Gelband and Laxminarayan had been involved in domestic policy work on antibiotic use in the USA when she saw the potential to reshape the project more globally, prioritising low-income countries. GARP was born in 2009, initially in Kenya, India, Vietnam, and South Africa, and has expanded to 12 countries, many of which now independently advise government and other organisations on antibiotic policy.“It's extremely rewarding to see a local GARP working group become a country's ‘antibiotic brain trust’, especially now that antibiotic concerns are front and centre on the global health stage”, Gelband says.

Brought up in rural Long Island, New York, Gelband's high-school biology teacher inspired her to get involved in a local environment group, which brought the first environmental lawsuit in the USA—to stop the broadcast spraying of DDT for mosquito control. After studying botany at Pomona College in California, Gelband began her career on the US east coast as a nectar collector assessing the relationship between ants and plants, before changing direction and heading to Johns Hopkins University, in 1979, for a Masters in Public Health.“I realised that I wasn't going to be one of the extremely rare, brilliant botanists who changed thinking about plants, so I thought public health would give me a chance to make a difference. Discovering the world of epidemiology at Johns Hopkins was a revelation—it was the way I had always thought, without realising it”, she says. Part of her studies there covered tropical disease epidemiology, which would stand her in good stead for what lay ahead.