Resources for the Future Launches the Global Antibiotic Resistance Partnership
by Ramanan Laxminarayan and Hellen Gelband
Where AIDS, tuberculosis and malaria headline the health news, antibiotic resistance doesn’t make it above the fold. In fact, antibiotic resistance is a non-issue in most low- and middle-income countries. This audience hardly needs convincing, though, that antibiotic resistance is a serious problem already or will be within the decade. In a world where more infants and children are dying from pneumonia than from malaria, the challenge in saving lives is to make sure that children have access to antibiotic treatment, and to make sure that affordable antibiotics remain effective for the longer term.
Although drug resistance is a medical problem, the causes of resistance are ecological, epidemiological and economic. Patients, physicians, health care facilities and retailers—from large pharmacies to local drug sellers–have little motivation (economic or otherwise) to weigh the negative impact of their use of antibiotics on others, especially those in the future. Standard responses, such as increasing surveillance and launching public information campaigns on the hazards of resistance—while being a necessary part of an overall policy response—may have limited impact on their own. In order to work, policy solutions must alter incentives for patients, physicians, and others in the health care system to act in society’s best interests. Evaluating policy solutions involves understanding infectious diseases in populations. Research on evaluating focused, context-specific policy solutions that are likely to have a significant impact on resistance is a first step. Translating these policy solutions to policy action is the second.
The Global Antibiotic Resistance Partnership (GARP), a new initiative of Resources for the Future with support from the Bill & Melinda Gates Foundation, aims to address the challenge of antibiotic resistance by developing actionable policy proposals in five low- and middle-income countries: China, India, Kenya, South Africa, and Vietnam. GARP will develop the evidence base for policy action on antibiotic resistance in these five countries and identify policy opportunities where research dissemination, advocacy, and information can have the greatest impact in slowing the development and spread of resistance. The intent is to create a space for antibiotic resistance as a health policy issue.
Work has already begun in India, Kenya and Vietnam. In each country, a National Working Group on Antibiotic Resistance, with a small staff and resources to commission policy research, is being established. The chairs of these Working Groups will be appointed to an International Advisory Group that will also include about 6 global experts. The National Working Groups, as they explore the situation in their own countries, will be able to easily share their work, ask questions and problem solve with other countries through an interactive web platform.
GARP will complement the global policy work of the CGD Drug Resistance Working Group with detailed country-led research and policy development. GARP is led from RFF by Ramanan Laxminarayan, Principal Investigator and Hellen Gelband, Project Coordinator.
We welcome suggestions of people we might involve in the GARP countries, policy avenues to pursue, and scientific studies of which we should be aware as the project gets under way.