Antimicrobial Resistance

• 25 Nov 2021

Why in News

Recently, the Ministry of Animal Husbandry and Dairying has organized a workshop on the National Action Plan to combat Antimicrobial Resistance (AMR), while celebrating World Antimicrobial Awareness Week (WAAW - November 18-24).

• This year's theme of WAAW was “Spread awareness, stop resistance”.
• During WAAW an International Colour Campaign, ‘Go Blue’ campaign, was launched by the AMR tripartite organisations (World Health Organization, Food and Agriculture Organization of the United Nations and the World organisation for Animal Health) to help spread awareness about AMR.

Key Points

• About:
  
  • It is the resistance acquired by any microorganism (bacteria, viruses, fungi, parasite, etc.) against antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics) that are used to treat infections.
  • As a result, standard treatments become ineffective, infections persist and may spread to others.
  • Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.
  • The WHO has declared AMR as one of the top 10 global health threats.
• Reasons for Spread of AMR:
  
  • Contamination around pharmaceutical manufacturing sites where untreated waste releases large amounts of active antimicrobials into the environment.
  • Many factors have accelerated the threat of AMR worldwide, including overuse and misuse of medicines in humans, livestock and agriculture, as well as poor access to clean water, sanitation and hygiene.
• Concern:
  
  • Increased Cost of Healthcare:
    
    • AMR is already responsible for up to 7,00,000 deaths a year. It also increases the cost of healthcare with lengthier stays in hospitals, additional tests and use of more expensive drugs.
  • Undermining Progress:
    
    • AMR is undermining a century of progress in medicine, infections that were previously treatable and curable with our drugs are becoming (or at risk of becoming) incurable (as medicines are not working against infections).
  • Infections and Surgeries Becoming Risky:
    
    • Even common infections are becoming risky and a problem. Surgeries are becoming risky and the cause of all this is found in the behaviour of human beings who are misusing or overusing antimicrobials.
  • Inadequate Incentives for New Antibiotics:
    
    • No new classes of antibiotics have made it to the market in the last three decades, largely on account of inadequate incentives for their development and production.
  • Headed Towards Antibiotic Apocalypse:
    
    • Without urgent action, we are heading to antibiotic apocalypse – a future without antibiotics, with bacteria becoming completely resistant to treatment and when common infections and minor injuries could once again kill.
• AMR in India:
  
  • India, with its combination of large population, rising incomes that facilitate purchase of antibiotics, high burden of infectious diseases and easy over-the-counter access to antibiotics, is an important locus for the generation of resistance genes (such genes help bacteria in surviving on being exposed to antibiotics).
  • The multi-drug resistance determinant, New Delhi Metallo-beta-lactamase-1 (NDM-1), emerged from this region to spread globally.
    
    • Africa, Europe and other parts of Asia have also been affected by multi-drug resistant typhoid originating from South Asia.
  • In India, over 56,000 newborn deaths each year due to sepsis are caused by organisms that are resistant to first line antibiotics.
• Measures Taken to Address AMR:
  
  • National Programme on AMR containment:
    
    • The Surveillance Network has been strengthened by establishing labs in State Medical College.
  • National Action Plan on AMR:
    
    • It focuses on One Health approach with the aim of involving various stakeholder ministries/departments.
  • AMR Surveillance and Research Network (AMRSN):
    
    • It was launched in 2013, to generate evidence and capture trends and patterns of drug resistant infections in the country.
  • Antibiotic Stewardship Program:
    
    • ICMR has initiated antibiotic stewardship program (AMSP) on a pilot project across India to control misuse and overuse of antibiotics in hospital wards and ICUs.
  • Integrated One Health Surveillance Network for AMR:
    
    • To assess the preparedness of Indian Veterinary laboratories to participate in integrated AMR surveillance network.
  • Others:
    
    • India has undertaken many activities like Mission Indradhanush — to address low vaccination coverage — strengthened micro-planning and additional mechanisms to improve monitoring and accountability.
    • The Ministry of Health & Family Welfare (MoHFW) identified AMR as one of the top 10 priorities for the ministry’s collaborative work with the World Health Organisation (WHO).

Way Forward

• Detection and prevention of the sale of spurious drugs, particularly in tier 2 and tier 3 cities.
• The occasional measurement of bioavailability at pharmacokinetics and pharmacodynamics, enforcement of antibiotics policies via prescription databases and auditing of pharmacies.
  
  • Pharmacokinetics is defined as the study of the time course of drug absorption, distribution, metabo- lism, and excretion.
• Monitoring sale of drugs with GST (Goods and Services Tax) tracking/matching of e-prescriptions.
• Shift from the syndromic approach to treatment of the diagnosis, use of new technologies such as imaging and bioinformatics and geographic information systems.
• Adherence to the WASH strategy: antibiotic-free animal feed, and antibiotics fed to animals should be different from those consumed by humans (e.g. marked by different colour schemes).

Source: PIB