Be Mains Ready

Approach

• Define antimicrobial resistance and brief mechanism how it is acquired
• Give reasons that aid in development of AMR
• Enumerate the interventions of government of India in this regard

Introduction

Antimicrobial resistance (AMR) is the resistance acquired by any microorganisms (bacteria, viruses, fungi, parasites, etc.) against antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics) that are used to treat infections. AMR is one of the biggest threats to global health, food security, and development today.

Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”. AMR leads to the growing number of infections – such as pneumonia, tuberculosis, gonorrhoea, and salmonellosis etc, which are becoming harder to treat as the drugs used to treat them become less effective.

Body

Reasons for the development of Superbugs and spread of AMR

• Antibiotic consumption in humans: Unnecessary and injudicious use of antibiotic fixed-dose combinations could lead to the emergence of bacterial strains resistant to multiple antibiotics.
• Social factors: Self-medication, access to antimicrobial drugs without prescription and lack of knowledge about when to use them.
• Cultural Activities: Mass bathing in rivers as part of religious mass gathering occasions.
• Antibiotic Consumption in Food Animals: Antibiotics which are critical to human health are commonly used for growth promotion in poultry.
• Pharmaceutical Industry Pollution: The wastewater effluents from the pharmaceutical manufacturing units contain a substantial amount of antimicrobial drugs leading to contamination of rivers and lakes.
• Environmental Sanitation: Untreated disposal of sewage water bodies - leading to contamination of rivers with antibiotic residues and antibiotic-resistant organisms.
• Infection Control Practices in Healthcare Settings: A report on hand-washing practices of nurses and doctors found that only 31.8% of them washed hands after contact with patients

AMR in India

• AMR is of particular concern in developing nations, including India, where the burden of infectious disease is high and healthcare spending is low(just 1.3% of GDP)
• India is among the nations with the highest burden of bacterial infections. Consequently, the impact of AMR is likely to be higher in the Indian setting.
• The National Health Policy 2017 highlights the problem of antimicrobial resistance and calls for effective action to address it.

Steps that can be taken to mitigate the spread of antimicrobial resistance:

• Steps taken by the Indian Government:
  
  • It laid down National Action Plan on AMR resistance 2017-2021
  • India has instituted surveillance of the emergence of drug resistance in disease-causing microbes in programmes on Tuberculosis, Vector-Borne diseases, AIDS, etc
  • Since March 2014 a separate Schedule H-1 has been incorporated in Drug and Cosmetic rules to regulate the sale of antimicrobials in the country.
  • India initiated Red Line Campaign that used red line on antibiotic packages to curb their over-the-counter sale
  • The Food Safety and Standards Authority of India (FSSAI) banned the use of antibiotics and several pharmacologically active substances in fisheries.
  • The government has also capped the maximum levels of drugs that can be used for growth promotion in meat and meat products.

Conclusion

The world urgently needs to change the way it prescribes and uses antimicrobial drugs. Even if new medicines are developed, without behaviour change, antimicrobial resistance will remain a major threat. Behaviour changes must also include actions to reduce the spread of infections through vaccination, hand washing, practising safer sex, and good food hygiene.