ANTI MICROBIAL RESISTANCE

 Antimicrobial Resistance (AMR) is today reckoned among the most ominous threats confronting Global Public Health. AMR implies that a pathogen sensitive to a certain drug ceases to respond to that drug.

While the more commonly known resistance is Antibacterial (ABR), the larger term AMR encompasses resistance to medicines for treatment of other pathogens too, which cause viral, fungal, and parasitic diseases.

AMR is a global issue, not confined by political boundaries, and is a threat to all humanity. Animals and plants are also afflicted by diseases caused by pathogens, and hence are vulnerable to AMR. Human beings are victims of AMR due to the irrational and improper use of drugs. Additionally, AMR spreads in humans through their food, water, and from their environment.

A serious concern around the world

The WHO’s global action plan (GAP) was adopted by member nations in 2015.

India’s NAP was approved in 2017. It is understood that NAP 2.0 is now envisaged. The thrust of India’s NAP includes coordinated action by the government and non-government sectors; a whole of government approach (Health, Animal Husbandry, Fisheries, Agriculture, Dairy, Pharmaceuticals and Biotechnology sectors); advocacy; awareness-building; involvement of the community; infection prevention and control; National AMR Surveillance Network (NARS Net); research and international collaboration. AMR is an important priority in the G20 health agenda under India’s presidency.

Need for a concerted, combined effort

Despite the International ‘One Health’ initiative and India’s own vision of inter-ministerial coordination for AMR prevention and control, the war against AMR is largely construed as the burden of the health sector. It is vital that other stakeholders too, especially the sectors overseeing food, drinking water, and environment, shoulder equal ownership, failing which the achievement of India’s AMR objectives will be difficult.

An area of immense concern is the apparently unregulated access to antibiotics for the animal husbandry, dairying, and poultry sectors.

Prompt and effective action in this area is warranted. This should include not only regulated access, but also no over- or under-use of drugs for non-human consumption.

Another important aspect that we must recognise and address is the role of the environment in the spread of AMR. Untreated wastewater and effluents, including such releases from antibiotics manufacturing units and healthcare facilities, can contaminate our environment, facilitating the propagation of AMR. Effective sanitation, sewage, and waste treatment infrastructure is required to keep the environment safe and prevent AMR contamination and transmission.

In fact, the pharmaceutical industry must also weave in sustainable manufacturing into their existing production chain.

How crucial are the state governments and local bodies in India’s AMR agenda?

AMR containment measures including hospital infection and control, regulation of pharmacies/ pharmacists, treatment of sewage and pharmaceutical effluents, adoption of standard treatment protocols, AMR surveillance etc., are largely implemented by the state governments.

Hence, our efforts cannot be successful without the active and enthusiastic involvement of the states. This realisation must quickly resonate across the country.

Why urgent action is needed; how to go about it

AMR puts a huge economic burden on both individual families and society as a whole. . This can be prevented by effectively neutralising the threat of AMR.

India has achieved huge success in the application of digital technology. Leveraging such applications, especially conceived for the AMR programme, will yield good dividends. This can also add value to India’s contribution in the G20 collaboration.

Applications can be for monitoring the use of antibiotics, prescription audits, movement of antibiotics from the production source to the ultimate user, for surveillance of incidence and prevalence of AMR including state-wise or interspatial variations, etc.

Parallel efforts on a war footing are needed for the discovery and commercialisation of new antibiotics and new antimicrobials.

The influence of social media

, leverage these platforms to spread the message of AMR. inculcate community realisation for rational and correct use of antimicrobials.






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