Font size:
Print
Tackling Antimicrobial Resistance (AMR) in India
Context: AMR poses a grave health threat in India, with superbugs resisting last-resort antibiotics. ICMR’s call to restrict new antibiotic sales to select hospitals underscores the urgent need for strict stewardship amid rising drug-resistant TB and hospital infections.
What is Antimicrobial Resistance (AMR) and why is it a major public health threat globally and in India?
Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi, or parasites evolve to resist the effects of drugs, rendering treatments ineffective.
- Global threat: WHO warns that AMR could cause 10 million annual deaths worldwide by 2050, surpassing cancer fatalities.
- India-specific crisis: TB exemplifies the problem. Drug-resistant TB (MDR-TB) requires newer medicines like bedaquiline and delamanid, but resistance is rising. Similarly, resistance to last-resort antibiotics like carbapenems and colistin in Klebsiella and E. coli has left physicians with shrinking treatment options.
Relevant Regulatory Bodies and their Role
- Indian Council of Medical Research (ICMR) – Surveillance, stewardship programmes, research.
- Drug Controller General of India (DCGI) – Regulates approval, manufacture, and restricted sale of antibiotics.
- Union Health Ministry – Policy formulation (e.g., National AMR Action Plan 2017).
- National Centre for Disease Control (NCDC) – Coordinates AMR containment, infection prevention, and surveillance.
- WHO & FAO – Provide global frameworks (e.g., AWaRe classification, One Health approach).
- Economic burden: According to Economic Survey 2020–21, AMR increases treatment costs by more than 50% for bloodstream infections caused by superbugs, deepening poverty-health linkages.
What regulatory policies and guidelines have been initiated in India to counter AMR?
- National Policy for Containment of AMR (2011):First comprehensive framework for regulating antibiotic use and infection prevention.
- National Action Plan on AMR (2017–2021): Based on WHO’s Global Action Plan; emphasised One Health approach linking human, animal, and environmental health.
- Schedule H1 (2014): Restricted over-the-counter sale of critical antimicrobials through mandatory prescription.
- Red Line Campaign (2016): Marked antibiotic packs with a red line to discourage misuse (Down to Earth, 2019).
- National List of Essential Medicines (NLEM – revised 2022): Rationalised availability of critical antibiotics.
- Surveillance initiatives: ICMR’s Antimicrobial Resistance Surveillance & Research Network (AMRSN) tracks resistance trends across tertiary hospitals.
- TB Programme model: Restricted rollout of new TB drugs (e.g., bedaquiline) only through DOTS-Plus centres with strict monitoring, ensuring long-term benefits despite short-term challenges.
