Antimicrobial Resistance (AMR)

Context: 

While the world is emerging from the acute phase of the COVID­19 pandemic, the very harmful but invisible pandemic of Antimicrobial Resistance (AMR) is unfortunately here to stay. The rapidly rising AMR rates also need an accelerated, multi­sectoral, global and national response.

Threats posed by AMR:

•  Global public health response has been threatened due to rising misuse and overuse of antibiotics in humans and animals.

•   Microbial resistance to antibiotics has made it harder to treat infections such as pneumonia, tuberculosis (TB), blood poisoning (septicaemia) and several food­borne diseases.

• AMR also imposes a huge health cost on the patient in the form of longer hospitalization, health complications and delayed recovery.

• It puts patients undergoing major surgeries and treatments, such as chemotherapy, at a greater risk.

• Many times, patients recover from advanced medical procedures but succumb to untreatable infections.

 Facts related to AMR:

•  In 2019, AMR was associated with an estimated 4.95 million human deaths.

• A 2018 report by the Organisation for Economic Co-operation and Development (OECD) warned of a phenomenal increase, by 2030, of resistance to back up antibiotics.

•  ICMR study in 2022 showed that the resistance level increases from 5% to 10% every year for broad spectrum antimicrobials.

Muscat conference:

• At the Third Global High­Level Ministerial Conference on Antimicrobial Resistance, over 30 countries adopted the Muscat Ministerial Manifesto on AMR.

• The Muscat Manifesto recognised the need to accelerate political commitments in the implementation of One Health action for controlling the spread of AMR.

• The manifesto encourages countries to prioritize their national action plans for AMR keeping the One Health approach.

• 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 agri­food system at least by 30­-50% by 2030;

• • eliminate 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.

One Health approach:

• The One Health approach requires all stakeholders to work together towards an integrated programme linking challenges of humans, terrestrial and aquatic animals, 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.

India’s efforts against AMR:

• India has committed to strengthening surveillance and promoting research on newer drugs.

• 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.

•  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 also offered specific guidelines regarding use of antibiotics, limiting the use of antibiotics as over the counter medications and banning or restricting the use of antibiotics for growth promotion in livestock.

• It also called for scrutiny of prescriptions to assess antibiotic usage in hospitals and among doctors

• India 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 standardized systems.

Measures needed:

• Phenotypic and genotypic surveillance of priority pathogens and sharing of data, including through WHO’s GLASS platform.

•   Regulatory and policy action to stop use of antibiotics that are important for human health in animals.

•  No use of antibiotics for growth promotion in animals; more government investment in research and innovation for new antibiotics.

• Explore use of vaccines to prevent certain infections due to AMR organisms in humans and animals.

• Special focus on combating TB and drug­ resistant TB.

Countries such as the Netherlands and Thailand have decreased their usage by almost 50%. In China, the consumption of antibiotics in the agricultural sector has fallen substantially.  

News Source: The Hindu