Facilitating access to antibiotics for everyone (GARDP)

Antimicrobial resistance occurs when pathogens (e.g., bacteria, viruses, fungi, and parasites) change over time and no longer respond to drugs, making infections more complicated to treat and increasing the risk of disease spread, severe illness, and death. Antimicrobial resistance is an urgent global public health threat, killing at least 1.3 million people worldwide and associated with nearly 5 million deaths in 2019. Antimicrobial resistance is among the top 10 global health threats but disproportionately burdens low-resource regions and populations. About 20% of global deaths occur in Sub-Saharan Africa, and 1 in 5 deaths caused by antibiotic resistance arises in children under age 5, almost all in low- and middle-income countries. Action is needed regarding infection prevention and control, access to essential and effective antibiotics, and research and development of new antibiotics. The global response to COVID-19 has contributed to a greater focus on addressing antimicrobial resistance and ensuring global health security. The pandemic raised awareness about the overuse of antibiotics and the importance of using them wisely, and assumably, antimicrobial resistance increased the number of COVID-19 deaths because of secondary bacterial infections, which worsen the condition of critically ill patients.

The Geneva headquartered Global Antibiotic Research and Development Partnership (GARDP) is recognized as the leading international actor addressing antimicrobial resistance. By jointly working with governments, the private sector, academia, and civil society, it is driving efforts to develop new and improved antibiotics and ensure access to effective, safe, and quality-assured products.

Addressing antimicrobial resistance is a priority of the Swiss health foreign policy and of SDC health portfolio. SDC is supporting GARDP since 2022 to improve the access to essential antibiotics in low- and middle-income countries (e.g., Cefiderocol, a treatment for complicated urinary tract infections and bacterial pneumonia), while at the same time building a sustainable ecosystem to ensure equitable access to these antibiotics, through the SECUREinitiative ". 

Direct beneficiaries are governments, pharma companies, procurement and regulatory agencies, health professionals, and public and private health providers.

The ultimate beneficiaries are vulnerable populations in low- and middle-income countries who need treatments for deadly and harmful resistant pathogens unavailable in their national health system.

Outcome 1: Ensure sustainable, affordable, and equitable access to Cefiderocol and build partnerships, networks, and processes for future product introductions.

Outcome 2: Expand access to essential antibiotics and support low- and middle-income countries in addressing drug-resistant bacterial infections.

Outcome 3: Facilitate knowledge exchange and learning on solutions for access to antibiotics in low- and middle-income countries.

Principaux résultats attendus:  

Cefiderocol:

Output 1: The needs of sustainable, affordable, and quality production of Cefiderocol in low- and middle-income countries are met.

Output 2: A broader registration for Cefiderocol and a coordinated procurement is in place.

Output 3: Evidence for optimal Cefiderocol use in select populations/countries is developed.

SECURE Initiative:

Output 4: Antibiotics market intelligence of gathering and analyzing data to drive future decisions and transparency are increased.

Output 5: Guidelines and support for antibiotic drug optimization within countries are strengthened and harmonized. 

Principaux résultats antérieurs:  

Achievements of the preparatory phase include:

1. GARDP has identified a lead sub-licensee manufacturer for Cefiderocol, and the WHO Prequalification Program has launched an “Expression of Interest” for it
2. Within the SECURE initiative, 3 key access barriers for different antibiotics have been identified as potential interventions to address these barriers
3. SECURE has developed a model of different economic and procurement tools to assess the benefits and cost of various access interventions to address barriers to access
4. Global interventions within the SECURE initiative have been incubated, such as the development of an antibiotic forecasting model, the cost-effectiveness analysis for select antibiotics, a landscaping review of best practices in regulations that would mitigate against shortages, and the development of WHO operational guidance on the introduction and preservation of new reserve antibiotics
5. Several webinars focused on antibiotics in low- and middle-income countries have been organized through REVIVE, a tool to facilitate knowledge exchanges and learning