India sat on WHO warning on NDM-1for 10 years

The WHO flagged the issue in 2001 foreseeing a big gap in the development of new antibiotics but India ignored the warning. The global health agency published a document titled “WHO Global strategy for containment of antimicrobial resistance”, which gave 68 recommendations to curb the development of antibiotic resistance worldwide.

“This document has been completely ignored by the Indian government and as far as I am aware none of the recommendations have been taken up. Consequently India has the highest rate of antimicrobial resistance in the world,” Cardiff University researcher Mark Toleman, who was involved in the study to find out NDM-1 in Delhi waters told Deccan Herald.

Contrary to the claims of ICMR and Union Health Ministry, Toleman said “NDM-1 has the potential to be an important public health threat,” as the drug resistance has moved to many organisms, some of them causing fatal diseases.

NDM-1 was found in a bug called shigella that caused about 3,000 deaths of children under the age of five every day in developing nations, he said.

After Toleman and his colleagues published their research on the presence of NDM-1 super bug in Delhi water system in the “Lancet Infectious Disease” last week, ICMR Director-General VM Katoch and Director-General of Health Services R K Srivastava at the Union Health Ministry categorically stated that it was not a public health threat as many such bugs exist in the wild.

Medical researchers, however, has a different opinion. In a July 2006 issue of “Indian Journal of Medical Research”—incidentally published by ICMR—microbiologists at the All India Institute of Medical Science reported thousands of cases of carbapenem resistance at AIIMS.

The AIIMS team analysed 34,275 samples to discover 2,626 cases of carbapenem resistance, out of which 469 were from intensive care units.

“There is a need to alarm our clinicians for judicious use of antibiotics,” they reported. Toleman said the earliest examples of NDM-1 in New Delhi was found in a study in Iowa in the USA in 2006.

The American group were looking at stored isolates from a previous study and found a low incidence of NDM-1. Only 15 out of 1,443 isolates had the NDM-1 gene and only nine of these isolates were from New Delhi.