Contents
Introduction
Antimicrobial Resistance (AMR) threatens global health security, causing an estimated 4.95 million deaths annually (Lancet, 2022). India’s TB, polio, and HIV campaigns provide vital behavioural and community-driven lessons for AMR containment.
Lessons From TB, Polio, and HIV Campaigns for AMR Governance
- Community mobilisation as the anchor of behaviour change: India’s polio eradication succeeded due to mass mobilisation through Pulse Polio Campaigns, religious leaders, panchayats, celebrities, and school networks. Lesson for AMR: Behavioural change—rational antibiotic use, adherence to prescriptions, resisting OTC misuse—requires similar community-led mobilisation and sustained awareness.
- Survivor networks and peer support improve adherence: TB treatment adherence improved through Nikshay Mitras, TB survivor advocates, and community DOTS providers. HIV campaigns used peer educators, targeted intervention (TI) groups, and PLHIV networks. Relevance to AMR: Antibiotic misuse often stems from incomplete dosages. Peer-led reinforcement can ensure completing antibiotic courses and discouraging self-medication.
- Strong surveillance and monitoring systems work only with societal cooperation: TB surveillance (Nikshay Portal), HIV Sentinel Surveillance and polio micro-planning illustrate that technical systems succeed when communities report symptoms early. AMR parallel: National AMR Surveillance Network and NAP 2.0 require community participation in reporting irrational antibiotic sale, infection outbreaks, and hygiene violations.
- Stigma reduction helps improve compliance
HIV campaigns effectively reduced stigma through counselling, mass communication (NACO red ribbon), and sensitisation. AMR analogy: Misconceptions such as “antibiotics cure viral infections” or “strong antibiotics mean better medicine” require destigmatising discussions and scientific temper.
- Infection prevention and control (IPC) is central: Polio campaigns strengthened sanitation and hygiene. TB efforts promoted cough hygiene. HIV efforts improved safe practices.
For AMR: Fewer infections → fewer antibiotics → less selective pressure. Citizen-led interventions—handwashing in schools, vaccination uptake, clean water efforts—mirror IPC-based reductions in antibiotic demand. - Public communication campaigns build societal accountability: Polio’s “Do Boond Zindagi Ki”, TB’s “Mitigate TB”, and HIV’s multimedia drives generated trust. AMR needs similar social marketing, targeting: virus–antibiotic misconception, leftover antibiotic use, OTC sales from informal vendors. Examples: Thailand’s community AMR awareness reduced unnecessary purchases. UK’s “Keep Antibiotics Working” campaign lowered demand for antibiotics for viral infections.
- Bridging gaps in weak enforcement: Despite Schedule H1 restrictions, antibiotic OTC sales remain widespread. Empowered citizens can question irrational prescriptions and avoid unlicensed sellers, complementing regulatory constraints.
- Democratising scientific literacy: Citizen ownership transforms AMR from a “technical issue” to societal responsibility. Local influencers, SHGs, ASHA workers, youth networks, and teacher–student groups serve as “behavioural multipliers”.
- Strengthening multisectoral One-Health response: Citizens influence food hygiene, livestock antibiotic misuse, waste disposal, water quality, and vaccination uptake—critical for the One Health AMR framework linking humans, animals, and environment.
- Ensuring long-term sustainability of NAP 2.0: Global experience shows NAP success correlates with community engagement. Citizen ownership ensures that AMR containment transcends government schemes and becomes embedded in daily practices.
Conclusion
As Paul Farmer notes in Pathologies of Power, public health succeeds when communities participate. Embedding citizen ownership in AMR strategies ensures behavioural change, social responsibility, and lasting health security.
