A manifesto for tackling the silent pandemic of AMR

Source– The post is based on the article “A manifesto for tackling the silent pandemic of AMR” published in The Hindu on 16th February 2023.

Syllabus: GS3- Science and Technology

Relevance– Various diseases and treatments

News– As the current G-20 president, and as a vulnerable country, India has a key role in ensuring that AMR remains high on the global health agenda.

What shows the prevalence of antimicrobial resistance?

New drugs have become resistant to drugs.There is rising misuse and overuse of antibiotics in humans and animals.

In 2019, AMR was associated with an estimated 4.95 million human deaths. A 2018 report by OECD warned of a phenomenal increase of resistance to antibiotics by 2030.

AMR adds to the burden of communicable diseases and strains the health systems of a country. ICMR study in 2022 showed that the resistance level increases from 5% to 10% every year for broad-spectrum antimicrobials.

An Indian Network for Surveillance of Antimicrobial Resistance study indicated a high rate of resistance to commonly used drugs such as ciprofloxacin, erythromycin and clindamycin.

According to WHO, resistance to ciprofloxacin varied from 8.4% to 92.9% for Escherichia coli and from 4.1% to 79.4% for Klebsiella pneumoniae.

The global epidemic of TB has been severely impacted by multidrug resistance. Patients have less than a 60% chance of recovery.

What are the impacts of AMR?

Microbial resistance to antibiotics has made it harder to treat infections such as pneumonia, tuberculosis and several food-borne diseases.

AMR also imposes a huge health cost on the patient in the form of longer hospitalisation, health complications and delayed recovery.

It puts patients undergoing major surgeries and treatments, such as chemotherapy, at a greater Risk.

What were important developments during the Third Global High-Level Ministerial Conference on Antimicrobial Resistance?

It was held in Muscat. It led to the adoption of the Muscat Ministerial Manifesto on AMR.

The Muscat Manifesto recognised the need to accelerate political commitments in the implementation of One Health action for controlling the spread of AMR.

It also recognised the need to address the impact of AMR not only on humans but also on animals, and in areas of environmental health, food security and economic growth and development.

The conference focused on three health targets: reduce the total amount of antimicrobials used in the agri-food system at least by 30-50% by 2030.

Eliminate use in animals and food production of antimicrobials that are medically important for human health

Ensure that by 2030 at least 60% of overall antibiotic consumption in humans is from the WHO “Access” group of antibiotics.

What is the One Health approach?

It requires all stakeholders to work together towards an integrated programme linking challenges of humans, terrestrial and aquatic animals, plant health, food and feed production and the environment.

What are the steps taken by the Indian government to overcome AMR?

The National Action Plan on Antimicrobial Resistance (2017-21) emphasised the effectiveness of the government’s initiatives for hand hygiene and sanitation programmes such as Swachh Bharat Abhiyan, Kayakalp and Swachh Swasth Sarvatra.

The government has also attempted to increase community awareness about healthier and better food production practices, especially in the animal food industry.

The National Health Policy 2017 also offered specific guidelines regarding use of antibiotics, restricting the use of antibiotics for growth promotion in livestock. It also called for scrutiny of prescriptions to assess antibiotic usage in hospitals and among doctors.

What is the way forward to overcome AMR?

The various G-20 health summits spread through 2023 offer an opportunity for India to ensure that all aspects of AMR are addressed and countries commit to progress.

Some key areas for action are:

Surveillance of priority pathogens and sharing of data, including through WHO’s GLASS platform.

Regulatory and policy action to stop use of antibiotics that are important for human health in animals.

No use of antibiotics for growth promotion in animals.

More government investment in research and innovation for new antibiotics.

Explore use of vaccines to prevent certain infections due to AMR organisms in humans and animals.

Special focus on combating TB and drug-resistant TB.

Further, There is also an urgent need to reduce the usage of antimicrobials in the agri-food system. Countries such as the Netherlands and Thailand have decreased their usage by almost 50%.

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