Global Antimicrobial resistance Platform for ONE Burden Estimates (GAP-ONE)



Many global and international institutions and organisations acknowledge the cost of antimicrobial resistance (AMR). Even so, current figures fail to capture the full health and economic burden caused by AMR.

Completed project

Most current estimates are based only on the human health perspective from high-income countries, and a fully One Health integrated approach to the cost estimate is lacking. The entire shadow costs attributable to AMR should consider the worldwide One Health areas. If available, these estimates would constitute a powerful benchmark for advocating in favour of global action against AMR, providing opportunities for evaluating the cost-effectiveness of interventions aiming at tackling AMR and for identifying opportunities for re-allocating resources to research and development of new antimicrobial therapies.

The GAP-ONE network aims to create a virtual research environment that will:
1) Involve all stakeholders into a network that will provide an opportunity for participants from different disciplines to interconnect more fully and effectively.
2) Identify all the data elements required to build a reliable tool for estimating resource waste due to AMR worldwide, in not only human health but also integrating veterinary and environmental data, within a One Health approach.
3)Provide a framework to assess data quality.
4) Devise a strategy for sharing the currently available information.

The GAP-ONE network includes human and veterinary clinicians, human and veterinary microbiologists, experts in antimicrobial resistance burden, food safety, health-economics, and international law, as well as infection control experts, clinical epidemiologists, statisticians, and health information librarians. As part of this proposal, the network will involve additional stakeholders, such as patient organisations, drug and diagnostics manufacturers, and experts in social sciences, behavioural change experts, health authorities, and governmental agencies. The network aims to include all stakeholders in the “AMR stakeholder mapping” done by ReAct Europe – Action on Antibiotic Resistance a global mapping of stakeholders working with antimicrobial resistance.

Network partners

  • Luigia Scudeller, IRCCS Policlinic San Matteo Foundation, Italy (Coordinator)

This network includes 20 partners, please click on the following link to see complete network composition: Network composition Global Antimicrobial resistance Platform for ONE Burden Estimates (GAP-ONE)

How much does antimicrobial resistance cost? The overall worldwide cost attributable to it is certainly high, but remains largely unknown. The economic studies performed so far only consider direct costs associated with human infection from a hospital perspective, primarily from high-income countries. But antimicrobial resistance is a One Health issue: it applies to human, animal, and environmental health.

We have developed a framework, called The Global Antimicrobial Resistance Platform for ONE-Burden Estimates (GAP-ON€), that shows the immense number of often hidden, human, animal and environmental costs across the many individual and societal dimensions, inextricably linked together in a One Health picture. There are many bacteria (but other germs as well) that can colonize or even cause disease in human beings and animals, in a common environment. These cause direct health costs (costs of medicines, hospital stay, diagnostic tests, etc) and also indirect costs (loss of working days, loss of farm animals in the food chain, insurance costs etc). Building on this framework, future studies will be able to assess more precisely what the costs of antimicrobial resistance are, and will hopefully increase global public awareness of the real burden of AMR in all areas of life, across the world.