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UPSC Editorial Analysis

Antibiotics and their Statute in India

[GS Paper 3 - Health and Related Issues]

Context – The recent publication of The Lancet’s global burden of bacterial antimicrobial resistance estimated that 4.95 million deaths were associated with bacterial AMR in 2019 alone. It also identified the pathogens and pathogen-drug combinations that cause such resistance. 

Bacterial AMR occurs when the drugs used to treat infections become less effective, as a result of the pathogens becoming resistant to the drugs. This happens due to:

  • indiscriminate use of antibiotics
  • availability of antibiotics over the counter
  • poor hygiene and sanitation
  • antimicrobial use in the farming and poultry industry
  • lack of vaccines and newer antibiotics, and 
  • poor infection control practices in hospitals

An elaborate and studied estimate validated by using counterfactual analysis for the first time — comes at a time when the world, weary with battling COVID-19, seems to have lost steam to mount a robust AMR policy. But the report makes it clear that no slacking can be allowed on this front any longer.

Impacts of AMR

  • Medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery (for example, cesarean sections or hip replacements) become very risky.
  • It increases the cost of healthcare with lengthier stays in hospitals, additional tests and use of more expensive drugs.
  • AMR puts us in a situation where we are looking at a future without antibiotics, with bacteria becoming completely resistant to treatment and when common infections and minor injuries could once again kill.
  • Antimicrobial resistance is putting the gains of the Millennium Development Goals at risk and endangers achievement of the Sustainable Development Goals.

AMR Policy in India

  • AMR is of particular concern in developing nations, including India, where the burden of infectious disease is high and healthcare spending is low. India is among the nations with the highest burden of bacterial infections.
  • In 2008, when the NDM1 enzyme that renders bacteria resistant to a range of antibiotics was traced back to India, it served as an urgent call for action. 
  • India released its own AMR action plan in 2017, and announced a task force for implementation. 
  • By 2019, Kerala and Madhya Pradesh had rolled out State action plans. Since then, little progress has ensued: 11 other States are still framing their action plans. 
  • The Chennai Declaration, a consortium of doctors and health-care institutions against AMR, was also formed in 2012 to draw up a road map. 

Way Forward

While the scientific community looks for solutions in its ken, governments must raise the standard of living for citizens, provide them accessible and affordable quality health care, besides regulating the sale and use of antibiotics. Not doing so in studied haste will only land up eroding the significant health-care gains India has proactively, and painfully at times, secured over the years.

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