Tackling Antimicrobial Resistance (AMR)

Tackling Antimicrobial Resistance (AMR)

Subject : Science and technology

Section: Health

Concept :

• The COVID-19 pandemic has highlighted the urgent need for governments to prioritize health care and respond quickly to a crisis.
• The silent pandemic of Antimicrobial Resistance (AMR) is thriving with poor response from governments across the globe.
• AMR threatens global public health due to the misuse and overuse of antibiotics in humans and animals.
• India’s role is critical in ensuring that AMR remains high on the global public health agenda as it is currently the G-20 president and a country vulnerable to this silent pandemic.
• Recent UNEP report on antimicrobial resistance report states that the AMR crisis is disproportionately affecting countries in the Global South countries.

Burden of AMR:

• AMR happens when microorganisms (such as bacteria, fungi, viruses, and parasites) develop the ability to continue to grow, even when they are exposed to antimicrobial medicines that are meant to kill them or limit their growth (such as antibiotics, antifungals, antivirals, antimalarials, and anthelmintics).
• As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spreading to others.
• Superbugs is a term used to describe strains of bacteria that are resistant to the majority of antibiotics commonly used today.
• Microbial resistance to antibiotics has made it harder to treat infections such as pneumonia, tuberculosis (TB), blood poisoning (septicaemia) and several food-borne diseases.
• The global epidemic of TB has been severely impacted by multidrug resistance – patients have less than a 60% chance of recovery.
• According to WHO, resistance to ciprofloxacin (an antibiotic commonly used to treat urinary tract infections) varied from 8.4% to 92.9% for Escherichia coli (E. coli) and from 4.1% to 79.4% for Klebsiella pneumoniae (a bacteria that can cause life-threatening infections such as pneumonia and intensive care unit- related infections).
• An Indian Network for Surveillance of Antimicrobial Resistance (INSAR) study indicated a high rate of resistance to commonly used drugs such as ciprofloxacin, gentamicin, co-trimoxazole, erythromycin and clindamycin.
• AMR also imposes a huge health cost on the patient in the form of longer hospitalisation, health complications and delayed recovery.
• It puts patients undergoing major surgeries and treatments, such as chemotherapy, at a greater risk.
• It is estimated to cause 10 million deaths per year and an overall cost of $100 trillion to the global economy by 2050.
• AMR adds to the burden of communicable diseases and strains the health systems of a country.
• AMR in human and animal pathogens is among the top ten threats compromising global health, the WHO said in 2021.

Spread of AMR

• AMR spread is not confined to point sources.
• Transient and diffuse sources, which include water (rivers, lakes and sediments), overflows, agricultural runoff, soil, airborne transmission and wildlife migration (such as the movement of migratory birds) can also be important.
• Other critical factors are globalisation, climate change and the mobility of people and goods, and wildlife.
• AMR challenges are closely linked to the triple planetary crisis of climate change, biodiversity loss and pollution and waste, all of which are driven by human activity, including unsustainable consumption and production patterns.

Antimicrobials in Agri-food system

• Antimicrobials including antibiotics, antivirals and fungicides have helped treat numerous infectious diseases in people and animals and are also used to improve crop and animal production.
• However, their effectiveness is fast waning because microbes have developed resistance to them, and continue to do so.

Global High-Level Ministerial Conference on AMR:

• The Third Global High-Level Ministerial Conference on Antimicrobial Resistance (November 24-25, 2022) held in Muscat, Oman, saw over 30 countries adopt the Muscat Ministerial Manifesto on AMR.
• The Muscat Manifesto recognised the need to accelerate political commitments in the implementation of the One Health approach to effectively prevent, predict and detect the health crisis induced by AMR.
• It also recognised the need to address the impact of AMR not only on humans but also on animals, and in areas of environmental health, food security and economic growth and development.
• The conference focused on three health targets:
• Reduce the total amount of antimicrobials used in the agri-food system at least by 30-50% by 2030.
• Eliminate the use in animals and food production of antimicrobials that are medically important for human health.
• Ensure that by 2030 at least 60% of overall antibiotic consumption in humans is from the WHO “Access” group of antibiotics.

India against AMR:

• India’s bacterial disease burden is the highest in the world.
• A large population in India suffers from diseases like diabetes, heart ailments and cancer, making them prone to infections.
• 40% of children are malnourished and at risk of infection.
• An Indian Council of Medical Research (ICMR) study in 2022 showed that the resistance level increases from 5% to 10% every year for broad-spectrum antimicrobials.
• The National Action Plan on Antimicrobial Resistance (2017-21) emphasised the effectiveness of the government’s initiatives for hand hygiene and sanitation programmes such as Swachh Bharat Abhiyan, Kayakalp and Swachh Swasth Sarvatra.
• India has committed to strengthening surveillance and promoting research on newer drugs.
• It also plans to strengthen private sector engagement and the reporting of data to the WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) and other standardised systems.
• The government has also attempted to increase community awareness about healthier and better food production practices, especially in the animal food industry.
• The National Health Policy 2017 has guidelines to limit the use of antibiotics as over-the-counter medications and restrict the use of antibiotics for growth promotion in livestock.

One Health Approach

• The One Health approach requires all stakeholders to work together towards an integrated programme linking challenges of humans, terrestrial and aquatic animal, plant health, food and feed production and the environment.
• This approach will enable the world to effectively prevent, predict and detect the health crisis induced by AMR.

Global Antimicrobial Resistance and Use Surveillance System (GLASS):

• WHO launched the GLASS in 2015 to continue filling knowledge gaps and to inform strategies at all levels.
• GLASS has been conceived to progressively incorporate data from surveillance of AMR in humans, surveillance of the use of antimicrobial medicines, AMR in the food chain and in the environment.

National Action Plan on Antimicrobial Resistance (2017-21 )

• National Action Plan on Antimicrobial Resistance (NAP-AMR) focusing on One Health approach was launched on 19th April 2017 with the aim of involving various stakeholder ministries/departments.
• Delhi Declaration on AMR– an inter-ministerial consensus was signed by the ministers of the concerned ministries pledging their support in AMR containment. In the line with NAP-AMR various states have launched their state action plan.

Kindly refer concept notes on AMR –  https://optimizeias.com/anti-microbial-resistance-