Summary:

A 2-year field pilot of Antimicrobial Resistance (Drug Resistance)to cut OTC antibiotic misuse 30% across 200 CHCs + 400 pharmacies in 4 districts of North East Uttar Pradesh in india. Delays pan-resistant outbreaks by training doctors, pharmacies, and ASHAs. An $55k project, individual researcher. Pandemic prevention where no one else is working. Delays outbreaks save lives.

What are this project's goals? How will you achieve this?

Project :

In India, North East Uttar Pradesh districts is breeding the next pandemic, and on borderline of antibiotics resistance,

Gorakhpur, maharajganj, deoria and Kushinagar districts are sit on a biosecurity fault line dense population, cross-border movement to Nepal, and near-zero AMR stewardship.

1. People are dying now: As a clinical AMR researcher in UP for 2 years, I’ve seen ICU mortality from carbapenem-resistant Klebsiella cross 60%. These deaths are preventable.

2. Cause is awareness, not access: CHCs and pharmacies dispense Watch/Reserve antibiotics like azithromycin and cefixime for viral fever due to patient pressure + no training. OTC sales are rampant.

3. No one is working here: No govt program, NGO, or research group runs sustained AMR behavior-change work at CHC/pharmacy level in these districts. We’re flying blind into a pandemic.

If a pan-resistant strain emerges here, it won’t stay in Kushinagar. This is neglected pandemic prevention.

Solution: 24-Month Field Pilot, 2026-2028

I’ll run a targeted awareness + stewardship program at the 2 highest-leverage nodes: Community Health Centres and private pharmacies.

Where: All 4 districts of Gorakhpur Mandal. ∼10M population catchment.

Who we reach:

1. 200+ CHC doctors/nurses: Monthly CMEs using local resistance data from Lucknow hospitals. Laminated treatment charts. “Antibiotic pause” checklists.

2. 400+ pharmacy staff: Training + public pledges to stop OTC Watch/Reserve sales. “Refer to CHC” cards in Hindi/Awadhi.

3. 1,000+ ASHAs: Cascade training to take messages village-to-village.

4. 2 lakh public: Videos on CHC waiting-area TVs, local FM radio spots, posters, 50k WhatsApp infographics/month.

How we prove it works:

Baseline/midline/endline measurement across 2 years:

1. Primary metric: % of azithromycin/cefixime/carbapenems sold OTC in 25 audited pharmacies. Target: 30% drop.

2. Secondary: % Watch/Reserve in 20 CHC prescriptions; community KAP scores in 500-person surveys.

3. Output: Open-source playbook + all data given to NHM UP for future.

We will do in upcoming 2 years:

1. Train 200+ CHC doctors/nurses with local resistance data + treatment charts

2. Get 400+ pharmacies to pledge no OTC Watch/Reserve sales

3. Train 1,000+ ASHAs to take messages village-to-village

4. Reach 2 lakh public via videos, radio, posters, WhatsApp

Proof: Baseline/midline/endline audits. Primary metric: % azithromycin/cefixime sold OTC in 25 pharmacies. Target: 30% drop.

Impact-

30% drop in unnecessary Watch/Reserve use delays local pan-resistance by 2-4 years. Expected: ∼1,500 deaths averted/10yr + reduced global spillover risk. ∼$18 per life-year saved.

Why me?

An clinical AMR researcher with 2 years surveillance in Delhi, Lucknow ICUs. I know the bugs, the prescription patterns, and speak the dialect. As an individual, I have 0% university overhead and can start in 4 weeks.

Linkdn: www.linkedin.com/in/ aadarsh-pandey-b96564308

Why Manifund?

No other funder backs individuals for field health work in India. This is neglected, high-EV pandemic prevention.

How will this funding be used?

Budget: $55,000 | 2-Year AMR Pilot

1. Team Salary:

Lead researcher-$964/mo x 24=$23,133

2 Field coordinators-$301/mo x 24=$14,458

Data analyst-$241/mo x 12=$2,892

2. Equipment:

Laptop for data + reports=$843

Tablet for field surveys=$361

Projector + printer for workshops=$602

3. Field Work:

60 workshops-$48 each=$2,892

Travel/lodging-$96/mo x 24 month=$2,313

Posters 5000 pcs-$0.27 =$1,325

4. Content & Media:

6 videos=$2,892

Radio spots 20= $1,928

SMS/WhatsApp=$1,446

Infographics 12 sets=$867

5. Measurement:

Surveys 3 rounds=$1,446

Pharmacy audits 75=$904

CHC audits 3 rounds=$289

6. Admin & Other:

Training module design=$602,

Bank/forex fees 2%=$1,096

CA + audit 2 years=$723

Contingency 5% =$2,602

Total=$55,000

How will funds be used?

56% for team salaries to run the 2-year program. 25% for field work + media reaching 200 CHCs, 400 pharmacies, and 2 lakh public. 11% for measurement to track 30% drop in OTC antibiotic sales. 8% for equipment, compliance, and contingency. All expenses tracked with receipts.

Fiscal sponsorship:

Yes, I need Manifund fiscal sponsorship to my personal current account. Non-political health education project. CA confirms no GST or FCRA trigger for $55k. All spending will be receipted. Will re-check compliance before any withdrawal >₹50k.

Who is on your team? What's your track record on similar projects?

Team:

I’m the full-time project lead and sole grant recipient. I have advisory support from 3 senior researchers I worked with at my previous university: 2 PhDs in microbiology/public health and 1 MD. They are providing technical guidance, reviewing training materials, and helping with data analysis pro bono. No salaries paid to advisors. I’ll hire 2 local field coordinators once funded.

This keeps the project individual-led with 0% institutional overhead, while showing you have expert backup.

Previous track record:

For 2 years I done a part time job clinical AMR surveillance across max hospitals Delhi, as part of my university research group. Work included:

1. Data collection: Tracked resistance patterns for Klebsiella E. coli Acinetobacter from 3 tertiary hospitals

2. Analysis: Identified that >60% of carbapenem-resistant _Klebsiella_ cases had prior exposure to OTC antibiotics from community pharmacies

3. Dissemination: Presented findings to hospital AMS committees; data used to update 2 hospital antibiotic policies

That project gave me direct experience with the pathogens, prescription behavior, and hospital networks this pilot targets. No prior external grants — most Indian AMR funding requires institutional PI status. This would be my first independently-run field project.

What are the most likely causes and outcomes if this project fails?

Most likely causes of failure:

1. Pharmacy non-compliance: 40% chance this is the blocker-

Cause: Pharmacy margins on azithromycin/cefixime are 30-60%. If we can’t convince owners they’ll keep revenue via ORS/paracetamol/consult fees, they keep selling OTC. Drug inspectors in UP are understaffed and some take cuts.

Early signal: <20% of trained shops sign the pledge, or OTC sales don’t budge at 6-month audit.

Why likely: This is the core economic incentive problem in all AMR work in India. We’re asking people to lose money for public good.

2. CHC doctor turnover/apathy: 25% chance-

Cause: MOs transfer every 1-2 years. New MO ignores the training. Or they face patient pressure: “Doctor saab, antibiotic likh do warna private jaunga.” Without system-level enforcement, CMEs get forgotten.

Early signal: Prescription audits at month 12 show no drop in Watch/Reserve use. <50% attendance at CMEs.

Why likely: CHCs are overburdened. AMR feels abstract vs. 200 patients/day.

3. Measurement failure / no signal: 20% chance-

Cause: Our surveys/audits are noisy. Pharmacies lie or hide OTC sales once they know we’re tracking. Baseline data is wrong. Or 30% drop is unrealistic — maybe behavior change takes 5 years, not 2.

Early signal: Wild variance in data. Can’t tell if change is real or Hawthorne effect.

Why likely: Field measurement in India is hard. No electronic records at pharmacies.

4. External shocks: 10% chance-

Cause: Major outbreak like dengue/chikungunya in Gorakhpur. All CHCs/pharmacies go into crisis mode, AMR work pauses. Or govt launches competing program and tells us to stop. Or FCRA issue blocks withdrawals mid-project.

Why likely: Purvanchal gets disease outbreaks + political interference often.

5. Me as single point of failure: 5% chance-

Cause: I get sick, get a better job offer, or burn out. As an individual with no institution, project stops. No one to take over.

Why likely: 2-year solo field work is hard. No backup PI.

Outcomes if the project fails?

If we fail at the pharmacy level:

1. Money outcome: ∼$14k spent on training/materials with no behavior change. Sunk cost.

2. Data outcome: We still publish a null result: “Training + pledge alone doesn’t stop OTC sales in UP without enforcement.” That’s valuable for the field. Prevents others wasting money on same approach.

3. Human outcome: OTC misuse continues. Expected ∼1,500 deaths/10yr in these districts that we _could_ have delayed still happen. Pan-resistance timeline unchanged.

If we fail at measurement:

1. Money outcome: Spent $6k on surveys/audits, can’t prove impact. Funders can’t tell if it worked.

2. Reputation outcome: I lose credibility for future grants. Manifund funders may discount individual-led field work.

3. Field outcome: We don’t know if the intervention works. Worse than null — it’s ambiguous. Govt won’t scale it.

If project stops early due to FCRA/external/PI dropout:

1. Money outcome: Remaining funds returned to Manifund. Partial work done, but no endline data.

2. Ethical outcome: Worst case — we raise expectations in CHCs/pharmacies, train them, then disappear. Damages trust for next person trying AMR work here.

3. Personal outcome: I owe funders a postmortem. Have to explain why $30k got spent for incomplete data.

What failure does NOT mean?

1. Doesn’t mean AMR isn’t important: Failure here would be operational, not about cause prioritization. NE UP stays high-risk.

2. Doesn’t mean individuals can’t do this: Just means this design or this region needs a different approach maybe need drug controller buy-in, or cash incentives to pharmacies.

How I’m de-risking-

Risk Mitigation built into plan:

Pharmacy non-compliance: Start with 50 “friendly” shops. Test incentives: give them free BP/weight machines if they join. Track revenue — show them they don’t lose money.

CHC turnover: Laminated charts + ASHA training persist after MO leaves. Get CMO Gorakhpur letter of support upfront.

Bad measurement: Use mystery-shopper audits, not self-reported sales. 3 survey rounds. Pre-register analysis plan.

PI dropout: Train 2 coordinators to run ops by month 6. All materials open-source. If I exit, they can hand to NHM.

FCRA-CA opinion before first withdrawal. Keep withdrawals <$50k chunks. Project is education, not advocacy.

Bottom line: Most likely failure = pharmacies ignore us and OTC sales don’t move. Outcome = $55k buys a well-documented null result + open-source materials. Still worth running because expected value is huge if it works, and nulls prevent others repeating mistakes.

In future benefits if failure happen: if by chance or any chance,

Data: We Have 4 Districts data for future initiative and amr precautions planning.

Awareness: Education works on ground level, people Aware about malpractices of antibiotics at home.

How much money have you raised in the last 12 months, and from where?

$0 from external grants, This would be my first independent grant. Manifund is the only platform that backs individuals for field health work in without affiliation.