Serious threat of antimicrobial resistance (AMR) in India

Source: The post serious threat of antimicrobial resistance (AMR) in India has been created, based on the article “AMR, A DEADLY RESISTANCE” published in “Business Standard” on 24th August 2024

UPSC Syllabus Topic: GS Paper2- Issues relating to development and management of Social Sector/Services relating to Health

Context: The article discusses the serious threat of antimicrobial resistance (AMR) in India, highlighting efforts by the Kerala government and pharmaceutical companies to reduce the misuse of antibiotics. It emphasizes the need for responsible antibiotic use to prevent AMR.

For detailed information on Increasing Antimicrobial Resistance in India read this article here

What is Antimicrobial Resistance (AMR)?

Antimicrobial Resistance (AMR) is a critical public health issue where microbes become resistant to antimicrobial medicines such as antibiotics, antivirals, antifungals, and antiparasitics. Here are key points about AMR:

a) Global Impact: AMR caused approximately 4.95 million deaths globally in 2019, with 1.27 million deaths directly attributed to it.

b) Impact in India: In 2019, India reported 297,000 AMR-related deaths.

c)Children’s Risk: One in five AMR-related deaths occurred among children under five years of age, highlighting the severe risk to vulnerable populations.

How is Kerala Addressing AMR?

Kerala is proactively addressing antimicrobial resistance (AMR) through several strategic initiatives:

1. State Coordination Committee: Established to oversee AMR control measures.
2. District-Level Efforts: Appointment of coordinators and formation of AMR squads in districts.
3. Public Awareness Campaigns: Targeted at retail shops, identified as key points in AMR spread.
4. Operation Amrith: Launched in January 2024 to conduct surprise inspections in pharmacies to curb over-the-counter sales of antibiotics.
5. Regulatory Actions: Strict actions against shops violating prescription norms, which led to a 30% decline in antimicrobial sales in the state.

What are the Challenges in Addressing AMR?

1. Overuse in Retail Outlets: Despite regulatory efforts like Kerala’s Operation Amrith, antibiotics continue to be sold over-the-counter, leading to misuse and increased resistance.
2. Exposure Through Migration and Trade: Kerala faces unique challenges due to antibiotic-resistant pathogens brought in through vegetable supplies from Tamil Nadu and human migration, exposing the population to new strains of resistant bacteria.
3. Balancing Access and Regulation: Experts suggest that while restricting higher-tier antibiotics, first-line antibiotics should remain accessible, especially in regions with limited medical services, ensuring essential care while preventing resistance escalation.

Why are Pharma Companies Involved in AMR Stewardship?

1. Pharmaceutical companies have a vested interest in ensuring that antibiotics remain effective for longer periods.
2. By promoting responsible usage and marketing practices, they aim to prevent the rapid development of resistance which would render these drugs ineffective.

What Should be Done?

1. Implement Strict Regulation: As demonstrated by Kerala’s Operation Amrith, strict regulations and surprise raids can effectively reduce the sale of antimicrobials without prescriptions, cutting down misuse.
2. Educational Campaigns: Increase awareness among the public and healthcare providers about the proper use of antibiotics, similar to Kerala’s campaigns in retail shops and Cipla’s Oasis program for medical professionals.
3. Promote Responsible Marketing: Encourage pharmaceutical companies to engage in responsible marketing and stewardship programs, like those conducted by Cipla and Venus Remedies, to prolong the effectiveness of antibiotics and prevent resistance.

Question for practice:

Examine the role of pharmaceutical companies in combating antimicrobial resistance (AMR) and how their involvement helps prevent the rapid development of resistance.