Context: India is at the centre of the hidden epidemic of Antimicrobial resistance (AMR). There are over 1.2 million (12 lakhs) deaths globally and over 3 lakhs in India alone, due to drug-resistant infections and superbugs.
Relevance of the topic:
Prelims: Key facts about Antimicrobial Resistance.
Mains: Issue of AMR: Key factors & Govt. Initiatives.
What is Antimicrobial Resistance (AMR)?
- Antimicrobial resistance is the resistance acquired by any microorganism (bacteria, viruses, fungi, parasite, etc.) against antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials) that are used to treat infections.
- As a result, standard treatments become ineffective, infections persist and may spread to others. Microorganisms that develop antimicrobial resistance are sometimes referred to as superbugs.
- The World Health Organisation (WHO) has identified antimicrobial resistance (AMR) as one of the top threats to public health.
What are the factors contributing to AMR?
- Misuse of antibiotics by buying over-the-counter/wrong prescriptions. Widespread use of antibiotics over the last years due to COVID-19.
- Rampant use of antibiotics in agriculture and farming sector. E.g., Streptomycin used for treating Tuberculosis is used indiscriminately to grow fruits & vegetables, Colistin is mixed in poultry feed to make chickens grow faster.
- Untreated waste from pharmaceutical manufacturing sites and hospitals releases large amounts of active antimicrobials into the environment.
- Incomplete courses of antimicrobial drugs may develop drug resistance. E.g., MDR-Tuberculosis.
- Lack of hygiene and sanitation, infrastructural standards such as quality of drinking water and sanitation levels also contribute to AMR.
Govt. Initiatives to prevent AMR:
1. Prevent counter-sale of Antibiotics:
- Antibiotics are included in Schedule H and H1 of the Drugs and Cosmetics Rules, 1945. These drugs have specific caution labelling requirements and are sold by retail only under the prescription of a Registered Medical Practitioner.
- The supply of a drug specified in Schedule H1 is recorded in a separate register at the time of the supply and such records are maintained for three years and are open for inspection.
- Central Drugs Standard Control Organisation (CDSCO) has placed 24 hi-end antimicrobials under schedule H1 by issuing notification.
2. National Action Plan for containment of Antimicrobial Resistance:
- National Action Plan on containment of Antimicrobial Resistance (NAP-AMR) focusing on One Health Approach was launched in April 2017 involving various stakeholder ministries/departments.
- Delhi Declaration on AMR– an inter-ministerial consensus was signed by the ministers of the concerned ministries pledging their support in AMR containment.
3. Red Line Campaign:
- Launched in 2016 by the Ministry of Health and Family Welfare to create awareness among the public on AMR and avoid self-medication.
- A red line is put on the packaging of two dozen antibiotics and antimicrobials identified by the Ministry, such that these should not be sold over the counter without prescription of a medical practitioner.
4. National Centre for Disease Control:
- Designated as the national coordinating centre for AMR activities in India.
- Provides technical assistance to states and stakeholders in implementing the NAP-AMR, and monitors progress and impact of AMR interventions.
5. AMR Surveillance Network:
- Established by the Indian Council of Medical Research.
- Comprises a network of laboratories across the country to monitor trends and patterns of drug-resistant infections.
Conclusion: AMR is a global emergency that requires urgent, multi-sectoral intervention. Governments must enforce stricter regulation on antibiotic sales and distribution, in human medicine and agriculture. Countries must collaborate to share data, create unified strategies, and implement global responses to AMR.