HYDERABAD: Antimicrobial Resistance Awareness Week is observed annually from November 18 to 24. This year’s theme, ‘Preventing antimicrobial resistance together,’ highlights the significance of unified action in tackling the worldwide health issue of antimicrobial resistance.
Antimicrobial resistance (AMR) refers to the process when the microbes that cause infections like bacteria, viruses and fungi, gain resistance to medicines that are meant to act on them, making infections harder to treat. This is a natural process but misuse and overuse of antimicrobials like antibiotics accelerate the problem.
Dr J Anish Anand, Consultant, Internal Medicine, Apollo Hospitals, Jubilee Hills, explains, “Antibacterial resistance (ABR) is the ability of microorganisms, such as bacteria, to resist the effects of antimicrobial drugs, such as antibiotics. This means that the drugs are no longer effective in killing the bacteria.”
Dr Anand stated that as antibiotic resistance increases, a growing number of diseases are becoming more difficult or impossible to treat. These include Pneumonia, a leading cause of death among children worldwide; Tuberculosis (TB), one of the top 10 causes of death worldwide; Sepsis, a life-threatening condition that occurs when the body’s response to an infection injures its own tissues and organs. Apart from these, AMR also makes it difficult to treat foodborne diseases, like salmonellosis and campylobacteriosis, which are infections spread through contaminated food or water. Antibiotic resistance is also making it more difficult to treat a number of other infections, including urinary tract infections, skin infections, and ear infections.
Co-founder and Co-lead of Superheroes Against Superbugs, an initiative that works to spread awareness of AMR in India, Dr Ponnari Gottipati, said, “India is the largest producer and consumer of antibiotics. With a high infectious disease load and indiscriminate use of antibiotics both in the human and animal sectors, AMR is a big problem in India. People are inadvertently adding to the problem.”
She listed many reasons for AMR: Misuse and overuse of antimicrobials like taking antibiotics for viral infections, over-the-counter sale of antibiotics, indiscriminate use of antibiotics in animal husbandry and aquaculture, poor infection control, lack of hygiene and sanitation, lack of regulatory oversight of antibiotics production and disposal (lack of effluent treatments) etc.
The doctors suggested a few steps that individuals can take to tackle AMR: Maintaining hygiene and sanitation; preventing infections; taking timely vaccines; not buying antibiotics over the counter; always taking antibiotics only when prescribed by a doctor; finishing the full course and following the doctor’s instructions; not sharing antibiotics; being mindful of where our food is sourced from - buying antibiotic-free meat and poultry and spreading awareness in our circles.
Dr Anand added that access to essential medicines remains a significant challenge in India, despite being the world’s largest producer of generic drugs. “Several factors contribute to this issue, including affordability and availability of generic medicines, uneven distribution of medicines across India, inadequate infrastructure, including storage and transportation facilities and lack of awareness,” he said. Hence, while on one hand indiscriminate use of antibiotics is adding to the problem of antimicrobial resistance, on the other, the access to antibiotics is not complete as the distribution of medicines is inadequate. However, there are governmental initiatives that try to spread awareness about AMR.
“There are guidelines by the government restricting the over-the-counter sale of antibiotics or banning last-resort antibiotics like colistin in animal agriculture but implementation is lacking. India came up with a National Action Plan on AMR in 2017 and surveillance and stewardship programmes are being run in the country. But there needs to be a more coordinated effort,” said Dr Gottipati.
“As per the Global Research on AMR (GRAM) report, 4.95 million people who died in 2019 suffered from drug-resistant infections, and AMR directly caused 1.27 million of those deaths around the world. In India in 2019, 2,97,000 deaths were attributable to AMR and 10,42,500 deaths associated with AMR. The number of AMR deaths in India in 2019 was higher than deaths from TB, enteric infections, diabetes, kidney disease and maternal and neonatal disorders as per the GRAM report. Globally, AMR killed more people than HIV or malaria in 2019 as per this report,” added Dr Gottipati.
In conclusion, Dr Anand said that expanding the affordability of generic medicines, strengthening public procurement systems to prevent shortages and promoting rational medicine use, are some of the strategies that can improve medicine accessibility in India and empower individuals to make informed health decisions, which in turn can help combat anti-microbial resistance.