This project addresses two major healthcare and societal challenges of the early 21st century: those of the rise of antimicrobial resistance (AMR) and of the growing epidemic, in developed and developing nations of chronic (non-healing) wounds. The recent report of Lord Jim O'Neil (TACKLING DRUG-RESISTANT INFECTIONS GLOBALLY, 2016) highlights the scale of the problem we now face as micro-organisms develop resistance to antibiotic therapies that have served us extraordinarily well for now over sixty years. In his report he draws attention to a world in 2050 where AMR is a 'devastating problem' unless we find new alternative strategies to effectively destroying invading pathogens. Whilst in 2016 it was estimated that AMR gave rise to an "already large" 700,000 deaths every year, this number will increase to an "extremely disturbing" 10 million every year, which is in fact more than the number of people that currently die from cancer every year. O'Neil also makes clear, in addition to the 'tragic human costs' the economic penalty of not tackling the rise in in AMR would grow by 2050 to 'an enormous' 100 trillion USD if we do not take action. Whilst new drug therapies will no doubt play a role in combating the rise in AMR, there is a significant role for engineering solutions. In this project plasma technology is used to generate (from ambient air) agents such as hydrogen peroxide (H2O2) that are extremely effective at killing pathogens. Because plasma delivers several agents at one time, unlike antibiotics there is no evidence to date that microbes can develop resistance to plasma. One of major complications of chronic wounds is infection, arising from opportunistic micro-organisms. Wound infections, like any other type of infection are showing AMR. Therefore the ability to (i) detect the first signs infection and (ii) neutralise the responsible organisms immediately would provide healthcare professionals a significant new weapon. Finally the combined technologies that will be developed can be applied to problems beyond wound infection, for example bacterial colonisation of other medical devices including urinary catheters.

The water sector in the UK has, by many measures, been very successful. In England and Wales, drinking water standards stands at over 99.9%, water pipe leakage is down by a third, sewer flooding reduced by more three quarters in the last 10 years and bathing water standards are at record high levels. This success has been achieved using a 19th century design approach based on the idea of plentiful resources, unrestrained demand and a stable climate. However, a perfect storm of climate change, increasing population, urbanisation, demographic shifts and tighter regulation is brewing! Each one of these challenges is a threat to the water sector and, taken in isolation, existing approaches may be able to cope. Taken together and compounded by the speed, size and uncertainty of change, the system is heading for failure unless something radical is done. The current way of working looks increasingly out of date and out of step with emerging thinking and best practice in some leading nations. This fellowship aims to meet these emerging challenges and global uncertainties head on by developing a new approach to water management in UK cities. The starting point is a new vision that is: Safe & SuRe. In a sense, our existing water systems are all about safety goals: public health, flood management and environmental protection. These are important and still need to be respected, but they are NOT sufficient to rise to the coming challenges. In the new world of rapid and uncertain change, water systems in cities must also be Sustainable and Resilient. Only a 'Safe & SuRe' system can be moulded, adapted and changed to face the emerging threats and resulting impacts. In this fellowship. my vision will be developed, tested and championed into practice over a period of 5 years. It will draw from multi-disciplinary collaboration with leading academics inside and outside the field. A comprehensive, quantitative evaluation framework will be developed to test in detail what options or strategies can contribute towards a Safe & SuRe water future, focussing on the challenges of water scarcity, urban flooding and river pollution. Recommendations and best practice guidance will be developed in conjunction with key stakeholders.