Lessons learned

Abstract

Abstract: The Global Antibiotic Resistance Partnership (GARP) is a project started by the Center for Disease Dynamics, Economics & Policy in 2008, with funding from the Bill & Melinda Gates Foundation. GARP now includes eight low- and middle-income countries, including the ones represented in this session, and is set to expand further in Africa and Asia. The GARP model involves bringing together professionals already expert in aspects of antimicrobial resistance (AMR), and covering both human and animal antibiotic use and resistance in what we have called “working groups.” Although the working groups are free standing and uncompensated, where possible, they include representation from Ministries of Health and Agriculture. These groups become a national brain trust on AMR, working collaboratively with government. We have learned that this is a way for low-resource countries to start on an evidence-based path to national AMR plans without an initial government investment. A key tool that we have required working groups to produce is a situation analysis that includes all available (published and unpublished) information on antibiotic resistance in humans and animals in the country, enriched by contextual information, such as the burden of antibiotic-treatable disease in the country, the supply chain for antibiotics, access to antibiotics among the population, etc. Important to completing the situation analysis has been the requirement of a paid working group coordinator, in all cases a young professional, which brings the added benefit of capacity building. Building up to national AMR plans may take several years in countries that have not started the process, but the global imperative now evident may help to shorten that timeline. The GARP process of relying on local leadership through a working group is one model that has been successful and is available for other countries to borrow and improve upon.