The Global Research on Antimicrobial Resistance (GRAM)

The Global Research on Antimicrobial Resistance (GRAM) Project is a partnership between the University of Oxford and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, to provide rigorous quantitative estimates of antimicrobial resistance (AMR) burden; to increase global-, regional-, and country-level awareness of AMR; to boost surveillance efforts, particularly in low and middle income countries (LMICs); and, to promote the rational use of antimicrobials worldwide. GRAM estimates the burden of AMR worldwide using data, health statistics and geospatial maps. The team is adapting and refining methodologies established in the Institute for Health Metrics and Evaluation (IHME)'s ongoing Global Burden of Disease (GBD) study to build an evidence base of bacterial AMR across the globe, with corresponding visualisations. Our work investigates the prevalence of resistance in bacterial pathogens, and models covariates relating to the spread of AMR, including global antibiotic consumption and household crowding. GRAM also examines the mortality and morbidity burden of resistance across clinical syndromes from 1990 to the present in all 204 countries and territories included in the GBD study. These findings will assist the global research community and policymakers in tailoring interventions at the local, national, and international level.