Why infections picked up in hospitals are the big threat today, how world is trying to cope:

Why infections picked up in hospitals are the big threat today, how world is trying to cope:

Context

• A Bengaluru firm has become India’s first to receive the international Combating Antibiotic Resistant Biopharmaceutical Accelerator (CARB-X) grant to develop antibiotics to treat hospital-acquired infections.

What is Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator (CARB – X)?

•  CARB-X, or Combating Antibiotic Resistant Bacteria Biopharmaceutical Accelerator, is a public-private international partnership.
•  The partnership provides a new, collaborative approach to speed research, development and delivery of new antibiotics, vaccines, diagnostics, and other innovative products to address the urgent global problem of drug-resistant bacterial infections.

Why was CARB instituted?

•   It was set up in 2016 to focus on innovations to improve diagnosis and treatment of drug-resistant infections.
•   It grew out of President Barack Obama’s 2015 Combating Antibiotic Resistant Bacteria (CARB) initiative.
•  CARB-X is headquartered at BU Law, and will provide grants up to $ 455 million (over Rs 2,900 crore) over a five-year period to firms across the globe for antibiotics R&D.

From where is the CARB funding comes from?

•    CARB is funded by the London-based biomedical research charity Wellcome Trust, and the Biomedical Advanced Research and Development Authority (BARDA) of the US Department of Health and Human Services.
•   There were two sets of funding announced on March 30 and July 25, 2017, covering 18 projects in six countries.
•   All CARB-X funding so far is focused on projects to address the most resistant “Gram-negative” bacteria.

what are Gram-negative bacteria?

•   Bacteria are classified as Gram-positive and Gram-negative, based on a structural difference in their cell walls that is detectable through a staining technique developed in 1884 by the Danish bacteriologist Hans Christian Gram.
• Gram-negative bacteria are responsible for 20-25% of infections, and are multi drug resistant, which is the ability of bacteria to defend themselves against drugs that try to kill them.

What is Antibiotics resistance?

• Antibiotic resistance is a subset of antimicrobial resistance (AMR), which is a wider category that covers resistance in all micro-organisms bacteria, parasites, viruses and fungi to drugs.
•  Some 700,000 people die of resistant infections every year globally, a number that is estimated to rise to 10 million by 2050.

Why has antibiotic resistance become a global crisis?

•  Antibiotic resistance has become a global crisis that threatens the management of infections, both in the community and in hospital practice.

Reason behind it are:

•  The indiscriminate use of antibiotics, including against viral infections;
•  Their prolonged use in patients admitted to hospitals;
•  Their abuse in animal husbandry as growth promoters;
•  Cheaper antibiotics such as penicillin, tetracycline or co-trimoxazole can often no longer cure an infection.
•  The high-end antibiotics like third- and fourth-generation cephalosporin and carbapenem are commonly used.
•   In hospital critical care units, more than 50% organisms are now resistant even to these drugs.

How is antimicrobial resistance a serious threat to India?

•  India, because of its sheer numbers, poor literacy and awareness, and lax controls over medical practices, is on the frontlines of the global AMR public health crisis.
• A 2015 WHO multi-country survey recorded “widespread public misunderstanding” about antibiotic use in India.
• The Health Minister J P Nadda, in April 2016, highlighted antimicrobial resistance as a “serious threat to global public health”.
• As per the National Action Plan on Antimicrobial Resistance (NAP-AMR), the crude mortality from infectious diseases in India is 417 per 100,000, and India is among countries with the highest burden of bacterial infections.

How is India trying to get rid of it?

•  Two, an Indian company, Bangalore-based Bugworks Research, has received an Initial fund of $ 2.6 million for its work on a new class of antibiotics to fight what is known as the “ESKAPE”.
• ESKAPE is group of pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species).
• ESKAPE pathogens are considered the leading cause of nosocomial (hospital-born) and hospital acquired infections throughout the world.
• India has formed a National Surveillance System for AMR, and issued National Guidelines for use of antibiotics.
• A national policy for containment of antimicrobial resistance was formulated in 2011.
• Health Minister J P Nadda released a multi-sectoral National Action Plan on Antimicrobial Resistance (NAP-AMR) 2017-21 earlier this year.

What is Delhi Declaration?

• Several Ministers signed a ‘Delhi Declaration’ to strategies together to contain AMR.
• Specific objectives of the plan include the prevention of emergence and spread of resistant bacteria through infection prevention and control, optimized use of antibiotics in all sectors, and enhanced investments for AMR activities, research and innovations.
• The plan also aims to enable monitoring and evaluation (M&E) of the implementation of NAP-AMR based on the M&E framework.