Answer

Antimicrobial resistance (AMR) refers to the ability of microorganisms, such as bacteria, viruses, fungi, and parasites, to resist the effects of medications that were originally effective for treating infections caused by them. As per a Lancet study, in 2019, five million human deaths were associated with bacterial antimicrobial resistance worldwide, including nearly 1.3 million human deaths attributable to bacterial AMR. India has one of the highest rates of AMR in the world, with more than 60,000 newborns dying each year from antibiotic-resistant infections.

Concerns related to Antimicrobial resistance:

• High Burden of Infectious Diseases: India faces a significant burden of infectious diseases such as tuberculosis, respiratory infections, and diarrheal diseases. The reliance on antimicrobials for treatment increases the risk of resistance development.
• Over-the-Counter Availability: Easy access to antibiotics without prescription in many parts of India contributes to overuse and misuse, as individuals may self-prescribe or improperly use these medications.
• Agricultural Practices: Widespread use of antibiotics in the agriculture sector for promoting growth and preventing diseases in livestock may contribute to the spread of resistant strains through the food chain.
• Limited Surveillance and Regulation: Inadequate monitoring of antimicrobial use and resistance in both human healthcare and agriculture makes it challenging to implement targeted interventions
• Inadequate Sanitation and Hygiene: Insufficient access to clean water and sanitation in certain regions of India hampers effective infection prevention and control, promoting the spread of resistant pathogens.

Measures can be taken to Address the AMR: 

• Strengthening Surveillance and Research: Implement robust surveillance systems to monitor antimicrobial use and resistance. There is a need to conduct research to understand the patterns and drivers of AMR in different settings.
• India, under the leadership of the ICAR and with technical support from FAO and USAID, has established a network of laboratories from the fishery and livestock sectors, known as the Indian Network for Fisheries and Antimicrobial Resistance (INFAAR) to undertake surveillance of AMR
• Promoting Responsible Use of Antimicrobials: Enforce regulations to restrict the over-the-counter sale of antibiotics without a prescription and educate healthcare professionals, farmers, and the public on responsible antimicrobial use.
•  Regulate and monitor the use of antimicrobials in agriculture, especially in livestock farming.

• One Health Approach: Adopt a One Health approach that recognizes the interconnectedness of human health, animal health, and environmental health in the context of AMR.
• FAO undertakes a coordinated, multisectoral, One Health approach in all countries in the context of the 2030 Agenda for Sustainable Development to address AMR. 

• Educating Healthcare Professionals and the Public: Provide continuous education for healthcare professionals on rational antimicrobial use and raising  awareness among the general public about the consequences of misuse and overuse of antimicrobials.
• International Collaboration: Collaborate with international organizations and neighboring countries to address AMR on a global scale and share information and best practices to collectively combat the spread of resistant strains.
• India played a leadership role in 2011 through the Jaipur Declaration on Antimicrobial Resistance during the annual meeting of the World Health Organisation (WHO) Regional Committee for Southeast Asia

The multifaceted efforts undertaken by the Government of India, as outlined in the National Action Plan on AMR, reflect a commitment to a comprehensive and collaborative approach. India’s NAP is in alignment with the objectives and strategic approaches enunciated by the WHO Global Action Plan and was shared with the global community in April 2017. It may be noted that  sustained efforts from all stakeholders are essential to successfully combat the complex challenges posed by antimicrobial resistance and to ensure the resilience of our healthcare systems for future generations.