AMR threat must be tackled urgently

Antimicrobial resistance threatens public health in India and the world

The World Health Organisation (WHO) has published its first global research agenda for scientists, which includes anti-microbial resistance (AMR) to be addressed as a most urgent human health priority. It wants the AMR challenge to be met by 2030, in line with the Sustainable Development Goals. The research agenda was decided after a review of the issues involved, and 40 pivotal topics have been identified. WHO has been concerned over AMR for many years and has issued many warnings about it. AMR occurs when bacteria, viruses, fungi, and parasites develop resistance and no longer respond to antimicrobial medicines. That makes infections harder to treat and increases the risk of disease spread, severe illness, and death. It is now a top global public health threat and was associated with the death of close to 5 million people globally in 2019. Importantly, it is also a threat to the global economy because it will impact international trade, healthcare, and productivity. It is estimated that AMR could cost the world economy $100 trillion by 2050 if no action is taken to control it.

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Some details are more concerning. According to a recent study of cases from 99 countries over the last decade, India has the third-largest number of hospital-acquired, antibiotic-resistant infections in the world, after China and Pakistan. The study found that people in the middle-income bracket were more affected than others. The present-day antibiotics become ineffective against bugs that have developed immunity to them. That increases dependence on stronger and more expensive drugs. It becomes a vicious circle of drugs and resistance, and it becomes more and more difficult to treat diseases. The Covid pandemic is considered to have aggravated the situation.

The WHO has prescribed a set of initiatives to tackle the situation. The best and most effective step is to promote responsible use of antimicrobial medicines, including reducing the use of antibiotics. Doctors have the highest responsibility in this. Attempts have been made to address the issue but it has not worked so far. In India, pharmacies sell antibiotics even without a doctor’s prescription. The use of antibiotics has actually been increasing year by year. An ICMR study found that a large number of patients in India may no longer benefit from carbapenem, a powerful antibiotic used to treat pneumonia and septicemia. It has said that antibiotic resistance has the potential to take the form of a pandemic in the near future if corrective measures are not taken. The National Health Policy of 2017 stressed on AMR, but action has been scant in dealing with it. The public health challenges in India will become more serious if AMR is not tackled effectively.