Anti-Microbial Resistance (AMR)

Subject – Science and Tech

Context – There is an urgent need to replenish the antimicrobial pipeline, as many antibiotics are now ineffective in combating infections

Concept –

AMR occurs when microbes (bacteria, viruses, fungi, and parasites) change over a period and stop responding to medicines intended to treat them. This results in longer treatments, severe illness, and death. AMR is already having a detrimental effect on medical advances made over decades. This is especially true for diseases like tuberculosis and various cancers.
With only a few replacement antibiotics in the pipeline, AMR could lead us to a scenario in which common infections could be fatal once again. In addition, most of the antibiotics in the pipeline offer only short-term solutions.
The WHO noted decreasing private investment and lack of innovation in the development of new antibiotics.
The World Health Assembly recognised the seriousness of this crisis and adopted a Global Action Plan on AMR in May 2015.
- The plan sets out five clear objectives with regard to combating AMR. These include improving awareness concerning AMR, strengthening knowledge through increased surveillance of AMR, and optimising the use of antimicrobial medicines.
- The plan also required that every country has an aligned national action plan in place by 2017.
In 2017, the Indian government released the National Action Plan (NAP) on AMR with an additional sixth priority of developing India’s leadership in combating AMR.

AMR in India

AMR becomes especially relevant in India as it is among the nations with the highest burden of bacterial infections.
The NAP envisages a ‘One Health Approach’ based system towards combating AMR in India. This would include increasing surveillance for AMR to a wider range of sources beyond humans such as animals, poultry, and food samples.
The policy also calls for regulatory frameworks to limit the unrestricted use of antimicrobials across the entire spectrum including food and animals.
There are multiple ways by which AMR can spread. Misuse and overuse of antimicrobials is a primary driver of AMR. These resistant microbials can then spread between individuals or between people and animals.
The government recognises the cruciality of the threat of AMR and has taken certain steps to curb the same.
The Ministry of Health and Family Welfare has merged the schemes to strengthen branches of the National Centre for Disease Control, strengthening inter-sectoral coordination of prevention and control of zoonotic diseases, and surveillance of viral hepatitis and anti-microbial resistance have been merged into one.
- The proposed budgetary allocation for the scheme is ₹52 crore for the year 2020-21.This is a step in the right direction to make India a global leader in the fight against AMR.

Government Initiatives

To address the problem of growing antimicrobial resistance, the government has launched the ‘National Programme on Containment of Antimicrobial Resistance’ under the 12th Five Year Plan with the National Centre of Disease Control (NCDC) as the coordinating centre. Under this programme, IEC (information, education and communication) activities are being conducted for creating awareness in the community for rational use of drugs.
Moreover, the Drugs and Cosmetics Rules of 1945, have been amended to regulate the overuse of 24 antibiotics and other drugs through over-the-counter sale without prescription by the pharmacies.
- Schedule H1 drugs can be sold only on production of a valid prescription by a registered medical practitioner and a warning to this effect is printed on the label in a box with red border and Rx symbol.
- Today, pharmacists must file details of the patient, co-ordinates of the prescribing doctor and the name and dispensed quantity of the drug in another register, which would be frequently inspected by the officials in the drug control department. This register must be preserved for a minimum of three years.

To know about AMR, please refer April 2021 DPN.