Joint Programming Initiative on Antimicrobial Resistance


GAP-ON€ is a network of human, animal, environmental and economical sciences experts, seeking to estimate the costs imposed by resistant infection and its knock-on effects.

The impact of antimicrobial resistance (AMR) is an almost invisible enemy, which slowly, but steadily has impacted society as a whole. Multi-, and/or pan-drug resistant strains have emerged, and have been spreading readily, causing deaths, disabilities and economic losses. Like for viruses, emergence of successful clones could further aggravate the immense impact of AMR on the global economy, especially if there is an outbreak of multi- or pan-resistant infections. As AMR has been rising slowly, little data has been available about its impact, especially for low- and middle income countries, and especially with regards to economic costs. Understanding how AMR currently affects health care expenditure and economic productivity in health care and agriculture, and how it is likely to do so in times of greater transmission in the future, are key to being able to making informed decision-making with regards to public health interventions, including economically-sound decisions such as surrounding the relative cost-effectiveness of interventions.

To address the complex issue of building the cost picture associated with AMR, we have a three-step roadmap.
In the first step, a cost framework completed by the GAP-ON€ network, funded under the 2018 Network Call. Also, GAP-ON€ also identified and contacted a list of 102 key stakeholders.
The second step is to gather a smaller group of critical experts from all the One Health areas to co-write a much larger proposal detailing relevant data sources, data gaps, applicable methodologies, and their interconnectedness.
The third step will be the actual cost study that needs to be undertaken to gauge the real cost magnitude associated with AMR.
Such a major undertaking will require careful planning, and sufficient resources to carry out and coordinate. We plan to hold one F2F meeting amongst key experts to develop these study structures, map out potential funding sources, and write a coherent project proposal worthy of funding.

Network partners

  • Luigia Scudeller, Coordinator, IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano Foundation, Italy
  • Herman Goossens, University of Antwerp, Belgium
  • Richard Alm, CARB-X at Boston, USA
  • Finola Leonard, University College Dublin, Ireland
  • Luca Guardabassi, University of Copenhagen, Department of Veterinary and Animal Sciences, Denmark
  • Jesús Rodríguez-Baño, Hospital Universitario Virgen Macarena, Spain
  • Christine Årdal, Norwegian Institute of Public Health, Norway
  • Nico Mutters, University Hospital Heidelberg/University Hospital Bonn, Germany
  • Souha Kanj, American University of Beirut Medical Center, Lebanon
  • Evelina Tacconelli, University of Verona, Italy
  • Chantal Morel, Uppsala University, Sweden
  • Joanna Wiecek, Wellcome Trust, UK
  • Marlieke E.A. de Kraker, Geneva University Hospitals, Switzerland
  • Sabiha Essack, University of KwaZulu-Natal, South Africa
  • Sushmita Lahiri, Boehringer Ingelheim Pharmaceuticals Inc, USA
  • Malgorzata Mikulska, IRCCS Ospedale Policlinico San Martino and University of Genova, Italy
  • Gabriel Levy Hara, Universidad Maimónides, Argentina
  • Nicola Petrosillo, National Institute for Infectious Diseases “Lazzaro Spallanzani”, Italy
  • Ramanan Laxminarayan, Center for Disease Dynamics Economics & Policy, India


Network Plus 2020: