In the recent news, the Ministry of Health and Family Welfare in India has shed light on the measures being taken to overcome the challenges imposed by Antimicrobial Resistance (AMR), which is posing a significant risk to public health currently.
About Antimicrobial Resistance
Antimicrobial resistance happens when microorganisms such as bacteria, fungi, viruses, and parasites develop resistance against drugs including antibiotics, antifungals, antivirals, antimalarials, and anthelmintics. These are the drugs commonly used to treat infections. Consequently, standard treatments lose their efficacy, leading to prolonged illnesses and spreading of infections to others. These evolved microorganisms are sometimes termed as “superbugs”.
Factors Contributing to the Spread of AMR
The primary reasons for the spread of AMR include misuse and overuse of antimicrobials in medical treatments and their inappropriate application in agriculture. Additionally, contamination around pharmaceutical manufacturing sites also contribute to this problem where untreated waste releases active antimicrobials into the environment.
AMR Scenario in India
India stands at a crucial position considering its large population, surging incomes which enable the purchase of antibiotics, high prevalence of infectious diseases, and easy access to antibiotics without prescription. As a result, India is a prominent source of resistance genes which aid bacteria in surviving exposure to antibiotics. The multi-drug resistance determinant, New Delhi Metallo-beta-lactamase-1 (NDM-1), which emerged from this region has spread globally, affecting regions including Africa, Europe, and other parts of Asia with multi-drug resistant typhoid.
Steps Taken to Tackle AMR
To address the growing threat of AMR, various initiatives have been undertaken. First among these is the National Programme on AMR containment launched in 2012 to strengthen AMR Surveillance Network by establishing labs in State Medical College. The National Action Plan on AMR, launched in April 2017, focuses on the One Health approach and aims to involve various stakeholder ministries and departments.
AMR Research & International Collaboration
The Indian Council of Medical Research (ICMR) has initiated steps to develop new drugs and medicines through international collaborations. ICMR, along with the Research Council of Norway (RCN), initiated a joint call for research in antimicrobial resistance in 2017. Moreover, they also have a joint Indo-German collaboration for research on AMR with the Federal Ministry of Education and Research (BMBF), Germany.
Antibiotic Stewardship Program
ICMR has initiated an Antibiotic Stewardship Program (AMSP) on a pilot project across India to control the misuse and overuse of antibiotics in hospital wards and ICUs. The Drug Controller General of India (DCGI) has banned 40 fixed dose combinations (FDCs) which were found inappropriate.
Integrated One Health Surveillance Network for AMR
ICMR has established an Integrated One Health Surveillance Network for AMR in addition to creating a veterinary standard operating procedure (Vet-SOPs) for better comparison of antimicrobial resistance patterns in animals and humans.
Additional Initiatives
India has also undertaken various activities like Mission Indradhanush to address low vaccination coverage, strengthened micro-planning, and implemented additional mechanisms to improve monitoring and accountability. The Ministry of Health & Family Welfare (MoHFW) identified AMR as one of the top 10 priorities for the ministry’s collaborative work with the World Health Organisation (WHO).
WHO’s Perspective on AMR
The World Health Organization (WHO) also identifies AMR as one of the top ten global health threats. They recommend that countries prioritize their national action plans to scale up financing and capacity-building efforts and establish stronger regulatory systems. WHO also advocates for programmes promoting responsible and prudent use of antimicrobials by healthcare professionals in human, animal, and plant health sectors. They suggest multiple strategies to minimize the impact and prevent the further spread of resistance.
