Insights into Editorial: Is Indian pharma breeding superbugs?
In India’s neonatal hospital wards they struggle for life – sick infants battling untreatable “superbugs”. Tens of thousands of them lose their lives every year. This is the frontline in the fight against antibiotic-resistant bacteria, one of the most serious threats to global health of our time, according to the World Health Organization. Various studies show that India is becoming a hotbed for superbugs.
What are superbugs?
Superbugs are bacteria that can no longer be killed by the current spectrum of antibiotics known to humans. A superbug is a bacterium that carries several resistance genes. These are resistant to multiple antibiotics and are able to survive even after exposure to one or more antibiotics.
What’s the main concern now?
Antibiotic-resistance is passed relatively easily from one bacteria to the next, since it is transmitted by way of loose genetic material that most bacteria have in common. The World Health Organization (WHO) is afraid of a post-antibiotic world, where loads of bacteria are superbugs. Already, infections like tuberculosis, gonorrhoea, and pneumonia are becoming harder to treat with typical antibiotics.
Why India is more vulnerable?
- Bacteria spread easily in India because half of Indians defecate outdoors, and much of the sewage generated by those who do use toilets is untreated. As a result, Indians have among the highest rates of bacterial infections in the world and collectively take more antibiotics, which are sold over the counter here, than any other nationality.
- A study found that Indian children living in places where people are less likely to use a toilet tend to get diarrhoea and be given antibiotics more often than those in places with more toilet use.
- All those drugs that create resistance to antibiotics find their way into hospital sewage, which is mostly dumped untreated into rivers, canals and pits in the surrounding community where pregnant women can become infected.
- Equally worrisome has been the rapid growth of India’s industrialised animal husbandry, where antibiotics are widespread. Most large chicken farms here use feed laced with antibiotics banned for use in animals in the United States.
- Also, antibiotics are still readily available over the counter, and people still self-medicate. The Indian government has notably failed to institute and implement real regulations to stop chemists from handing out antibiotics like cheap candy.
What has the Indian government done in this regard?
For a while it looked like the Indian government was taking the matter seriously. A commission was set up in 2011 which duly produced a report on how to contain the growth of anti-microbial resistance. Yet too little has changed since.
Recently, to tackle the threat faced by India from resistance to antimicrobial drugs, the Department of Biotechnology (DBT) — through the Biotechnology Industry Research Assistance Council (BIRAC) — has launched a fund. This is an India-focussed seed fund. DBT has invested an initial $1,00,000 in this fund. This fund is also expected to encourage biotechnology start-ups in the country.
What needs to be done?
First step would be to limit antibiotic use. If a patient has a virus, for instance, an antibiotic won’t work, so doctors shouldn’t prescribe antibiotics even if the patient insists. And when patients do need antibiotics, it’s important to make sure they take the full course to kill off every last infection-causing germ. Otherwise the strong survive, mutate, and spread. As a society, curbing antibiotic use in healthy animals used in human food production is another important step.
Antibiotic resistance is a crisis on the level of climate change. It’s already killing tens, perhaps hundreds of thousands a year. The world needs to be looking more closely at drugmakers and the governments that choose to protect them. Also, the global community needs to urgently address the indiscriminate use of antibiotics in an actionable manner and fast-track research on the next generation of drugs.