NG-TIN-18941011-0001-VacAMR-NIHR156011 Nigeria Center for Disease Control and Prevention (NCDC) AMR-attributable deaths (~1.3 million/yr) are mostly due to respiratory infection (LRI). Annually there are >2 million lower respiratory infection (LRI) deaths globally, most commonly in sub- Saharan Africa (SSA). Streptococcus pneumoniae (Spn), then RSV & Hib are the leading causes of LRI deaths among under-5 children. AMR Klebsiella pneumoniae is a leading cause of pneumonia & sepsis in newborns & vulnerable adults. Influenza virus, RSV & Spn infections are major drivers of antimicrobial use & therefore AMR. Deaths due to AMR respiratory pathogens are vaccine preventable. We therefore propose to improve AMR control by focusing on preventing disease syndromes (e.g. fever & pneumonia), as part of a multimodal approach that includes vaccine and non-vaccine interventions. Building on previous NIHR-funded success, we will tackle AMR through new strategic South-South partnerships between KEMRI-Wellcome, Kenya, Malawi-Liverpool-Wellcome (Kamuzu University of Health Sciences), Navrongo Health Research Centre, Ghana Nigeria Centre for Disease Control, & Nigerian Institute of Medical Research Overall Aim: Africa-led transformation of the public health approach to controlling respiratory pathogens & AMR through vaccine & non-vaccine-based multimodal interventions. University College London London School of Hygiene and Tropical Medicine Liverpool School of Tropical Medicine Malawi-Liverpool-Wellcome Trust Clinical Research Programme Navrongo Health Research Centre Nigeria Centre for Disease Control and Prevention Centre Suisse de Recherches Scientifiques en Côte d'Ivoire Nigeria Institute of Medical Research Wellcome Connecting Science Kamuzu College of Health Sciences Health Research Operations Kenya Limited This is the actual start date of the project NCDC NIGERIA 3026376 301940.28