Pill talk(TH Ed)

Pill talk(TH Ed)

Context

Article talks about the World Antibiotic Awareness Week, a World Health Organisation campaign to focus attention on antibiotic resistance

What is AMR?

Antibiotic drug resistance is developed in the micro-organisms. AMR is the ability of a microorganism such as bacteria, viruses etc., to render the anti-microbial such as antibiotics, antivirals and anti-malarials ineffective against them. It results in failure of standard treatments and the spread of infections

Similarities b/w climate change & Antibiotic resistance issues

  • In both cases, the actions of people in one region have consequences across the globe. Also, tackling both requires collective action across multiple focus areas.
  • For resistance, this means cutting the misuse of antibiotics in humans and farm animals, fighting environmental pollution, improving infection control in hospitals, and boosting surveillance

India’s unique problem

India grapples with a unique problem as many of around 4 lakh children die of pneumonia every year due to lack of antibiotics while a part of the population uses too much of these medicines

Plan to ban antibiotics shelved

Moves to ban the sale of the antibiotics met with strong opposition in 2011. You can read more about it here

Present situation

  • The Drugs and Cosmetic Rule, 1945 were amended in 2013 to incorporate a new Schedule H1 under the said rules containing 46 drugs which include III and IV generation antibiotics, anti TB drugs and certain habit forming drugs for  having  strict  control  over the   sale of   these drugs. The drugs falling under Schedule H1 are required to be sold in the country with the following conditions:
  • The supply of a drug specified in Schedule H1 shall be recorded in a separate register at the time of the supply giving the name and address of the prescriber, the name of the patient, the name of the drug and the quantity supplied and such records shall be maintained for three years and be open for inspection
  • The drug specified in Schedule H1 shall be labeled with the symbol Rx which shall be in red and explicitly displayed on the left top corner of the label
  • Lax implementation: Even Schedule H1 hasn’t accomplished much: pharmacists often flout rules, and drug controllers are unable to monitor them. Thus, the power to purchase antibiotics still remains in the hands of the consumer

What can be done?

  • Author states that the onus now lies totally on the consumers to appreciate the threat of antibiotic resistance and exercise this power with care. Losing these drugs would mean that even minor illnesses could become killers, and the cost of health care will soar.
  • Awareness must be created so that consumers know that not all illnesses need antibiotics, and the decision on when to take them and for how long is best left to a doctor

Global learnings

Multidrug-resistance in some tertiary-care hospitals (health care from specialists in a large hospital after referral from primary care and secondary care) to bugs like Staphylococcus aureus has grown to dangerous levels. But the experience of countries like Australia shows that cutting down on antibiotics can reverse such trends. The National Action Plan on Antimicrobial Resistance aims to repeat such successes in India

National Action Plan on Antimicrobial Resistance

  • Finalization of India’s National Action Plan on AMR (Anti-Microbial resistance) was announced at the ‘Inter-Ministerial Consultation on AMR containment’ held at New Delhi. The ministers present also signed a ‘Delhi Declaration’ to contain AMR
  • A draft national action plan prepared by the National Centre for Disease Control, under MoHFW was released in March 2017. It called for surveillance of antibiotic use in humans and animals and surveillance of antibiotic resistance in humans, animals and environment
  • In 2015, the WHO released a global action plan on AMR and passed a resolution urging member countries to develop national action plans by May 2017

Delhi Declaration

It calls on the World Health Organization (WHO) and Food and Agricultural Organization (FAO) of the United Nations to help implement the national and state action plans on AMR

AMRRSN

In order to strengthen the surveillance of antimicrobial resistance (AMR) in the country, Indian Council of Medical Research (ICMR) has set up a National Anti-Microbial Resistance Research and Surveillance Network (AMRRSN) to enable compilation of National Data of AMR at different levels of Health Care

Government of India formulated a National policy for containment of antimicrobial resistance in 2011

National Programme for Containment of AMR

  • A National Programme for Containment of AMR has also been initiated in 12th Five Year Plan with the following objectives.
  • To establish a laboratory based surveillance system by strengthening laboratories for AMR in the country and to generate quality data on antimicrobial resistance for pathogens of public health importance
  • To generate awareness among healthcare providers and in the community regarding rational use of antibiotics
  • To strengthen infection control guidelines and practices and promote rational use of antibiotics.
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