Antimicrobial Resistance

HEALTH / GOVERNANCE

Topic: General Studies 2:

• Issues relating to development and management of Social Sector/Services relating to Health
• Government policies and interventions for development in various sectors and issues arising out of their design and implementation. 

Antimicrobial Resistance

Context: While the COVID-19 pandemic continues to wreak havoc on our daily lives, a silent pandemic (AMR) has been brewing in the background for decades

In India, the largest consumer of antibiotics in the world, this is a serious problem. 

AMR Data

• Antimicrobial resistance (AMR) is growing at an alarming rate. Globally, about 35% of common human infections have become resistant to available medicines. 
• About 700,000 people die every year because available antimicrobial drugs — antibiotics, antivirals, antiparasitic and antifungals — have become less effective at combating pathogens. 
• Resistance to second- and third-line antibiotics — the last lines of defence against some common diseases — are projected to almost double between 2005 and 2030. 
• According to a study published in The Lancet, an estimated 58,000 new-born children die annually from sepsis in India alone because antibiotics can no longer treat certain bacterial infections.

Reasons

• Natural process catalyzed: Microorganisms develop resistance to antimicrobial agents as a natural defence mechanism. But, human activity has significantly accelerated the process.
• Misuse of Antibodies: The misuse and overuse of antimicrobials for humans, livestock and agriculture is probably the biggest reason for this, but other factors also contribute.
• Waste releases:  Once consumed, up to 80% of antibiotic drugs are excreted un-metabolised, along with resistant bacteria. Also, they are release in effluents from households and health and pharmaceutical facilities, and agricultural run-off, is propagating resistant microorganisms. 
• Ineffective Wastewater treatment: An analysis of single wastewater discharge from a treatment facility in India catering to drug manufacturers found concentrations of antibiotics high enough to treat over 40,000 people daily. Thus, Wastewater treatment facilities are unable to remove all antibiotics and resistant bacteria.
• Pollution: Research points to the role of environment and pollution in AMR. 
• Other reasons: Water, then, may be a major mode for the spread of AMR, especially in places with inadequate water supply, sanitation and hygiene. Wildlife that comes into contact with discharge containing antimicrobials can also become colonised with drug-resistant organisms.

Interventions

• UN agencies are working together to develop the One Health AMR Global Action Plan (GAP) that addresses the issue in human, animal, and plant health and food and environment sectors.
• Centre and State governments in India can strengthen the environmental dimensions of their plans to tackle antimicrobial resistance. 
• Promote measures that address known hotspots such as hospitals and manufacturing and waste treatment facilities.
• Ministry of Health and Family Welfare and MoEF&CC constituted the inter-ministerial Steering Committee on Environment and Health, with representation from WHO and UNEP.
• Ministry of Environment, Forest and Climate Change (MoEF&CC) issued draft standards which set limits for residues of 121 antibiotics in treated effluents from drug production units.

Conclusion

Antimicrobial resistance is growing exponentially and needs to be tackled before it is late