Context: In November, the world observed Antibiotic Awareness Week. The Indian government banned the manufacture, sale and use of colistin in the poultry industry in July 2019.
- 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, post-antibiotic future.
- Antimicrobial resistance, including antibiotic resistance, is a global public health threat, as antibiotics and antimicrobials are becoming increasingly ineffective to treat common diseases
- Besides misuse of antibiotics in human health, its misuse in food animal production such as in case of chicken, fish, dairy and honey also adds to the problem.
- The environmental spread of AMR through waste from healthcare settings, animal farms, animal food processing units and pharmaceutical manufacturing units is also a cause of concern.
- An antibiotic is a type of antimicrobial substance active against bacteria and is the most important type of antibacterial agent for fighting bacterial infections
- Antibiotic medications are widely used in the treatment and prevention of such infections. They may either kill or inhibit the growth of bacteria
WHY ANTIBIOTICS HAVE BECOME 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.
- 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.
- 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.
- Globally, use of antibiotics in animals is expected to increase by 67% by 2030 from 2010 levels.
ANTI MICROBIAL RESISTANCE (AMR)
- AMR has been recognized worldwide as an important public health challenge with serious impact on economy and development.
- The Sustainable Development Goals have articulated the importance of containing AMR.
- Similar articulations have been made by the UN general Assembly, G7, G20, EU, ASEAN and other such economic and political platforms.
- The O’Neill report on AMR warned that inaction in containing AMR is likely to result in annual mortality reaching 10 million people and a 3.5% fall in global GDP by 2050.
- Inter-country development agencies (WHO, FAO, and World Organisation for Animal Health) developed a Global Action Plan on AMR.
- India developed its National Action Plan on AMR (NAP) in 2017.
- It is based on the One Health approach, which means that human health, animal health and the environment sectors have equal responsibilities and strategic actions in combating AMR.
NATIONAL ACTION PLAN ON ANTIMICROBIAL RESISTANCE
- TheNational Action Plan on anti-microbial resistance (AMR) was finalised in 2017 during an inter-ministerial consultation under the leadership of Union Health Minister Jagat Prakash Nadda.
- The consultation witnessed 13 ministries coming together in support of the plan. A joint declaration, “Delhi Declaration on Antimicrobial Resistance–an inter-ministerial consensus”, was also endorsed by the ministries to adopt a collaborative approach for prevention of AMR.
The Indian NAP focuses on six strategic priority areas, namely
- Awareness and understanding through education,
- Communication and training,
- Strengthening knowledge and evidence through surveillance,
- Infection prevention and control,
- Optimized antimicrobial use in health, animals and food,
- AMR-related research and innovation and strengthened leadership and commitment at international, national and sub-national levels.
The ambitious and comprehensive plan highlights the need for tackling AMR across multiple sectors such as human health, animal husbandry, agriculture and environment in consideration of the “One-Health” approach.
Highlights of the plan on animal and environmental aspects include the following:
1. Education and training
3. Infection prevention and control
4. Responsible and optimized antibiotic use
5. Focus on environment
SIGNIFICANCE OF NAP
The NAP is an important first step in the right direction. Effective implementation of the plan would require sustained political will, multi-ministerial involvement, funding support from government and suitable state-level action plans.
Implementation of NAP needs to be accelerated.
- The health of humans and animals falls in the domain of State authorities, and this adds complexity to the nationwide response.
- Surveillance networks have to be established in human health and animal health.
- 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.
QUESTION: Antimicrobial resistance is one of the greatest threats we face as a global community. Substantiate. (15 marks)
What steps has the Indian government taken to tackle the menace of anti microbial resistance? (10 marks)