Submitted
The Trinity Challenge: Community Access to Effective Antibiotics

CAG for effective antibiotics

Team Leader
Deepak C. Bajracharya
Our solution employs a community-based, bottom-up, and one-health approach to combat antimicrobial resistance (AMR) in Nepal through a Community Action Group (CAG) in ten selected municipalities. The CAG, composed of local members, will leverage digital tools to enhance antibiotic access and use. CAG leaders will receive master training on responsible antibiotic practices, AMR risks, and monitoring substandard or falsified drugs,...
What is the name of your organization?
GTA Foundation
What is the name of your solution?
CAG for effective antibiotics
Provide a one-line summary or tagline for your solution.
Social mobilization through Community Action Group and digital supply chain solution for equitable access to Effective Antibiotics
In what city, town, or region is your solution team headquartered?
Lalitpur, Nepal
In what country is your solution team headquartered?
NPL
What type of organization is your solution team?
Nonprofit
Film your elevator pitch.
What specific problem are you solving?
The antimicrobial resistance (AMR) crisis is a growing public health threat. WHO estimates the AMR is responsible for over 4.9 million deaths annually, with projections suggesting 10 million deaths by 2050. Several factors including the misuse of antibiotics, along with falsified and substandard drugs, significantly contribute to AMR. Furthermore, global and national supply chain disruptions lead to antibiotic shortages, increasing the risk of inappropriate use and exacerbating the AMR situation. In Nepal, the situation is dire with above 67% of antibiotics in community pharmacies being dispensed without prescriptions. Nepal is largely dependent on the global supply chain of antibiotics with over 60% of antibiotics being imported. Similarly, 46% of veterinary drugs were dispensed through self-prescriptions, and 12% were dispensed at farmers’ request. These factors have contributed to the rise of AMR in Nepal, exacerbated by frequent supply chain disruptions that leave communities vulnerable to falsified/counterfeit drugs. In addition, weak regulatory enforcement and poor infrastructure for managing medicine supply worsen the issue. Complemented by a digital system, our solution focuses on strengthening the supply chain reliability and curbing the use of falsified drugs through community engagement with a targeted, sustainable approach to promote rationale use and access to effective antibiotics.
What is your solution?
Our solution employs a community-based, bottom-up, and one-health approach to combat antimicrobial resistance (AMR) in Nepal through a Community Action Group (CAG) in ten selected municipalities. The CAG, composed of local members, will leverage digital tools to enhance antibiotic access and use. CAG leaders will receive master training on responsible antibiotic practices, AMR risks, and monitoring substandard or falsified drugs, then train ward-level members. Together, they’ll conduct awareness campaigns and monitor oral antibiotic quality, linking the community and municipality by reporting on antibiotic use, supply, and stock. A Technical Working Group (TWG) with stakeholders from the Department of Drug Administration, Nepal Chemist and Druggist Association, and Ministry of Health and Population will oversee implementation, train pharmacists, agrovet owners, and CAG leaders, and regulate pharmacies for drug quality. The CAG will hold dispensaries accountable, fostering participatory leadership. A digital record-keeping system, using the mSupply app, will track antibiotic usage, stock, and expiry dates. Pharmacists and agrovet owners will be trained in AMR, stewardship, and digital monitoring. Combining community engagement and technology, this initiative promotes responsible antibiotic use in humans and animals.
Who does your solution serve, and in what ways will the solution impact their lives?
Our solution serves community members, pharmacists, agrovet owners, healthcare workers, local leaders, women’s groups, and municipal authorities across ten municipalities in five provinces of Nepal i.e. Udayapur (Koshi), Saptari (Madhesh), Sindhuli (Bagmati), Tanahun (Gandaki), and Dang (Lumbini). These regions, spanning 250-400 km from the capital, include marginalized Indigenous and ethnic populations facing systemic barriers such as limited antibiotic awareness, misuse due to poor health literacy, inadequate health and veterinary care training, and gaps in community-led health advocacy. The solution empowers these communities through three pillars: 1) Knowledge—contextualized education on antibiotic use and AMR co-created with local stakeholders; 2) Data—a digital dashboard (e.g., mSupply) for real-time, anonymized tracking of antibiotic stocks and usage to inform decisions; 3) Community Capacity—leadership programs for women’s groups and local leaders to advocate for responsible one health practices. Pharmacists, agrovet owners, and healthcare workers receive stewardship training, while mixed-gender accountability groups ensure inclusive governance. By addressing knowledge gaps, enhancing supply-chain transparency, and amplifying marginalized voices, the initiative fosters sustainable behavior change, reduces AMR risks, and improves antibiotic access. This holistic, community-driven approach bridges systemic inequities and capacitates underserved populations with tools to lead lasting health improvements while contributing to global AMR mitigation.
Solution Team:
Deepak C. Bajracharya
Deepak C. Bajracharya
Program Director