Antimicrobial Resistance

Published on 13 Feb 2025

Antimicrobial resistance (AMR) is the ability of bacteria, fungi, viruses and parasites to no longer respond to antimicrobial medicines which result in prolonged illness, increasing the risk of disease spread and causing death. As per WHO, AMR causes an estimated five million deaths every year globally, with projections suggesting a rise to ten million by 2050.

Reasons for the emergence of AMR

✔     Overuse of antibiotics: The overprescription and inappropriate use of antibiotics in both human and animal healthcare leads to the development of resistance.

●      Example: Drug resistant HIV(HIVDR) making antiretroviral (ARV) drugs ineffective.

✔     Use of antibiotics in farming: Use of antibiotics to speed the growth of chickens and other livestock, which develops resistant bacteria that will transmit from animals to humans through direct contact or consumption.

●      Example: According to a report in the journal Science, from 2000 to 2018, the proportion of antimicrobial compounds that were more than 50 percent resistant increased from 15 percent to 41 percent in chickens and from 13 to 34 percent in pigs.

✔     Social factors: This includes self-medication and access to antibiotics without prescription.

●      Example: Practice of self-medication is high in India, with around 37% and 17% in urban and rural India respectively (NCBI).

✔     Improper Disposal of Pharmaceuticals: The wastewater effluents from the antibiotic manufacturing units contain a substantial amount of antibiotics, leading to contamination of rivers and lakes.

✔     Environmental sanitation: Poor sanitation and inadequate wastewater treatment lead to contamination of water sources with antibiotics and resistant bacteria.

●      Example: Globally, over 600 different Active Pharmaceutical Ingredients (API) have been detected in the environment.

Impact of AMR

✔     Risk in treatments: Microbial resistance to antibiotics has made it harder to treat infections such as pneumonia and several foodborne diseases.

●      Example: According to WHO, the global epidemic of TB has been severely impacted as multidrug resistance patients have less than 60% chance of recovery.

✔     Increase in healthcare cost: Antimicrobial resistance increases the cost of healthcare with prolonged hospital stays, additional tests and use of more expensive drugs.

✔     Higher mortality rates: When standard treatments fail, patients may succumb to infections that were once easily treatable, leading to increased fatalities.

●      Example: Antibiotic-resistant neonatal infections are responsible for the deaths of nearly 60,000 newborns each year.

✔     Spreading and treating of infections: Resistant microorganisms can spread globally which makes it more challenging to control the infectious diseases, leading to potential outbreaks and epidemics.

●      Example: Continuous use of antimicrobials leads to the emergence of zoonotic pathogens.

✔     Impact on biodiversity: The deposition of API’s and the development of resistant microbes has reduced the quality of water and soil, affecting other life forms.

●      Example: Endocrine disrupting drugs can affect the reproductive ability of fish.

Government Initiatives to address AMR

✔     National programme on AMR containment: Under this programme, AMR Surveillance Network has been strengthened by establishing labs in State Medical College.

✔     National Action Plan on AMR: Launched in 2017, the programme focuses on One Health approach with the aim involving various stakeholders and ministries/departments.

✔     AMR Surveillance Network: Launched in 2013, to generate evidence and capture the trends and patterns of drug resistant infections in the country.

✔     International Collaborations: ICMR has taken initiatives to develop new drugs through international collaborations to strengthen the medical research in AMR.

●      Example: ICMR along with Research Council Norway initiated a joint call for research in AMR in 2017.

✔     Antibiotic Stewardship Program(AMSP): ICMR has initiated AMSP to control misuse and overuse of antibiotics in hospital wards and ICUs.

Way Forward

✔     Improved Antibiotic Stewardship: Encourage the healthcare professionals to prescribe antibiotics only when necessary and in correct dosage and duration.

✔     Research and Development: Discover new antibiotics and alternative therapies, encourage the development of vaccines to prevent infectious disease.

✔     One Health Approach: There is a need for a One Health Approach through coherent, integrated, multi sectoral cooperation and actions, as human, animal and environmental health are integrated.

✔     Enhanced Surveillance: Adopt strategies for optimising the use of antibiotics and exercise prudence across the board including in pharmaceutical effluent discharge.

✔     Public Awareness: Raise awareness among the people, health professionals and policymakers about the dangers of antibiotic misuse and promote education on proper hygiene practices to prevent infections.

Hence, antimicrobial resistance is an imminent threat to human health, which needs to be addressed at the earliest. The government and the medical networks in India are on track to reduce the spread and potential impact of AMR.

Tags:
Social Justice

Keywords:
Antimicrobial Resistance

Syllabus:
General Studies Paper 2

Topics:
Social Justice