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[Insights into Editorial]- Battling anti-microbial resistance

[Insights into Editorial]- Battling anti-microbial resistance

 

         Antibiotic resistance

 Context:

In November, the world observed Antibiotic Awareness Week.

India in its fight against the growing problem of resistance to antibiotics in disease-causing germs, the Indian government banned the manufacture, sale and use of colistin in the poultry industry.

Colistin is considered the last-resort medicine to treat a person with life-threatening infection.

The government’s move is among the numerous steps that will contribute to global efforts to preserve and prolong the efficacy of antibiotics and prevent the world from moving towards a dark, post-antibiotic future.

 

Effective medicines are becoming ineffective:

  • Antibiotics have saved millions of lives till date.
  • Unfortunately, they are now becoming ineffective as many infectious diseases have ceased to respond to antibiotics.
  • Globally, use of antibiotics in animals is expected to increase by 67% by 2030 from 2010 levels. The resistance to antibiotics in germs is a man-made disaster.
  • Irresponsible use of antibiotics is rampant in human health, animal health, fisheries, and agriculture.
  • While in humans’ antibiotics are primarily used for treating patients, they are used as growth promoters in animals, often because they offer economic shortcuts that can replace hygienic practices.
  • In their quest for survival and propagation, common bugs develop a variety of mechanisms to develop antimicrobial resistance (AMR).
  • The indiscriminate use of antibiotics is the greatest driver in selection and propagation of resistant bugs. It has the potential to make fatal even minor infections.
  • Complex surgeries such as organ transplantation and cardiac bypass might become difficult to undertake because of untreatable infectious complications that may result post-surgery.

 

 

How Antibiotic Resistance (AMR) will evolve and spreads:

Antibiotic Resistance (AMR) occurs when bacteria develop the ability to defeat drugs which have been specifically designed to kill them.

Infections caused by such resistant germs are very difficult and often impossible to treat and it can affect humans at all stages of life.

AMR is occurring across the globe and is severely affecting the treatment of infectious diseases.

Even though antimicrobial resistance is a natural process, the misuse of antibiotics in humans and animals is accelerating the process.

A large number of infections such as tuberculosis, pneumonia and gonorrhoea are becoming very difficult to treat since the antibiotics used for their treatment are becoming less effective.

 

India’s NAP- National Action Plan to fight against AMR:

  • The World Health Organization is also coordinating a global campaign “Handle with care” to raise awareness and encourage best practices for antibiotic use.
  • In India, the government has launched a National Action Plan on Antimicrobial Resistance (NAP-AMR) as well.

 

NAP-AMR 2017 – 2021:

  • India’s NAP- National Action Plan to combat Antimicrobial Resistance goes hand in hand with the World Health Organization’s Global Action Plan (GAP) for AMR.
  • The plan is very comprehensive and covers all the five major objectives listed in GAP along with one added objective to strengthen India’s leadership on AMR.
  • This plan aims to target all the human and non-human sectors affected by AMR.
  • The target period to achieve these goals have been listed as short-term (ending within one year), medium-term (between one to three years) and long term (more than three years).

 

Way Forward: A global movement

The magnitude of the problem in India remains unknown. Surveillance networks have been established in human health and animal health.

The health of humans and animals falls in the domain of State authorities, and this adds complexity to the nationwide response.

The FAO has assisted India in forging the Indian Network for Fishery and Animals Antimicrobial Resistance for the generation of reliable data on the magnitude of the problem and monitoring trends in response to control activities.

Implementation of India’s NAP needs to be accelerated.

There needs to be some demonstrable political intent to thrash this issue out, reflected by equally robust field level implementation by multiple stake holders.

It is critical to expand and sustain such surveillance networks.

There is an urgent need to augment capacity for regulatory mechanisms, infection control practices and diagnostics support, availability and use of guidelines for therapy, biosecurity in animal rearing practices and understanding the role of the environment and the engagement of communities.

For this, the world must launch a global movement to contain AMR.

Putting people at the centre of this fight is important, especially if we need to ameliorate the social and economic contributors to contagion.