Lay summary
Disease causing (pathogenic) mycobacteria are the causative agents of some of humankind’s greatest afflictions, including tuberculosis (TB), leprosy, and Buruli ulcers. Social inequity continues to shape infectious disease outcomes with indigenous populations, in Aotearoa and globally, bearing a disproportionate infectious disease burden. Antibiotic pumps in pathogenic mycobacteria remove antibiotics from the intra-cellular space. This reduces the clinical efficacy of antibiotics, including many that have just entered clinical practice, threatening the long-term use of these essential medicines. By understanding how these pumps remove antibiotics this project will develop the next generation of diagnostic tools and antibiotic regimens to ensure the use of essential medicines for in-need patient populations. Achieving this will allow this investment to address public health problems of international and regional significance, whilst also generating significant economic value as the market for non-tubercular mycobacterial infections is expected to reach > 4 USD billion by 2033.