Antimicrobial resistance (AMR)

GOVERNANCE/ HEALTH

Topic:

• GS-2: Government policies and interventions for development in various sectors and issues arising out of their design and implementation.

Antimicrobial resistance (AMR)

About

• The phenomenon by which bacteria and fungi evolve and become resistant to presently available medical treatment is known as anti-microbial resistance. It is one of the greatest challenges of the 21st century.
• Drug resistance in microbes emerges for several reasons. These include 
  • The misuse of antimicrobials in medicine
  • Inappropriate use in agriculture
  • Contamination around pharmaceutical manufacturing sites where untreated waste releases large amounts of active antimicrobials into the environment. 

Concerns

• Undoes Medical Progress: AMR represents an existential threat to modern medicine. AMR is a slow tsunami that threatens to undo a century of medical progress. 
• Increased Mortality: AMR is already responsible for up to 7,00,000 deaths a year. Neonatal and maternal mortality will increase due to AMR.
• Economic Loss: Unless urgent measures are taken to address this threat, we could soon face an unprecedented health and economic crisis of 10 million annual deaths and costs of up to $100 trillion by 2050.
• Increased Vulnerability to infections: Without functional antimicrobials to treat bacterial and fungal infections, even the most common surgical procedures, as well as cancer chemotherapy, will become fraught with risk from untreatable infections. 
• Disproportionate Burden on Poor Economies: The low- and middle-income countries (LMICs) of Asia and Africa are at severe risk of being overrun by untreatable infectious diseases.

Way Ahead

• Comprehensive Surveillance Framework: To track the spread of resistance in microbes, surveillance measures to identify these organisms need to expand beyond hospitals and encompass livestock, wastewater and farm run-offs. 
• Sustained Investments: Finally, since microbes will inevitably continue to evolve and become resistant even to new antimicrobials, we need sustained investments and global coordination to detect and combat new resistant strains on an ongoing basis.
• Managing Pharmaceutical Waste: Given the critical role of manufacturing and environmental contamination in spreading AMR through pharmaceutical waste, there is a need to look into measures to curb the amount of active antibiotics released in pharmaceutical waste.
• Controlled Prescription & Consumer Awareness: Efforts to control prescription through provider incentives should be accompanied by efforts to educate consumers to reduce inappropriate demand.
• Multi-sectoral Coordination: AMR must no longer be the remit solely of the health sector, but needs engagement from a wide range of stakeholders, representing agriculture, trade and the environment. Solutions in clinical medicine must be integrated with improved surveillance of AMR in agriculture, animal health and the environment.