livestock farm, and laboratory demonstrations at Chulalongkorn University. The sessions covered bioaerosol theory, equipment handling, DNA extraction techniques, and qPCR-based detection of AMR genes, engaging a diverse group of 36 participants including graduate students, lecturers, research assistants, and veterinarians. Building One Health Capacity: Knowledge, Skills, and Confidence Through the SEAOHUN OHRT Awards Program, the team not only honed their research and teaching skills but also cultivated a deeper understanding of the interplay between human, animal, and environmental health. Participants emerged from the workshop with increased confidence in their ability to conduct AMR surveillance using bioaerosol techniques—an area many had not encountered prior to the training. Pre- and post-assessments revealed marked improvement in participants' comprehension. The average score rose from 25 to 29 out of 40, with notable gains in understanding sample preparation and DNA analysis. While certain topics like sampler types and bioaerosol sources remained challenging for some, this feedback has been incorporated into updated versions of the training guides to improve future learning outcomes. The workshop also promoted critical soft skills. Group discussions encouraged reflection on real-world barriers to AMR surveillance, such as equipment costs, environmental logistics, and stakeholder coordination. These sessions emphasized the need for cross-sector collaboration, data transparency, and context-aware interventions—skills essential for driving long-term change in One Health initiatives. Elevating Education: Impacts on One Health Teaching and Research For faculty members at Chulalongkorn University and THOHUN member institutions, the project provides a springboard for transforming One Health education. The materials developed—now being integrated into graduate courses—enable instructors to offer experiential learning in environmental microbiology and AMR surveillance. This positions the university as a leader in training the next generation of scientists who can navigate complex health threats at the human-animal-environment interface. Plans are already underway to embed the bioaerosol sampling curriculum into upcoming MSc and PhD thesis projects. These studies will compare AMR profiles in bioaerosol samples against those in slurry and wastewater, offering a holistic view of microbial transmission pathways in agricultural ecosystems. Moreover, the guides are being prepared for broader dissemination to institutions across Southeast Asia, potentially serving as a model for regional training. Anticipated Impact and Sustainability The project’s benefits extend beyond the university walls. By empowering educators and students, the initiative has created a multiplier effect: those trained can now facilitate similar sessions, apply knowledge in their own institutions, and lead research that informs public health policy. In the near future, the team envisions expanding the scope of surveillance to include slurry, wastewater, and surface water sampling, further enriching the training materials. The bioaerosol samplers and reagents purchased for the workshop will be used in longitudinal studies, allowing for sustained AMR monitoring in Thai agricultural zones. A key concern, however, is the cost of sampling equipment, which can be prohibitive for many researchers. To address this, the project team recommends future OHRT cycles include funding provisions for follow-up studies and resource acquisition. Additionally, extending the project timeline from six to twelve months would allow for more robust implementation, stakeholder engagement, and data analysis. A Model for One Health Advancement in Thailand At its core, this initiative exemplifies how targeted investment in capacity-building can drive systemic change. By forging ties between veterinary and public health fields, between academia and practice, and between Thai and international experts, the project nurtures a resilient One Health ecosystem. It offers a replicable framework for environmental AMR surveillance in other low-resource settings across Southeast Asia. The project also demonstrates that technology transfer is not a one-way street. While global expertise informed the training materials, local feedback and field realities refined them. The result is a set of practical, adaptable tools that reflect both scientific rigor and cultural relevance. Reflections and Lessons for the Future Several insights emerged from this experience. First, flexibility is crucial—whether in adapting procurement timelines, modifying protocols using locally available reagents, or restructuring workshop activities. Second, engagement trumps exposure: while international guidelines are useful, localized, hands-on training produces deeper, more lasting learning. Finally, collaboration breeds innovation. The success of this project hinged on seamless cooperation among Chulalongkorn University, the University of Florida, Mahidol University, and the wider SEAOHUN network. Conclusion The “Capacity Building for AMR Research: Bioaerosol Sampling Practical Training Modules” project marks a pivotal contribution to One Health education, research, and practice in Thailand. It brings scientific inquiry out of the lab and into real-world settings, empowering a new generation of professionals to tackle AMR where it often begins—in the air we breathe, on the farms we rely on, and in the systems we build together. As One Health challenges grow in complexity, so too must our tools, our collaborations, and our commitment to sustainable change. This project is not an endpoint—it is a launchpad for future research, deeper regional partnerships, and the continual evolution of AMR surveillance strategies. Team Leader: Dr. Saharuetai Jeamsripong, Chulalongkorn University Team Members: Dr. Benjamin D. Anderson, University of Florida Ms. Thanaporn Thongthum, University of Florida Dr. Varangkana Thaotumpitak, Mahidol University Mr. Saran Anuntawirun, Chulalongkorn University

By Asst. Prof. Dr. Jirakrit Saetang and Team   Editor: Anti Rismayanti, SEAOHUN Regional Program Manager Amid growing concerns over antimicrobial resistance (AMR) in food systems, the SEAOHUN One Health Research and Training (OHRT) Awards Program offered an invaluable opportunity to explore the presence of AMR genes within aquaculture environments. Our team, led by Asst. Prof. Dr. Jirakrit Saetang from Prince of Songkla University, embarked on a project titled "Investigation of antimicrobial resistance (AMR) genes in Asian seabass throughout the supply chain in Southern Thailand by Nanopore sequencing approach." This initiative marked a significant step toward understanding how AMR might travel from aquatic farms to consumer tables, with implications for food safety, public health, and environmental sustainability. Implementation Experience Our implementation journey began with the collection of samples from various points along the supply chain—including aquaculture farms, container surfaces, and local markets—located in Songkhla, Thailand. Water was sampled from both inside and outside cage farms, while containers were swabbed, and fish were procured directly from markets. Samples were processed using Oxford Nanopore sequencing, a real-time DNA sequencing technology that allowed us to assess both resistome and microbiome profiles in each environment. While the technical process progressed efficiently, our field operations were met with logistical hurdles, such as coordinating multiple sampling sites and managing sample quality across different environmental matrices. However, strong collaboration among team members from various disciplines and institutions helped us overcome these obstacles. The sequencing results yielded a rich dataset of over 12 million reads, capturing bacterial diversity and AMR gene patterns across environments. Enhancement of One Health Knowledge and Skills The project significantly enriched the technical and practical understanding of One Health among team members. We advanced our laboratory skills in high-throughput DNA extraction and nanopore sequencing, and gained fluency in bioinformatics tools such as Kraken2, Phyloseq, and the Resistance Gene Identifier. More importantly, the project nurtured crucial soft skills such as stakeholder communication, particularly when translating genomic concepts into practical implications for farmers and local vendors. This dual capacity in science and engagement is essential for implementing impactful One Health solutions. Improving One Health Education and Practice As faculty at OHUN member universities, our team is already leveraging the knowledge gained to enrich academic curricula. Modules on AMR monitoring and microbial sequencing are being developed, integrating both theory and field practice. Students will benefit from exposure to real-world applications of genomic surveillance, enhancing their readiness to tackle health threats that cross human, animal, and environmental domains. This approach not only improves knowledge transfer but also promotes a holistic mindset critical to solving One Health challenges. Results and Insights Our results revealed critical insights into bacterial diversity and ARG (antimicrobial resistance gene) distribution. Synechococcus dominated the water microbiome, reflecting its role as a marine primary producer. Vibrio species appeared more abundantly inside fish cages at some sites, indicating potential health risks due to poor farming conditions. Containers exhibited different microbial profiles, including heat-tolerant Kocuria species, possibly introduced during storage and transportation. Fish samples presented a concerning profile, with bacterial genera such as Acinetobacter, Aeromonas, and Shewanella being consistently present. These genera include species that are not only pathogenic to fish but also resistant to multiple antibiotics, posing threats to food safety and human health. Notably, pathogenic species such as Acinetobacter johnsonii and Aeromonas salmonicida were detected alongside spoilage-related Shewanella baltica. The resistome analysis identified key ARGs such as rsmA, MOX-13, OXA-436, and rpsL. These genes confer resistance to commonly used antibiotics, including fluoroquinolones, cephalosporins, and streptomycin. The rsmA gene—present in containers and fish—highlighted the potential transfer of resistance during storage and handling. The detection of the rpsL gene in water samples, a marker for streptomycin resistance, underscored environmental contamination possibly linked to past antibiotic usage. These findings emphasize the interconnected nature of AMR across sectors. Public Awareness and Stakeholder Engagement Beyond laboratory results, the project included a strategic social media campaign aimed at raising AMR awareness among farmers, vendors, and the broader public. Although some components were delayed, initial content creation, including infographic design and message development, is in progress. The campaign will be rolled out via Facebook, Instagram, and relevant Thai governmental websites beginning in November 2024. Stakeholder engagement was integral throughout the project. Farmers were informed about the implications of antibiotic overuse and introduced to alternatives such as probiotics and vaccines. These interactions helped build trust and empowered farmers to explore sustainable aquaculture practices. Additionally, fact sheets summarizing our findings are being prepared for dissemination to national agencies overseeing food safety and AMR control. Anticipated Impact and Future Directions We anticipate that our findings will influence AMR surveillance policy and aquaculture management practices in Thailand. With data archived in the NCBI Sequence Read Archive and a manuscript in preparation for Food Control, the research will contribute to the global AMR discourse. Over the next six months, our outreach activities will expand, with the aim of sustaining behavioral change among farmers and promoting policy-level dialogue. We are also exploring the expansion of surveillance systems for continuous monitoring, supported by additional funding proposals. Such systems could include routine testing at fish markets and processing centers, supported by genomic dashboards that inform local AMR trends. Contributing to the Advancement of One Health This project exemplifies a robust One Health approach, bridging environmental science, veterinary pathology, food safety, and public engagement. It sets a precedent for how portable sequencing tools and cross-sectoral partnerships can address complex health threats. By fostering awareness, generating actionable data, and advocating sustainable practices, we are actively advancing the One Health agenda in Thailand and potentially, the broader Southeast Asian region. Insights and Lessons Learned Key lessons emerged throughout the project. Early and clear communication with stakeholders was crucial—simplifying scientific language using relatable analogies helped drive the message home. Preparing the team with field training ahead of sample collection optimized our workflow and minimized errors. We also learned the importance of robust data curation; even small misclassifications in ARG identification could lead to misinformed conclusions. Conclusion The SEAOHUN OHRT Awards Program has empowered our team to conduct meaningful research on AMR, bridging science and society in the process. Our results offer a foundation for long-term surveillance and sustainable aquaculture, while also enriching One Health education and collaborative practices. As we continue to share findings and expand our efforts, we aim to inspire other researchers, policymakers, and practitioners to join the fight against antimicrobial resistance—one genome at a time. Team Leader: Asst. Prof. Dr. Jirakrit Saetang, Prince of Songkla University Team Members: Prof. Dr. Soottawat Benjakul, Prince of Songkla University Asst. Prof. Dr. Matsapume Detcharoen, Prince of Songkla University Asst. Prof. Dr. Chonticha Romyasamit, Walailak University Asst. Prof. Dr. Watcharapol Suyapoh, Prince of Songkla University

By Asst. Prof. Dr. Dusit Laohasinnarong and Team   Editor: Anti Rismayanti, SEAOHUN Regional Program Manager   Parasitic infections remain a persistent threat to health systems across Southeast Asia, exacerbated by growing resistance to anti-parasitic drugs in both human and animal populations. The “Communities Against Parasites (CAP)” project, supported by the SEAOHUN One Health Research and Training (OHRT) Transition Award, emerged from this reality with a dual mission: to predict patterns of drug resistance through computational science, and to improve public health behaviors through regional advocacy. Implemented from May to November 2024, this collaborative project brought together researchers and educators from Mahidol University (Thailand), Suan Sunandha Rajabhat University (Thailand), and the University of the Philippines Manila—uniting veterinary medicine, public health, and computational biology under the banner of One Health. Implementation Experience The CAP project operated on two interlinked tracks. First, the scientific arm employed computational and mathematical modeling to analyze parasite genomes and predict how specific protein mutations affect the binding efficiency of WHO-recommended anti-parasitic drugs. By focusing on parasites of zoonotic concern—such as Ascaris spp., Trichinella spp., and Trypanosoma spp.—the team aimed to forecast drug resistance trends before they escalate. Notably, key amino acid substitutions were found to reduce drug-binding affinity, offering molecular insight that can guide early surveillance and treatment strategies. Simultaneously, the project’s advocacy arm engaged more than 275 individuals from various Southeast Asian communities through a region-wide webinar and an extensive Knowledge, Attitudes, and Practices (KAP) survey. This two-month pre-webinar assessment revealed both promising strengths and critical gaps: while over 90% of respondents understood basic food safety principles, only 14.38% adhered to full anti-parasitic drug regimens, and just 43.79% regularly dewormed their pets—highlighting vulnerabilities in both human and animal health behaviors. Enhancement of One Health Knowledge and Skills This project was a true crucible for enhancing both hard and soft skills in the One Health context. On the technical side, we strengthened competencies in bioinformatics, protein-ligand modeling, 3D structural analysis, and statistical interpretation. These are crucial tools for understanding and predicting drug resistance mechanisms in zoonotic and human parasites. Equally important were the soft skills we developed: stakeholder engagement, community communication, ethics navigation, and interdisciplinary teamwork. From consulting with local farmers and teachers to coordinating with mathematicians for mutation modeling, the project underscored the importance of effective cross-sector collaboration. The hands-on experience in designing, conducting, and interpreting KAP surveys has significantly boosted our capacity to engage communities with science-informed public health education. Improving One Health Education and Practice As a faculty member of an OHUN-affiliated university, I recognize how deeply this project has enriched my perspective as an educator. The CAP experience will be translated directly into One Health curriculum development at Mahidol University. Students will engage with case studies drawn from our research, including real-world data on parasite resistance trends, behavioral gaps, and bioinformatics findings. Moreover, the KAP survey methodology will be incorporated into student training, allowing future public health professionals to learn how to interpret behavioral data and design context-specific interventions. These enhancements will cultivate a generation of professionals who are not only grounded in science but also fluent in community engagement. Anticipated Impact on Target Groups Looking ahead, the CAP project is poised to create long-term ripple effects among its target groups. Our outreach and survey efforts have already increased awareness among the general public, but future activities will extend to school-age children and farming communities. Tailored content, localized in languages including Thai, Tagalog, Burmese, and Chinese, will be disseminated via online platforms and community-based programs. Plans are underway to conduct follow-up surveys in six and twelve months to assess the retention of health knowledge and to identify new gaps. We are also exploring partnerships with local governments and NGOs to distribute educational materials more widely and to host in-person workshops, especially in rural areas with limited access to digital content. By institutionalizing these efforts, we hope to cultivate health-conscious behaviors and reduce infection and resistance rates sustainably. Contributing to the Advancement of One Health The CAP project embodies the spirit of One Health by connecting molecular science with grassroots action. By analyzing genetic mutations that drive drug resistance and directly informing communities about their implications, we’ve demonstrated how interdisciplinary research can have practical applications. Our collaboration across countries and disciplines illustrates a regional model for One Health engagement. By sharing findings through international conferences and academic publications, and by involving both scientists and citizens, CAP is actively contributing to the larger movement toward integrated health systems that can respond to zoonotic threats, resistance trends, and public health misinformation. Insights and Lessons Learned Several key insights emerged from this journey. First, we learned that scientific rigor must go hand-in-hand with cultural sensitivity. Misunderstandings about parasite transmission—such as the belief that certain parasites only infect animals—highlighted the need for clear, accessible communication strategies. Second, digital tools can amplify outreach but must be supplemented with localized engagement, especially for older adults and rural populations. We also learned that resistance monitoring can no longer be confined to laboratories. Communities must be educated and mobilized as frontline observers and actors. Lastly, building trust and maintaining transparency—particularly through ethics-approved survey practices and feedback loops—were essential in ensuring credible results and meaningful engagement. Conclusion The CAP project stands as a compelling example of how targeted research and public health advocacy can come together under the One Health framework. By exploring the molecular underpinnings of antiparasitic resistance and promoting behavior change through community education, we have laid the groundwork for systemic improvements in health surveillance and communication across Southeast Asia. This experience has equipped our team—and the wider academic and public health community—with actionable insights, practical tools, and renewed energy to tackle zoonotic diseases and drug resistance in holistic, inclusive ways. We hope our work inspires further interdisciplinary collaboration and reminds stakeholders that sustainable health solutions require both advanced science and community empowerment. Team Leader: Asst. Prof. Dr. Dusit Laohasinnarong, Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Thailand Team Members: Faculty of Tropical Medicine, Mahidol University (MU-TM) College of Public Health, University of the Philippines Manila (UPM-CPH) Faculty of Science and Technology, Suan Sunandha Rajabhat University (SSUR-SC)

By Assoc. Prof. Dr. Chonticha Romyasamit and Team   Editor: Anti Rismayanti, SEAOHUN Regional Program Manager   In the bustling local markets of Thailand, where food stalls brim with vibrant produce and freshly ground meats, a silent threat may lurk unnoticed—Helicobacter pylori (H. pylori), a bacterium implicated in severe gastrointestinal diseases, including peptic ulcers and gastric cancer. With growing concerns about antimicrobial resistance (AMR) and foodborne transmission, a multidisciplinary team led by Assoc. Prof. Dr. Chonticha Romyasamit of Walailak University embarked on an ambitious study under the SEAOHUN Transition Award (TA) through the 2024 One Health Research and Training (OHRT) Awards Program. Their mission: to investigate the prevalence, resistance patterns, and genetic traits of H. pylori in minced meat and raw vegetables sold in Thai markets—and in doing so, promote safer food handling practices across communities. From Market to Microscope: Detecting a Foodborne Threat Between May and September 2024, the team collected and analyzed a total of 550 food samples, comprising 110 minced meat and 440 raw vegetable samples sourced from local retail markets. Employing MALDI-TOF MS (Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry), the researchers identified five H. pylori isolates—a notable finding given the general perception that H. pylori transmission is primarily person-to-person or via water sources. Antibiotic susceptibility testing revealed alarming resistance trends, with the isolates showing resilience to commonly used antibiotics such as ampicillin, penicillin, and trimethoprim-sulfamethoxazole. These results not only raise concerns about treatment efficacy but also highlight the potential for antibiotic misuse in agricultural or food preparation settings. To further understand the potential severity of these strains, the team conducted genotyping to detect virulence-associated alleles like cagA and vacA. Interestingly, none of the isolates possessed these genes, suggesting a possibly lower pathogenic profile in these specific strains. However, the team notes that other virulence markers may be at play, and further genomic studies are planned. Empowering the Public: Education as Prevention Beyond laboratory analysis, the project embraced a One Health approach by prioritizing public awareness and behavior change. The team developed visually engaging infographics detailing how H. pylori spreads and how to reduce transmission risks through proper food hygiene. These materials were disseminated online, paired with a questionnaire that garnered 115 responses from consumers and community members. The survey revealed some promising trends: 84% of respondents were aware of H. pylori, largely informed by healthcare professionals. 98% reported washing hands before and after handling food. 97% stated they consistently cook meat thoroughly. However, the data also highlighted critical gaps in food safety practices. Only 25% used separate cutting boards for meat and vegetables—a key factor in preventing cross-contamination. Moreover, 68% admitted to occasionally consuming raw or undercooked meat or vegetables, echoing cultural norms that may heighten infection risks. Public receptivity to health promotion was overwhelmingly positive, with 98% supporting further campaigns. This underscores a strong potential for long-term behavioral change when equipped with the right tools and knowledge. Navigating Challenges and Strengthening Collaboration Like many field-based studies, this project faced its share of challenges. Coordinating sample collection across diverse markets involved complex logistics, and laboratory resource constraints necessitated careful equipment management and adaptive planning. Still, the project’s success is owed in large part to robust partnerships—with academic institutions, local market vendors, and public health agencies. The team’s collaborative structure, which brought together researchers from Thailand and Indonesia, facilitated interdisciplinary problem-solving and knowledge exchange. Regular consultations with local health authorities also ensured that the research aligned with national public health priorities. Outcomes and the Road Ahead The outcomes of this research have already begun to make a tangible impact, with findings being considered in the context of strengthening public health guidelines, particularly those related to foodborne antimicrobial resistance (AMR) surveillance and prevention strategies. The revelation that H. pylori can be isolated from common food sources such as minced meat and raw vegetables has sparked a sense of urgency among local health authorities and food safety regulators. These findings serve as a wake-up call that food handling practices must be addressed as a critical front in the battle against AMR and infection risks. At the community level, the educational infographics and awareness campaigns initiated by the project have created a ripple effect. Not only have they encouraged households to reconsider their own kitchen habits, but they have also prompted dialogue within educational institutions, health departments, and local governance structures about the broader implications of foodborne pathogens. Discussions are now underway about how to institutionalize better food safety practices, and how to leverage public education to drive meaningful behavior change. Building on this momentum, the team plans to broaden their genotyping efforts, moving beyond the commonly studied cagA and vacA genes to explore a wider array of H. pylori virulence factors. By delving deeper into the genetic makeup of these isolates, they hope to better understand the pathogen’s potential impact on human health, particularly in the context of strains that may not present with traditional virulence markers but still pose significant risks. Geographically, the project will expand its scope across more provinces and markets in Thailand. A broader and more representative sampling of food products will enhance epidemiological accuracy and provide insights into regional differences in contamination rates, resistance patterns, and consumer behaviors. On the educational front, the next phase will scale up outreach campaigns. Recognizing that infographics alone are not enough, the team envisions a dual strategy: community-based workshops that provide hands-on demonstrations of safe food preparation, and digital platforms to reach broader audiences with multimedia content tailored to local languages and cultural practices. These campaigns aim not only to raise awareness but also to embed new habits that reduce infection risks. Simultaneously, the team is committed to advocating for integrated policy approaches that connect the dots between food safety, AMR monitoring, and public engagement. Their goal is to influence policymaking by demonstrating that One Health is not a theoretical framework, but a practical strategy with real-world benefits for community health and national preparedness. To ensure that the impact of their work endures, the team is developing a monitoring and evaluation framework to track behavioral shifts, knowledge retention, and policy uptake over time. This framework will help determine whether awareness campaigns translate into sustained improvements in hygiene and food handling—and will guide future interventions as they scale the model across different regions and contexts. Ultimately, the team sees this project not as a standalone event, but as the beginning of a long-term, systemic transformation in how food safety and zoonotic disease prevention are approached in Thailand. Reflections and Recommendations Reflecting on their journey, Dr. Chonticha and her team commend the SEAOHUN OHRT Awards Program for providing the necessary support to explore an under-investigated health threat. The project not only expanded the team’s technical and community engagement skills, but also enhanced their capacity to translate scientific findings into actionable strategies. Recommendations moving forward include conducting more frequent community workshops with hands-on demonstrations, increasing collaboration with public health stakeholders, and strengthening logistics for sample collection and testing. Conclusion This project underscores the vital connection between human health, food practices, and microbial threats in the environment. By addressing the transmission of H. pylori through an integrated One Health lens, the team has set a precedent for multidisciplinary public health research that is both scientifically rigorous and socially impactful. Through a combination of field research, lab analysis, and community outreach, Dr. Chonticha’s team has laid a foundation for preventing foodborne infections and promoting a safer, healthier Thailand. Team Leader: Assoc. Prof. Dr. Chonticha Romyasamit, Walailak University, Thailand Team Members: Dechawat Wongprot, Walailak University, Thailand Phoomjai Sorsenee, Prince of Songkla University, Thailand Tachpon Techarang, Mahidol University, Thailand Holipah Holipah, Brawijaya University, Indonesia

By Dr. Geraldine B. Dayrit and Team   Editor: Anti Rismayanti, SEAOHUN Regional Program Manager   Antimicrobial resistance (AMR) is rapidly becoming one of the gravest threats to global public health. As bacteria evolve and develop resistance to commonly used medications, particularly due to misuse in both human and animal health, communities worldwide face the mounting risk of untreatable infections. In the Philippines, where antibiotic use in agriculture is widespread and often unregulated, the potential for resistant strains to travel from farm to table is especially alarming. Food handlers, while central to ensuring the safety of what we eat, are often overlooked in national AMR strategies. Recognizing this urgent challenge, our team from the University of the Philippines Manila launched a community-centered initiative entitled “Impact of a Training Program on the Bacterial Antimicrobial Resistance Knowledge, Attitudes, and Practices of Food Handlers in the Greater Manila Area.” This project was implemented under the SEAOHUN One Health Research and Training (OHRT) Awards Program and aimed to build the capacity of food vendors—those who directly influence daily food safety practices—in combating AMR through tailored education, training, and behavior change interventions rooted in One Health principles. Implementation Experience Our project, spanning from June to October 2024, followed a carefully structured process of community engagement, scientific inquiry, and stakeholder collaboration. The journey began with the design and administration of a Knowledge, Attitudes, and Practices (KAP) survey to assess the baseline awareness of AMR among food vendors across various public markets in Manila, including Paco, Divisoria, Roxas, and Blumentritt. With the help of promotional materials and targeted outreach, we successfully engaged over 80 participants, ensuring representation from meat, seafood, fruit and vegetable, and street food vendors. After analyzing the survey data, we developed specialized training modules that addressed the specific knowledge gaps and occupational risks identified. The training sessions were not one-size-fits-all but were instead carefully customized based on the type of product handled by each vendor. For instance, fruit and vegetable handlers were taught safe washing and handling techniques to reduce microbial contamination, while seafood and meat vendors learned about cold chain maintenance and cross-contamination prevention. Street food vendors, whose working conditions are often informal and resource-constrained, were trained in practical, low-cost hygiene interventions. Our partners from government agencies played a pivotal role in this phase. Experts from the Manila Health Department, the Bureau of Plant Industry, the National Meat Inspection Service (NMIS), and the Bureau of Fisheries and Aquatic Resources (BFAR) provided lectures, discussed national and local food safety regulations, and offered real-world insights into best practices. These sessions were followed by a post-training evaluation using the same KAP tool, which enabled us to measure knowledge gains and behavior change. Like any community-based initiative, we encountered several challenges. These included inclement weather that disrupted workshop schedules, unanticipated withdrawals from participants, and unexpected costs—particularly related to ethics review processes. To address these, we adopted a flexible and responsive approach, rescheduling activities as needed, tapping into our networks to recruit replacement participants, and adjusting the budget without compromising core objectives. Through perseverance and adaptive management, we ensured the smooth implementation and completion of the project. Strengthening One Health Competencies The project significantly deepened our practical understanding and application of the One Health approach. It provided opportunities for our team to enhance not only technical skills, such as research instrument design, data analysis, and training facilitation, but also interpersonal competencies including negotiation, community mobilization, and problem-solving. The interdisciplinary nature of the initiative—bringing together professionals from public health, agriculture, veterinary science, and community development—underscored the importance of collaborative action in addressing complex health issues like AMR. Our staff and junior team members also gained confidence and competence in stakeholder engagement, navigating institutional procedures, and delivering training in lay-friendly language. These capacities are transferable to future research and community outreach efforts and will enrich our ongoing contributions to One Health education. Reflections as Educators As faculty members at the University of the Philippines Manila, this initiative has become a valuable extension of our educational mandate. The experiences and insights gained have already started informing our classroom teaching, particularly in subjects related to microbiology, food hygiene, and epidemiology. Case studies from the project are now being used to stimulate discussions and encourage critical thinking among students. Beyond curriculum content, the project demonstrated to our students the power of community engagement and how academic research can translate into real-world impact. We are currently exploring the development of elective courses or modules that will formalize AMR and food safety training for students across health, agriculture, and environmental disciplines. Anticipated Impact and Future Plans Looking ahead, we anticipate that the ripple effects of this project will extend well beyond its initial duration. The improved knowledge and practices observed among food vendors are just the beginning. Participants who once lacked awareness of AMR are now more informed and empowered, with many expressing a desire to share their learnings with fellow vendors. This organic form of peer education can significantly broaden the reach of our training messages. We are also in active discussion with the Manila Health Department to institutionalize our training modules within their existing food safety programs. If successful, these sessions could become part of the mandatory orientation or recertification process for market vendors across Metro Manila. Our team is preparing a manuscript that consolidates our findings and will be submitted for peer-reviewed publication. To ensure open access and timely dissemination, we are exploring preprint platforms and journals that support researchers from low-resource settings. Contribution to the One Health Agenda This initiative reinforces the core tenets of the One Health approach. By placing food handlers—an often-overlooked group—at the center of AMR prevention strategies, we challenge the traditional siloed approach that places disproportionate responsibility on hospitals and clinics. Instead, we present a community-based, systems-thinking model that recognizes the role of everyday actors in safeguarding public health. The project also fostered multi-sectoral collaboration, aligning our efforts with the Philippines’ National Action Plan on AMR and demonstrating how decentralized, locally driven interventions can meaningfully support national goals. Lessons and Insights Several valuable lessons emerged from our experience. Building strong relationships with local government units and public institutions early in the process was crucial in securing buy-in, resources, and logistical support. Tailoring the training to each vendor category proved highly effective, as it allowed us to connect with participants’ daily realities and offer practical, actionable solutions. Equally important was our commitment to flexibility. The willingness to adapt timelines, reallocate responsibilities, and recalibrate activities ensured that we remained responsive to on-the-ground conditions. Perhaps the most profound realization was the eagerness of food handlers to learn and improve. Their enthusiasm reminded us that change is possible when people feel respected, heard, and included in the process. It also affirmed our belief that education—when rooted in empathy and relevance—can be a powerful force for public health transformation. Conclusion Through the support of the SEAOHUN OHRT Awards Program, our project demonstrated that combating AMR does not require high-end technology or top-down directives alone. Sometimes, the most impactful change begins in local markets, through honest conversations, shared meals, and collaborative learning. By empowering food handlers with knowledge and practical skills, we are contributing to safer food systems, healthier communities, and a more resilient One Health future for the Philippines. Project Leader: Dr. Geraldine B. Dayrit, University of the Philippines Manila - College of Public Health Team Members: Fresthel Monica M. Climacosa Eric David B. Ornos Kathyleen S. Nogrado Regine O. Mendiola Ma. Kristina Carmela P. Aguilar Isabella Vera T. Cabanlig Normela Patricia F. Burigsay Arabelle Iza Barbin

By Dr. Liyana Azmi and Team Editor: Anti Rismayanti, SEAOHUN Regional Program Manager Under the SEAOHUN One Health Research and Training (OHRT) Awards Program, our team embarked on a transformative journey to address one of the world’s most pressing health challenges—antimicrobial resistance (AMR). Our project, "Empowerment of Housewives as Antimicrobial Resistance Guardians through Community-Based Participatory Research," was rooted in a simple but powerful premise: empowering women—particularly housewives—can ignite meaningful, sustainable change in community health practices. Set in the coastal district of Kuala Nerus in Terengganu, Malaysia, the initiative used a participatory approach to translate One Health concepts into accessible, culturally resonant knowledge that resonates with those who make daily health decisions at home. Implementation Experience: When Science Meets Culture From the outset, we knew that data alone wouldn’t shift behaviors—we needed trust, context, and collaboration. The project began with a baseline assessment using KAP (Knowledge, Attitudes, and Practices) surveys distributed among housewives. Results highlighted widespread misconceptions about antibiotic use, including the belief that antibiotics could treat viral infections and that sharing prescriptions within families was harmless. To bridge these gaps, we co-developed a training module with the community, informed by focus group discussions and feedback from mosque leaders and local women’s societies. Our AMR Awareness Day, complemented by medical check-ups and interactive booths, became more than an educational event—it became a celebration of community, inclusion, and shared responsibility. Significantly, we conducted these engagements with a deep sensitivity to local customs. No music was played in mosque-based events, and prayer times were carefully respected. Students and team members fluent in the Terengganu dialect acted as cultural liaisons, ensuring every message landed with empathy and clarity. A Living Laboratory for One Health Learning This project didn’t just benefit the community—it served as a living classroom for medical students and young professionals. Through training workshops and real-life outreach, students developed not only a clearer understanding of AMR but also vital soft skills. They learned to adapt their messaging, communicate with older adults, and deliver content in a relatable, culturally appropriate manner. For instance, one student who had represented Malaysia at the World Health Assembly in Geneva expressed how this grassroots experience offered insights that global forums could not—namely, the complex human dynamics behind health behaviors. Post-training evaluations revealed a boost in student confidence, communication skills, and critical thinking—all essential competencies for One Health champions. Strengthening Education and Institutional Synergies As educators, we found ourselves reinvigorated by this field experience. The modules we co-created with the community are now being integrated into coursework, enhancing our One Health curriculum with real-world relevance. Meanwhile, partnerships with institutions like Universiti Malaysia Terengganu and Majlis Belia Malaysia have expanded our reach, offering valuable interdisciplinary perspectives on health, environment, and gender. Notably, the mosque’s existing TikTok platform emerged as an unconventional but promising channel for public health education. Recognizing that many women relied on TikTok for health information, we are now exploring ways to co-create videos in collaboration with students and the mosque community—transforming social media into a tool for responsible antibiotic messaging. Navigating Challenges with Flexibility and Trust The journey wasn’t without obstacles. Seasonal monsoon rains delayed some sessions, and limited project disbursements early on required team members to front initial costs. But we adapted. When flooding disrupted plans, indoor venues and flexible timelines kept us on track. When questionnaire response rates lagged, we engaged a well-respected female leader to distribute surveys—and participation soared. The key lesson? Relationships matter. Our existing rapport with the community, especially the chief mosque leader and local women’s groups, was the backbone of our success. Trust enabled open conversations, especially around sensitive topics like medication use, privacy, and family health practices. Lasting Impact and Future Directions While the project has officially concluded, its momentum continues. Educational posters remain in community mosques, serving as constant visual reminders about AMR. More importantly, the women who participated have become informal ambassadors, spreading knowledge within their networks. Looking ahead, we plan to formalize our partnerships, develop more digital content tailored for community platforms, and secure new funding to replicate the model in other regions. We also aim to expand our outreach to include youth and male caregivers, ensuring that AMR stewardship becomes a shared family responsibility. At an international level, the recognition of our project by the ICID 2024 Ubuntu Community Village signals that this localized initiative holds global relevance. We hope to present our learnings on that platform, inspiring other countries to invest in community-led, culturally grounded One Health efforts. Reflections and Lessons for the Field Our work reinforces a core principle of One Health: sustainable change starts with the people most embedded in daily care systems. Empowering women—who cook the meals, care for the sick, and influence family decisions—has a ripple effect that no policy alone can achieve. We also learned that success isn’t just about what we teach; it’s about how we listen. By creating safe, small-group environments like our focus group discussions, women felt heard, respected, and valued. This emotional safety translated into openness, trust, and behavior change. Finally, the experience has emphasized the need for continuous engagement. Health behavior change doesn’t happen overnight. We envision periodic check-ins, refresher workshops, and a growing network of trained local advocates who can sustain the work long after funding cycles end. Conclusion This project has reaffirmed our belief that the best public health strategies begin with community voices. Through the SEAOHUN OHRT Awards Program, we didn't just implement an intervention—we built a movement grounded in empathy, cultural respect, and collective learning. The true reward has been watching housewives transform into guardians of their families’ health and seeing students evolve into holistic, culturally conscious public health leaders. With continued support, collaboration, and creativity, this model holds the potential to reshape how we address AMR—not just in Terengganu, but across Southeast Asia and beyond. Team Leader: Dr. Liyana Azmi – Universiti Sains Islam Malaysia Team Members: Associate Professor Dr. Nuruliza Roslan – Islamic Science Institute, USIM Mr. Ahmad Yussof Zainal Abidin – Islamic Science Institute, USIM Associate Professor Dr. Siti Nor Khadijah Addis – Universiti Malaysia Terengganu Associate Professor Dr. Nurul Azmawati Mohamed – Faculty of Medicine and Health Sciences Ustaz Muhammad Muzzammil Bin Mokhetar – Director, Ummah Relief Project

By Dr. Muhammad Kamil Che Hasan and Team   Editor: Anti Rismayanti, SEAOHUN Regional Program Manager   Antimicrobial resistance (AMR) stands as one of the most formidable global health threats of our time. Addressing it requires not only scientific innovation but also robust community engagement. Under the SEAOHUN One Health Research and Training (OHRT) Awards Program, our team at the Kulliyyah of Nursing, International Islamic University Malaysia, implemented the project “Community-Based Nursing Interventions for Antimicrobial Resistance through Public Empowerment” —a multifaceted initiative designed to tackle AMR through education, empowerment, and interdisciplinary collaboration. With a grant of USD 10,000 and a project timeline from May to November 2024, we sought to reach underserved communities in Kuantan, Malaysia, equipping them with the knowledge and resources needed to make informed decisions about antimicrobial use. The experience was nothing short of transformative—not only for the community but for our team of educators, health professionals, and collaborators. Implementation Experience: From Planning to Impact Launching the project required rigorous groundwork, including ethical approvals, tool development, and stakeholder coordination. Our journey began with a community needs assessment involving 300 residents of Kuantan. Conducted in fresh markets and community hubs, this assessment uncovered widespread misconceptions about antibiotic use. For instance, many participants incorrectly believed antibiotics could treat viral infections like the flu, or were unsure about completing prescribed courses once symptoms subsided. Armed with these insights, we developed the KAAP (Knowledge, Attitude, Awareness, and Practice) tool—later validated by experts and translated into Malay to ensure accessibility. Simultaneously, we designed a comprehensive training module titled “Combating Antimicrobial Resistance: Public Education and Action.” This module served as the backbone of our outreach efforts, guiding the development of seminars, brochures, flyers, and interactive sessions tailored for diverse learning styles. Our activities spanned three main pillars: (1) capacity building for healthcare providers and public participants, (2) interactive workshops in schools and community centers, and (3) outreach programs reaching over 500 individuals, particularly underserved populations. These sessions emphasized antimicrobial stewardship, infection prevention, and responsible health behaviors—all underpinned by the One Health approach. Enhancement of One Health Knowledge and Skills The project greatly enhanced our team's competencies in both technical and interpersonal domains. On the hard skills side, we strengthened our abilities in community health assessment, data analysis, intervention design, and monitoring and evaluation. We conducted pre- and post-intervention assessments that revealed statistically significant improvements in awareness, knowledge, and practices. On the soft skills front, the project deepened our capacity for community engagement, ethical sensitivity, cultural competence, and collaborative leadership. Working with local partners—from NGOs to senior citizen centers and schools—required building trust and tailoring our messages to resonate with diverse audiences. These experiences have enriched our professional development and expanded our capacity to deliver impactful, people-centered health initiatives. Improving One Health Education and Practice As faculty members in an OHUN member university, the project's influence on our teaching approach has been profound. By translating field experiences into case studies, simulation activities, and community-based learning modules, we can now offer students a more grounded and practical understanding of One Health principles. Our aim is to nurture a new generation of health professionals who are not only clinically competent but also community-conscious and systems-minded. Moreover, the research and evidence generated from this initiative will feed directly into our academic outputs. We are in the process of preparing six manuscripts for publication and submitting twelve products—including questionnaires and educational tools—for copyright. These outputs will serve as teaching resources and reference materials for future One Health training in academic and policy settings. Anticipated Impact on Target Groups Looking ahead, we foresee a cascade of positive impacts. For the community, increased awareness and behavior change around antimicrobial use will likely reduce misuse and strengthen infection prevention. For healthcare providers, the skills gained from training sessions will enhance their ability to educate patients and advocate for rational antimicrobial use. At an institutional level, the project strengthens the foundations for long-term integration of One Health concepts into national and regional health strategies. We are already working to formalize partnerships with local authorities to embed AMR education into ongoing health programs and explore digital learning platforms for broader dissemination. Contributing to the Advancement of One Health in Malaysia This initiative advances the One Health agenda by demonstrating how nursing-led, community-focused interventions can effectively address complex public health challenges. We bridged gaps between the human health sector, academia, and community organizations to deliver a cohesive, localized response to AMR. By situating community empowerment at the heart of our approach, we helped translate the One Health vision into actionable strategies that are both replicable and scalable. The collaboration between academic institutions, health professionals, local NGOs, and community leaders stands as a model for future interdisciplinary projects in Malaysia and beyond. Insights and Lessons Learned Throughout the implementation of our One Health project, a number of critical insights emerged that shaped both our strategy and the depth of our impact. One of the most important lessons was the role of community trust as a foundation for success. Establishing meaningful relationships with local leaders and tailoring our content to fit cultural and linguistic contexts proved vital in fostering participation and ensuring that messages were both understood and embraced. This trust not only encouraged active engagement during the sessions but also strengthened the likelihood of long-term behavior change within the community. Flexibility and adaptability were equally essential. As the project unfolded, we encountered diverse groups with varying needs—from senior citizens requiring adjusted schedules and delivery styles, to public audiences unfamiliar with medical terminology. By actively responding to feedback and being willing to revise our methods mid-course, we were able to create a more inclusive and effective learning environment. These adjustments, though sometimes minor, significantly enhanced the overall receptiveness and comprehension of our key messages about antimicrobial resistance (AMR). Another valuable insight was the power of local ambassadors in amplifying our impact. By training community champions, we not only extended our reach beyond the immediate project timeline, but also empowered individuals to continue educating others long after our sessions ended. These ambassadors became trusted sources of information and played a pivotal role in sustaining the momentum of AMR awareness in their respective communities. Our emphasis on continuous monitoring and evaluation also proved instrumental. Through pre- and post-intervention assessments, we were able to track measurable changes in community knowledge, attitudes, and practices. Notably, we observed a 35% increase in AMR awareness among participants, alongside a significant reduction in risky behaviors such as self-medication with antibiotics. These findings validated our approach and offered concrete evidence of the program’s effectiveness. Finally, the experience underscored the importance of multi-sector collaboration. Bringing together healthcare professionals, academic institutions, local NGOs, and community organizations created a holistic platform for action. This integration of One Health concepts into our educational strategies demonstrated how complex issues like AMR can be addressed more effectively when approached from multiple angles. It reaffirmed that tackling AMR is not solely a medical challenge, but a shared responsibility that requires the collective efforts of human, animal, and environmental health sectors working in synergy. In sum, these insights will not only inform the refinement of our future interventions but also serve as guiding principles for others undertaking similar initiatives within the One Health framework Conclusion The SEAOHUN OHRT Awards Program empowered us to bring science into the hands of the people—to turn concern about antimicrobial resistance into concrete, community-driven solutions. Through nursing-led education, evidence-based tools, and interdisciplinary collaboration, our project has contributed meaningfully to the advancement of One Health in Malaysia. We are committed to continuing this work by expanding outreach, enhancing digital access, and advocating for stronger AMR policies. As our findings transition into peer-reviewed publications and educational platforms, we hope they will inspire similar initiatives across Southeast Asia and beyond. Our journey proves that with the right support, even modest funding can yield meaningful impact when combined with community wisdom, professional expertise, and a shared commitment to health equity. Team Leader: Dr. Muhammad Kamil Che Hasan – Dean / Associate Professor, Kulliyyah of Nursing, International Islamic University Malaysia Team Members: Dr. Mohd Khairul Zul Hasymi Firdaus – IIUM Dr. Thandar Soe Sumaiyah Jamaludin – IIUM Dr. Zulkhairul Naim Sidek Ahmad – Universiti Malaysia Sabah Dr. Efta Triatuti – Universitas Brawijaya Kow Fang Fang – Hospital Tengku Ampuan Afzan Dr. Nik Noor Kaussar Nik Mohd Hatta – IIUM Dr. Shidqiyyah Abd Hamid – IIUM Dr. Nur Ain Mahat – IIUM

By Dr. Dr. Ana Masara binti Ahmad Mokhtar and Team   Editor: Anti Rismayanti, SEAOHUN Regional Program Manager   The implementation of the “AMbassadoR” program under the SEAOHUN One Health Research and Training (OHRT) Awards Program was a transformative experience that brought together science, education, and public health into a dynamic, action-oriented initiative. Designed to empower prospective secondary school teachers with the knowledge, tools, and motivation to address antimicrobial resistance (AMR), this program fostered a unique collaboration between educators in Malaysia and Thailand, promoting a One Health approach that is both sustainable and scalable. Transforming Teachers into Agents of Change Our core mission was to equip future educators with a comprehensive understanding of AMR and responsible antibiotic use, enabling them to serve as multipliers of knowledge in their future classrooms and communities. Teachers hold a uniquely influential role in society—they shape the mindsets of future generations. If we want to combat AMR effectively, we must reach students early, and who better to lead that charge than teachers? The project kicked off with a structured baseline assessment involving 47 prospective teachers—37 from Malaysia and 10 from Thailand—recruited from institutions such as Universiti Sains Malaysia, Universiti Putra Malaysia, Universiti Kebangsaan Malaysia, Universiti Teknologi MARA, Universiti Pendidikan Sultan Idris, and Prince of Songkla University. Using a comprehensive questionnaire, we evaluated participants' knowledge, attitudes, and practices (KAP) related to AMR and antibiotic use. This data guided the refinement of our core educational resource—the AMbassadoR module—into an updated e-module aligned with current scientific understanding and pedagogical practices. Bridging Science and Education: Module Implementation The improved AMbassadoR module was launched during a three-day immersive training held in Penang, Malaysia, from August 9–11, 2024. While the original plan envisioned a four-day program, we adjusted the timeline to accommodate student schedules and optimize attendance following final exams. Participants were exposed to an array of engaging activities, starting with lectures on AMR, the global burden of resistance, and the role of proper antibiotic stewardship. Experts from medical and academic backgrounds delivered content that was both evidence-based and practical. Hands-on lab sessions allowed participants to perform molecular biology techniques such as DNA extraction, polymerase chain reaction (PCR), and bacterial cloning—all contextualized around a fictional case study involving the antibacterial properties of bananas. This scenario-based learning approach bridged abstract scientific concepts with real-world applications, making it easier for future teachers to later translate these ideas to young learners. We also integrated interactive methods like Kahoot quizzes and discussion groups, and developed the “AMR Hunting Game,” an innovative and playful activity that tested and reinforced participant knowledge. Designed by our facilitators—12 science-trained undergraduates from Universiti Sains Malaysia—these activities fostered teamwork, communication, and problem-solving, all while reinforcing core AMR principles. The facilitators, close in age to the participants, played a critical role in maintaining a vibrant and relatable learning environment. Creativity, Competition, and Pedagogical Application One of the program’s most innovative elements was the AMR module competition. Participants were asked to design and submit their own AMR teaching modules, which were evaluated by a panel of education experts. The submissions were creative and diverse, ranging from classroom games and illustrated comics to mock teaching videos and storytelling projects. This variety demonstrated that AMR education could be tailored to different subject areas, including literature, mathematics, and social studies—not just science. Top-performing teams were awarded certificates of excellence and cash prizes, while all participants received certificates of participation. The judging criteria emphasized not only content accuracy but also creativity, clarity, and appropriateness for secondary school students. Enhancing Skills for the One Health Workforce This project was deeply enriching for both the organizing team and the participants. From a capacity-building perspective, it enhanced a wide range of One Health competencies. For participants, hard skills such as understanding antimicrobial mechanisms and interpreting lab data were matched by soft skills like leadership, teamwork, and critical thinking. Many had never before stepped into a laboratory or considered AMR a teaching topic, but by the end of the program, they were confidently designing and presenting AMR-themed lessons. As a team of academic professionals, we too benefited immensely. We improved our capabilities in project management, event logistics, stakeholder engagement, and data analysis. Most importantly, we gained a deeper understanding of how to translate complex scientific knowledge into classroom-friendly content that resonates with young learners. These skills will continue to enhance how we teach One Health topics at our universities. Collaboration and Stakeholder Engagement The success of this program was made possible through strong partnerships. Universiti Sains Malaysia provided the institutional foundation and waived venue fees, while Prince of Songkla University supported our Thai participants. Cell Agritech, a local industry leader in cultivated meat technology, hosted participants for an industrial visit, giving them a behind-the-scenes look at alternative protein innovations and their potential role in reducing AMR risk. Such cross-sector collaboration reinforced the real-world relevance of the AMR challenge and exemplified the One Health principle of integration across human, animal, and environmental health. Impact and Future Outlook The results of our post-program assessments were promising. Statistically significant improvements were observed across all dimensions of the KAP scores. Participants reported greater awareness of antibiotic misuse, a better understanding of AMR as a global threat, and increased confidence in integrating AMR topics into their teaching. Ninety percent of participants rated the overall program as excellent and said they would recommend it to peers. Looking ahead, we envision expanding the program to other universities in Malaysia and launching a parallel version in Thailand, in collaboration with PSU. We aim to secure additional funding to scale this model and eventually incorporate it into teacher education curricula nationwide. Our ultimate goal is to institutionalize AMR education across multiple disciplines, ensuring that the next generation of educators is equipped to influence health behavior at the grassroots level. A Model for One Health Advancement in Malaysia This initiative has proven that One Health promotion can begin in classrooms. By targeting educators-in-training, we have planted seeds that will flourish as these individuals enter the workforce. Their influence on thousands of students over the coming years can shape community norms around antibiotic use and help combat one of the most pressing global health threats of our time. The AMbassadoR program serves as a model of how One Health principles can be translated into actionable education. It demonstrates that even with limited time and resources, creative design, interdisciplinary teamwork, and student-centered learning can make a meaningful impact. Lessons Learned and Final Reflections Among the most valuable lessons we learned was the importance of flexibility and rapid adaptation. External factors such as exam schedules required us to revise plans, and by involving students in the organizing committee, we were able to distribute tasks efficiently and improve overall engagement. Another key takeaway was the power of peer learning—facilitators who were close in age to the participants fostered a more informal, approachable atmosphere that helped participants learn more effectively. Most importantly, we were reminded that One Health education does not require a science degree. With the right tools and encouragement, any educator can champion AMR awareness. The SEAOHUN OHRT Awards not only made this project possible but also gave it the visibility and legitimacy needed to draw strong participation and institutional support. Conclusion The “AMbassadoR” program proved that educators are powerful catalysts for change in the fight against antimicrobial resistance. With continued collaboration and support from institutions like SEAOHUN, we believe this model can be expanded regionally, embedding AMR education across Southeast Asia’s educational systems. This project reaffirmed our belief that the key to long-term public health lies in empowering people with knowledge—and there is no better place to start than with the educators who shape our future. Team Leader: Dr. Ana Masara binti Ahmad Mokhtar, Universiti Putra Malaysia Team Members: Prof. Dr. Syafinaz Binti Amin Nordin, Universiti Putra Malaysia Dr. Noreen Suliani Mat Nanyan, Universiti Sains Malaysia Dr. Nurul Izza Ismail, Universiti Sains Malaysia Dr. Nor Hawani Salikin, Universiti Sains Malaysia

By Somphanh Bounyavong and Team   Editor: Anti Rismayanti, SEAOHUN Regional Program Manager In an era of increasing antimicrobial resistance (AMR), the need for localized, data-driven responses has never been more critical. Under the SEAOHUN 2024 One Health Research and Training (OHRT) Awards Program, our team from Souphanouvong University undertook a timely and urgent project entitled “Antimicrobial Resistance of Bacteria in Poultry Pathogens in the Northern Lao PDR.” This initiative aimed to bridge the knowledge gap in AMR surveillance in animal production, especially in poultry, while engaging communities and health professionals in promoting more responsible antibiotic use. Implementation Experience The implementation of our project was both a scientific journey and a logistical challenge. We conducted sample collections from poultry farms and wet markets across four provinces—Luang Prabang, Xayaboury, Oudomxay, and Luangnamtha—targeting meat sold in areas representing different socioeconomic tiers. Using rigorous microbiological techniques, we analyzed resistance levels of Enterobacteriaceae, with a focus on Escherichia coli and Salmonella spp. Findings revealed a troubling prevalence of resistance to widely used antibiotics such as tetracyclines and sulfonamides, underscoring the public health risks of unregulated antibiotic use in poultry. Despite the obstacles—such as delays in budget disbursement, ethical approval procedures, fluctuating exchange rates, and challenging terrain during the rainy season—our team persevered. We also engaged district and provincial livestock officers early on, which facilitated community participation and built trust. Dissemination activities included workshops and poster campaigns aimed at farmers, veterinarians, and local officials. Enhancement of One Health Knowledge and Skills Our project has significantly deepened our understanding of the One Health framework, not only in theory but also in practice. From laboratory diagnostics to fieldwork coordination and stakeholder engagement, team members acquired both technical proficiencies and soft skills such as communication, cultural sensitivity, and problem-solving. These experiences were especially valuable for younger researchers and early-career faculty, equipping them with interdisciplinary competencies essential for modern health challenges. Improving One Health Education and Practice As faculty members of an OHUN member university, our involvement in this project has had a direct impact on our approach to education. We now integrate case studies from the project into classroom teaching and field-based learning, offering students a practical understanding of AMR and its implications within the One Health framework. The project also created opportunities for collaboration with government agencies, which we intend to sustain through joint research and internship placements. Anticipated Impact on Target Groups We expect our project to leave a lasting footprint in the northern regions of Laos. Farmers who participated in training activities now better understand the risks of indiscriminate antibiotic use. Post-workshop surveys indicated a 60% increase in awareness regarding AMR. Veterinary officers have expressed interest in integrating our recommendations into provincial animal health strategies. Looking ahead, we anticipate that our research data will inform national policy, foster more targeted AMR monitoring programs, and strengthen veterinary public health systems. Contributing to the Advancement of One Health By generating context-specific AMR data and promoting stakeholder collaboration, our project embodies the spirit of the One Health approach. It highlights how interdisciplinary teamwork and community-based action can influence both policy and practice. Importantly, the project sheds light on the underreported threat of AMR in food animals, pushing it higher on the national agenda in Laos. Insights and Lessons Learned The lessons drawn from this project extend beyond laboratory findings and data analysis. One of the most important realizations was the power of early and inclusive stakeholder engagement. From provincial livestock officers to local poultry farmers, involving key actors from the start ensured that the project goals were aligned with real-world needs and encouraged a sense of shared ownership. Trust was built through transparency and regular communication, which in turn facilitated access to farms and supported behavioral change. Another critical insight was the need for flexibility. Conducting research in remote, rain-affected regions presented both environmental and logistical difficulties. Our ability to adapt—whether by shifting travel dates or revising training delivery methods—was crucial to maintaining project momentum. These experiences emphasized the importance of resilience and pragmatic problem-solving in field research. Capacity building emerged as a central theme. By training local researchers, veterinarians, and extension workers in AMR surveillance and biosecurity practices, the project laid the foundation for sustained action beyond its funding period. The knowledge and tools imparted will continue to serve the region in managing AMR threats in the years to come. Lastly, we recognized that changing behaviors around antibiotic use requires more than a single intervention. While initial training was effective, long-term change depends on continuous follow-up, access to alternatives such as vaccines and probiotics, and reinforcement through community-led peer support. Several participants requested additional workshops and user-friendly materials, highlighting the importance of iterative, context-specific learning. Conclusion Through the generous support of the SEAOHUN OHRT Awards Program, our team was able to make tangible contributions to AMR mitigation in poultry production in Northern Laos. This project not only advanced our academic and professional capacities but also catalyzed a broader conversation about the role of One Health in rural development. As we move forward, we remain committed to expanding our work, nurturing partnerships, and driving policy change for a healthier, more resilient future. Team Leader: Somphanh Bounyavong, Deputy Head, Department of Animal Science, Faculty of Agriculture and Forest Resource, Souphanouvong University Team Members: Xaykham Onphachanh, Lecturer & Researcher, Souphanouvong University Khamla Duangvichith, Lecturer & Researcher, Souphanouvong University