Antibiotic resistance disproportionately affects low- and middle-income countries with low levels of health care access, sanitation infrastructure, training for human and animal health care professionals, and public health education. In these countries, the Global Antibiotic Resistance Partnership (GARP) created a platform for developing actionable policy proposals on antibiotic resistance to address the disparities.
The History of GARP
The Global Antibiotic Resistance Partnership (GARP), initiated in 2008, helps low- and middle-income countries develop country-led strategies and policies to address antimicrobial resistance (AMR). GARP comprises interdisciplinary working groups that have helped such countries meet World Health Organization goals for developing national action plans for AMR and roadmaps for implementation. GARP has built broad constituencies to begin the social change needed to preserve antibiotic effectiveness over the long term. The GARP network spans 15 countries in Africa and Asia.
The GARP Model
In the GARP model, a working group of local professionals in human and animal health disciplines, drawn from academia, NGOs, faith-based organizations, and the government, led each country’s efforts. The GARP secretariats were sited in prominent research institutions and universities, such as the Kenya Medical Research Institute, the Uganda National Academy of Sciences, and the Muhimbili University of Health and Allied Sciences in Tanzania. Supporting the activities of each working group were GARP country coordinators and CDDEP, which, as a technical partner, helped build capacity for local research and coordinated global collaborations.
Since the network’s inception in 2008, GARP partners have developed situation analyses assessing human and animal antibiotic use and resistance, infectious disease burden, health indicators, pharmaceutical supply chains, and pertinent health regulations.
National action plans on AMR
The situation analyses have informed the development of national action and implementation plans, produced in collaboration with and for the national governments.
Awareness and education
GARP working groups became focal points for many activities drawing attention to the AMR threat. Activities included antibiotic awareness weeks, research on appropriate antibiotic use and AMR surveillance, and the development of school curricula.
GARP Working Groups are found in Bangladesh, India, Kenya, Laos, Pakistan, Mozambique, Namibia, Nigeria, Nepal, Seychelles, South Africa, Tanzania, Uganda, Vietnam, and Zimbabwe.
The Global Antibiotic Resistance Partnership was supported by the Bill & Melinda Gates Foundation and an independent public policy grant from Merck & Co., Inc., Kenilworth, NJ, USA.
- GARP Pakistan Working Group. Situation Analysis Report on Antimicrobial Resistance in Pakistan: Findings and Recommendations for Antibiotic Use and Resistance; 2018. Available here.
- GARP Bangladesh Working Group. Antibiotic Use and Resistance in Bangladesh: Situation Analysis and Recommendations. Directorate General of Drug Administration; 2018. Available here.
- GARP Mozambique Working Group (B Sigaúque, E Sevene, co-chairs). Situation Analysis and Recommendations: Antibiotic Use and Resistance in Mozambique. Maputo: Manhiça Health Research Centre; 2015 July. 42 p. Available here.
- GARP Nepal National Working Group (B Basnyat, P Pokharel, co-chairs) Situation Analysis and Recommendations: Antibiotic Use and Resistance in Nepal. Kathmandu: Nepal Public Health Foundation; 2015 May. 20 p. Available here.
- GARP Tanzania National Working Group (S Aboud, R Mdegela, co-chairs) Situation Analysis and Recommendations: Antibiotic Use and Resistance in Tanzania. Dar es Salaam: Muhimbili University of the Health and Allied Sciences; 2015 June. 118 p. Available here.
- Uganda National Academy of Sciences (D Byarugaba, D Kusemererwa, co-chairs). Antibiotic resistance in Uganda: situation analysis and recommendations. Kampala: Uganda National Academy of Science; 2015 Aug. 94 p. Available here.
- GARP Vietnam National Working Group (NV Kinh, chair). Situation Analysis: Antibiotic Use and Resistance in Vietnam. Hanoi: Oxford University Clinical Research Unit; 2010 Oct. 36 p. Available here.
- AG Duse (chairman) et al. Global Antibiotic Resistance Partnership—Situation analysis: antibiotic use and resistance in South Africa. Supplement to South African Medical Journal-Part 2: August 2011. 2011; 101(8):549–96. Available here.
- Global Antibiotic Resistance Partnership India National Working Group (NK Ganguly, Chairman) Situation Analysis: Antibiotic Use and Resistance in India. New Delhi: Center for Disease Dynamics, Economics & Policy; 2011 Mar. 74 p. Available here.
- GARP Kenya Working Group (S Kariuki, ed) Situation Analysis and Recommendations: Antibiotic Use and Resistance in Kenya. Nairobi: Kenya Medical Research Institute; 2012. 102 p. Available here.