Integrating genomic, clinical and epidemiological data to better understand Mycobacterium tuberculosis transmission and emergence of drug resistance

The rapid emergence and transmission of Mycobacterium tuberculosis (M. tuberculosis) strains resistant to newer drugs, e.g. bedaquiline, threatens global tuberculosis care and prevention. Although drug-resistant tuberculosis accounts for 3% of cases, it consumes over 33% of the budget in South Africa. Research has largely focussed on host and environmental determinants, whilst the role of pathogen genomics in driving transmission and resistance remains under-explored, leaving a gap in knowledge needed to inform effective interventions. This Award will generate foundational insights into how M. tuberculosis lineage and resistance evolution influence transmission. It will accelerate my career by providing pathogen genomics training, enabling me to integrate my academic, clinical and implementation interests in drug-resistant tuberculosis and support the generation of pilot data to underpin a competitive application for a prestigious career development award. The Award will provide protected time to publish manuscripts arising from this work, support my transition to research independence, strengthen collaborations in the Global South and significantly raise my international visibility. By the end of this Award, I will be uniquely positioned to build a high-impact career as an interdisciplinary translational researcher contributing to transmission- cutting public health interventions and enabling precision-guided treatments to improve outcomes for people with drug-resistant tuberculosis.