Antimicrobial resistance: Health issue that will negate advances in medicine

Antimicrobial resistance: Health issue that will negate advances in medicine

Subject: Science and Tech

Section: Health

About Anti-microbial resistance

• Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, parasites, viruses and fungi.
• AMR occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death.
• As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.
• Antimicrobials – including antibiotics, antivirals, antifungals and antiparasitics – are medicines used to prevent and treat infections in humans, animals and plants. Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.

Multicentric Point Prevalence Survey of Antibiotic Use

• The ‘First Multicentric Point Prevalence Survey of Antibiotic Use at 20 NAC-NET Sites India 2021-22’ conducted by the National Centre for Disease Control under the Health Ministry has thrown up startling statistics, but more importantly, examining the minutiae italicises key issues that have been flagged by experts for years now.
• Over 70% of the patients in tertiary-care hospitals across 15 States and two Union Territories were prescribed antibiotics; over 50% of antibiotics prescribed have the potential to cause AMR.
• But the most crucial reveal was that 55% of the patients surveyed were prescribed antibiotics as prophylaxis, or as a preventive; only 45% were prescribed antibiotics to actually treat infections; of this, only 6% were prescribed the drugs after identifying the specific bacteria.

Occurrence of AMR and causes

• AMR occurs when pathogens evolve, fortifying themselves against drugs, and stop responding to antimicrobial drugs.
• While it is the nature of pathogens to evolve, this ever-increasing crisis is constantly being exacerbated by unsound medical, and animal husbandry practices. It is precisely the sort of misuse and overuse of antimicrobials, as revealed by the survey, which cause the development of drug-resistant pathogens that in turn pose great risk to life and exacerbate morbidity.
• The World Health Organization (WHO) estimates that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths.

What are the Steps taken by the Government to address AMR?

• National Action Plan (NAP) for AMR: In April 2017, India’s NAP for AMR was released by the Union Ministry of Health and Family Welfare. The objectives of the NAP include increasing awareness, strengthening surveillance, promoting research, and improving infection prevention and control.
• Signing the Delhi Declaration on AMR: The Delhi Declaration on Antimicrobial Resistance (AMR) is an inter-ministerial consensus that was signed by the ministers of the concerned ministries in India.
• Antibiotic Stewardship Program (AMSP): The Indian Council of Medical Research (ICMR) has initiated the AMSP on a pilot project basis in 20 tertiary care hospitals across India. The program aims to control the misuse and overuse of antibiotics in hospital wards and ICUs.
• Ban on inappropriate fixed dose combinations (FDCs): On the recommendations of the ICMR, the Drug Controller General of India (DCGI) has banned 40 FDCs that were found to be inappropriate.
• Ban on the use of Colistin as a growth promoter in animal feed: The ICMR, in collaboration with the Indian Council of Agriculture Research, Department of Animal Husbandry, Dairy and Fisheries, and the DCGI, has banned the use of Colistin as a growth promoter in animal feed in poultry.
• One Health approach: The government is working on a One Health approach by encouraging interdisciplinary collaboration at the human-animal-environmental interface. The key priority areas include zoonotic diseases, food safety, and antibiotic resistance.
• Integrated One Health Surveillance Network for AMR: The ICMR has undertaken a project on an “Integrated One Health Surveillance Network for Antimicrobial Resistance” in collaboration with the Indian Council of Agriculture Research to assess the preparedness of Indian Veterinary laboratories to participate in an integrated AMR surveillance network.