India joins the Global Antimicrobial Res

What is Global AMR R&D Hub?

The Global AMR R&D Hub was launched in May 2018 in the margins of the 71^st session of the World Health Assembly.  Hub is aims at helping countries decide the allocation of resources for research and development (R&D) on antimicrobial resistance (AMR) by identifying gaps and overlaps. It will also promote coordination among governments in the fight against AMR.

The global partnership now includes 16 countries, the European Commission, two philanthropic foundations and four international organizations (as observers). Its HQ in berlin. With India as a member, the Hub now represents more than half the world's population.

What is Anti-microbial resistance?

AMR is the ability of a microbe to resist the effects of medication that once could successfully treat that microbe. This means we need to develop a new drug to counter that microbe. Today, the emergence and spread of antimicrobial resistance continues unabated around the world. Given the important and interdependent human, animal, and environmental dimensions of antimicrobial resistance, India considers it reasonable to explore issues of antimicrobial resistance through the lens of One Health approach which should be supported by long-term commitments from all stakeholders.

Globally, more than 700,000 people die from AMR infections and the number is expected to spike to more than 10 million deaths each year, if proper action is not taken, according to the World Health Organization.  

What is significance for India of joining Global AMR R&D Hub?

India, which is among countries with the highest bacterial disease burden in the world, needs urgent coordinated action on AMR. The country is also the largest consumer of antibiotics in the world — consumption increased by 103 per cent from 2000 to 2015, the highest in low and middle-income countries. AMR is making treating TB very difficult. AMR means we need to develop more and more new drugs to counter advanced bacterial infections.

What are reasons for high AMR in India?

1. Indiscriminate use of Anti biotics in animal husbandry, Aquaculture and poultry
2. Patients not following complete regimen
3. Over the counter sell of un prescribed antibiotics
4. Hospital waste containment is unsatisfactory, spread of hospital waste that includes antibiotics in environment make bacterial population immune to current frontline drugs
5. Low doctor to patient and nurse to patient ratios along with lack of infection prevention and control (IPC) guidelines favor the spread of MDR organisms in the hospital settings
6. Pharmaceutical waste water from drug plant
7. Municipal waste water: With 30-90 per cent fraction of all antimicrobials being excreted unchanged via human faeces and urine, municipal waste water becomes an important dumping ground of resistant organisms or genes
8. Livestock discard: Animal excreta can contaminate the environment directly with resistant organisms or indirectly with antimicrobials.

What is government doing to tackle AMR?

India launched National Action Plan for antimicrobial resistance in 2017. The objectives of the NAP include improving awareness, enhancing surveillance measures, strengthening infection prevention and control, research and development, promoting investments, and collaborative activities to control AMR. On the basis of the NAP, various states have begun the process of initiating their State Action Plans. 

Challenges in implementation of NAP are

1. varied perceptions about antibiotic use and AMR among key stakeholders,
2. inappropriate antibiotic use owing to a number of reasons, 
3. lack of diagnostic facilities, 
4. widespread use of antibiotics in various sectors, 
5. environmental contamination because of pharmaceutical industry, agricultural and hospital waste, 
6. gaps in infection prevention and control, and difficulty in enforcing regulations. 
7. lack of sufficient finances remains a major challenge in NAP implementation. 
8. Overall, a strong political will, inter-sectoral co-ordination between public and private sectors and comprehensive strengthening of the healthcare systems are necessary to achieve the desired forward momentum.