March 11, 2025
Antibiotics are a cornerstone of modern medicine, yet millions of people worldwide still struggle to access these treatments. Ensuring that communities have access to quality antibiotics is important—not just to treat infections but also to prevent the growing threat of antimicrobial resistance (AMR).
AMR occurs when bacteria, viruses, fungi, and parasites no longer respond to the medicines designed to kill them. This makes infections harder to treat, increasing the risk of severe diseases.
To address these challenges, the One Health Trust partnered with The Trinity Challenge to host a one-day workshop on February 20, 2025, in Bangalore, India. The event coincided with the launch of a £1 million Innovation Competition on Community Access to Effective Antibiotics from Trinity Challenge. For the workshop, we brought together a diverse group of experts from healthcare, veterinary science, research, and policy.
The day began with a keynote by OHT’s president, Dr. Ramanan Laxminarayan, who presented key insights from The Lancet Series on Sustainable Access to Effective Antibiotics. He mentioned that better antibiotic access begins with infection prevention, particularly through vaccination and ensuring the availability of good quality, affordable medicines.
Dr. Ramanan Laxminarayan delivering a keynote at the Antibiotic Resistance Workshop
Professor Marc Mendelson, Director of The Trinity Challenge, introduced the Trinity Challenge’s mission to predict, detect, and respond to global health challenges. He highlighted key barriers to antibiotic access – resistance, misuse, availability, and quality – and noted that in many regions, antibiotics are accessed without prescriptions, worsening AMR and complicating regulation efforts.
Professor Marc Mendelson introducing The Trinity Challenge
Lightning Talks
The workshop featured a series of lightning talks by experts, each shedding light on different aspects of antibiotic use and AMR:
- Dr. Shivasharanappa N. of ICAR- National Institute of Veterinary Epidemiology and Disease Informatics (NIVEDI) spoke about mastitis in dairy cows, sharing concerning findings on carbapenem-resistant microbes in farm animals despite the antibiotic not being used in veterinary settings. He highlighted how the lack of access to full antibiotic courses contributes to resistance;
- Dr. Vasan Sambandamurthy of Bugworks Research explored sustainable antibiotic access, referencing the WHO’s Model List of Essential Medicines. He highlighted Operation Amrith, a 2024 initiative in Kerala, India, that successfully curbed antibiotic misuse, reducing antibiotic sales in the state by INR 1,000 crores;
Dr. Vasan Sambandamurthy discussing strategies for ensuring sustainable access to effective antibiotics
- Prof. Anita Kotwani of Vallabhbhai Patel Chest Institute, Delhi University, addressed the issue of substandard and falsified drugs. She explained how weak regulatory frameworks, complex supply chains, and lack of awareness allow poor-quality medicines to circulate. She outlined the three pillars of medicine manufacturing- identity, purity, and strength- and called for stronger consumer education and preventive measures.
Data-Driven Solutions
In a brainstorming session, stakeholders from the fields of economics, epidemiology, supply chain management, mobility, and climate science worked together to identify the root causes of antibiotic inaccessibility and AMR.
Brainstorming session
A major outcome of this session was a proposal for an illustrative dashboard that integrates community-level data to monitor antibiotic availability and resistance trends. Participants proposed innovative, technology-driven solutions to improve data collection and analysis, ultimately aiding policymakers and healthcare providers in making informed decisions.
Presenting ideas discussed during the brainstorming session
The winning team of the session, Saath Sur (Seven notes), included Prof. Y.K. Gupta, former dean of the All India Institute Of Medical Sciences, Delhi, and principal advisor, India GARDP; Dr. Savitha Nagaras, a professor of Microbiology at St. John’s Medical College Bangalore; Dr. Shivasharanappa N, a senior scientist at ICAR-NIVEDI; Dr. Shivaranjani Moharir, a senior scientist at Tata Institute for Genetics and Society, Bangalore; Dr. Nirupama AY, an assistant professor at Indian Institute Of Public Health, Hyderabad of Cyrus Poonawalla Center for Infectious Disease and Pandemic Preparedness, and Seshadri Dutta, senior research analyst at the One Health Trust.
Their proposed dashboard, DoReMi (Do Repeat Mitigate), is a digital tool designed to track antibiotic shortages in low- and middle-income countries (LMICs). It uses symptom-based surveillance from rural communities to identify early warning signs of antibiotic shortages. The dashboard provides real-time data on antibiotic stocks and demand, with red alert zones indicating when supplies need to be replenished; includes infographics on human, animal, and environmental health to help predict and respond to antibiotic-related challenges; provides QR codes for community-level data uploads, improving local tracking and comprises information on random lab tests to ensure antibiotic quality and standards.
The session’s winning team, Saath Sur
Ensuring equitable access to effective antibiotics is possible with collaboration, innovation, and policy-driven action. This workshop’s discussions and outcomes provided strategies to combat AMR and safeguard antibiotic availability for future generations.
Group photo from the Antibiotic Resistance Workshop
Check out the video put together by the Trinity Challenge team, capturing insights from stakeholders across various fields as they discuss key challenges related to antibiotic resistance at this important workshop.
- Dr. Vrinda Nampoothiri (Amrita Institute of Medical Sciences) on why tackling antibiotic resistance is crucial in India, pointing to the high disease burden and gaps in WASH interventions;
- Dr. Shivasharanappa Nayakvadi (ICAR NIVEDI) shares how his sector can help combat resistance;
- Dr. Vasan Sambandamurthy (Bugworks Research) highlights the need for solutions tailored to India’s geography, language, and culture.
Watch all three videos here:
