Antimicrobial Resistance may Become a Silent Pandemic

Synopsis:

The challenges posed by Antimicrobial resistance (AMR) demands a comprehensive and collaborative approach by all the countries. They must come together to tackle the silent pandemic.

Background:

• Covid 19 exposed the vulnerabilities of health systems across the globe. It took away the lives of more than 3 million people since January 2020.
• Experts believe that greater destruction would be caused by AMR in the coming years. This calls for taking strong steps at the national and global levels.

What is AMR?

• It is a phenomenon by which bacteria, fungi, parasites, and viruses evolve and become resistant to presently available Antimicrobial resistance treatment.
• The infections persist in the body, increasing the risk of spread to others.

Reasons behind the development of AMR:

Primary reasons:

• Misuse of antimicrobials in medicine – This happens when the proper course of medication is not done or the person indulges in self-medication.
• Inappropriate use in agriculture – Antibiotics are used to boost the productivity of livestock.
• Contamination around pharmaceutical manufacturing sites –  The untreated waste releases large amounts of active antimicrobials into the environment.

Secondary Reasons:

• No new antimicrobial developments: No new classes of antibiotics have made it to the market in the last three decades. This is a result of inadequate incentives for their development and production.
  • A recent report from the non-profit PEW Trusts found that over 95% of antibiotics in development today are from small companies.
• Easily Availability: Antimicrobials are easily available as ‘over the counter drugs’ in many countries. This ease facilitates more consumption and development of AMR.

Challenges posed by AMR development:

• Threat to the health care system: Antimicrobials prevent infections post a routine surgery or cancer treatment. Their ineffectiveness would impair the modern health system. 
  • The problem is more grave for low- and middle-income countries (LMICs) of Asia and Africa where cheap antimicrobials have significantly reduced the mortality rates.
• Loss of Human Lives: It is responsible for up to 7 lakh deaths a year. It is estimated that 10 million annual deaths would be caused by it post 2050.
• Economic Brunt: The countries would require abundant capital to manage the AMR crisis in the future. As per an estimate, it may cost up to $100 trillion by 2050.

Way Forward:

• Accessibility: There is a need to ensure better accessibility of antimicrobials. Globally, 5.7 million people die every year because they cannot access drugs for infections that are treatable.
• Incentivisation: The companies must be encouraged to develop new antimicrobial drugs. In this regard, a multi-sectoral $1 billion AMR Action Fund was launched in 2020 to support the development of new antibiotics.
• Judicious Use: There must be appropriate and judicious use of antimicrobial drugs. Countries can learn from:
  • Peru’s efforts on patient education to reduce unnecessary antibiotic prescriptions
  • EU-supported VALUE-Dx programme that has increased the use of point-of-care diagnostics. This has resulted in prudent drug intake.
• Tracking the spread of AMR: Surveillance measures to identify these organisms need to expand beyond hospitals. They should encompass livestock, wastewater, and farm run-offs.
  • For instance, Denmark’s efforts to prevent the use of antibiotics in livestock had reduced AMR prevalence and boosted agricultural productivity.
  • Similarly, countries must formulate a dedicated and holistic plan to deal with AMR like India’s National Action Plan for antimicrobial resistance.
• Global Coordination: International alignment and coordination are paramount in both policymaking and its implementation. The countries can use the Paris Agreement as a blueprint for developing a similar global approach to tackling AMR.

Source: The Hindu