The Public Health Agency of Sweden
Updated 1 December 2020

Indo-Swedish Collaboration on Containment of Antibiotic Resistance (ISCCAR)

The Indo-Swedish Collaboration on Containment of Antibiotic Resistance (ISCCAR) project was initiated to support the development of a programme for containment of resistance in India, and to benefit the preparedness and method development in Sweden as well as the policy development in both countries.


Anette Hulth
Phone: +4610-205 23 95

A global issue requires global efforts

Bacterial infections are still one of the major causes of disease in many countries, such as India. India's large population and high burden of infectious diseases both contribute synergistically to a high usage of antibiotics. A reduction in antibiotic demand, infection control and rational use of antibiotics would translate directly to slower growth of antibiotic resistance. An important aspect is strengthened and improved surveillance of antibiotic resistance and use.

Political support is crucial for success

The health ministers of India and Sweden signed a Memorandum of Understanding (MoU) on cooperation in the fields of health care and public health in February 2009, among other things encouraging cooperation on communicable diseases and antimicrobial resistance. In the spirit of the MoU and to state their intention and willingness to cooperate in the field of antibiotic resistance, the directors for the Indian National Centre for Disease Control and the former Swedish Institute for Communicable Disease Control (now Public Health Agency of Sweden) signed a bilateral Memorandum of Intent for cooperation in May 2011.

Development of tools for strengthened capacity

Three strategic, interdependent projects of mutual interest were defined within ISCCAR:

  • antimicrobial resistance surveillance
  • monitoring of antimicrobial use
  • compilation, prioritization and implementation of interventions for containment of antibiotic resistance

Main results

  • Ongoing construction of a laboratory network in New Delhi with 30 laboratories, including implementation of guidelines, and a concept plan for training at the laboratories and data collection systems.
  • Pilot studies on monitoring of antibiotic prescribing and use at the hospital level in Delhi under the coordination of NCDC.
  • NCDC is continuing and expanding their projects on specific antibiotic resistance in the community, in hospitals and sewage.
  • A report (available in English and in Swedish) called Swedish work on containment of antibiotic resistance - tools, methods and experiences that describes the context of the Swedish healthcare system and the tools for and examples of Sweden's successful work on containment of antibiotic resistance in human medicine.
  • A web portal to be set up at NCDC for data dissemination is in the developing phase and is expected to be a central feature in the National Indian policy implementation. The aim is to simplify data collection and analysis of antimicrobial usage and the resistance patterns throughout India. Ongoing discussions are held on the content and technical specifications of the web portal between the two agencies.