Current Affairs 12 November 2024

Antimicrobial Resistance (AMR)

Syllabus: Health

Source: DTE

Context:
Antimicrobial Resistance (AMR) is an escalating global threat that undermines progress in public health, affecting human, animal, and environmental health. Despite significant medical advancements, AMR continues to challenge global health systems, with projections suggesting up to 10 million deaths annually by 2050 if left unaddressed.

What is AMR?

Definition:
AMR occurs when microorganisms (bacteria, viruses, fungi, or parasites) evolve to resist the effects of antimicrobial drugs, rendering standard treatments ineffective. This can lead to prolonged illnesses, increased healthcare costs, and heightened mortality risk worldwide.

Impact:
AMR complicates medical treatments, makes infections harder to treat, increases the duration of illnesses, and can lead to fatalities. It poses a significant risk to global health systems and economies.

Causes of AMR:

1. Overuse of Antibiotics:
   • Unregulated sale of antibiotics and over-the-counter availability.
   • Over-prescription for non-bacterial infections like the common cold.
2. Underuse or Misuse:
   • Failure to complete prescribed antibiotic courses or incorrect dosages.
3. Industrial Agriculture:
   • Antibiotics used as growth promoters in livestock, fisheries, and poultry.
   • Poor waste management from farms increases environmental AMR.
4. Lack of Diagnostic Infrastructure:
   • Inadequate diagnostic facilities lead to incorrect treatment and unnecessary antibiotic use.
5. Inadequate Training:
   • Healthcare providers often lack knowledge about rational antibiotic use.
6. COVID-19 Pandemic Misuse:
   • Widespread, inappropriate antibiotic use during the pandemic worsened AMR.

India’s Approach to AMR:

1. National Action Plan (NAP):
   • Launched in 2017, focusing on rational antibiotic use and surveillance.
2. AMR Surveillance and Research Network (AMRSN):
   • Established by ICMR in 2013 to monitor resistance patterns in 30 tertiary hospitals.
3. One Health Approach:
   • Interlinked human, animal, and environmental health initiatives, including the Integrated One Health Surveillance Network.
4. National One Health Mission:
   • Approved in 2022 to combat AMR, zoonotic diseases, and environmental health concerns.
5. Policy Guidelines:
   • Developed by NCDC for rational treatment and infection control.
6. Zoonotic Disease Programs:
   • Part of the National Programme for Prevention and Control of Zoonoses under the One Health initiative.

Challenges Yet to Be Addressed:

1. Lack of Behavioral and Social Science Data:
   • Limited understanding of community-level antibiotic usage.
2. Structural Disparities:
   • Unequal access to healthcare, particularly in rural areas.
3. Insufficient Community Engagement:
   • Poor awareness and implementation of behavioral change initiatives.
4. Inadequate Workforce Training:
   • Outdated medical curricula and lack of inter-sectoral training for professionals.
5. Surveillance Gaps:
   • Inconsistent data collection from community and tertiary levels.

Way Ahead:

1. Strengthen Surveillance Systems:
   • Expand monitoring to include community-level data for better health planning.
2. Enhance Public Awareness:
   • Targeted campaigns on antibiotic stewardship and the risks of AMR.
3. Policy Implementation:
   • Enforce stricter regulations on over-the-counter antibiotic sales.
4. Inter-sectoral Collaboration:
   • Strengthen the One Health approach to include all sectors (human, animal, environment).
5. Update Curricula and Training:
   • Regular updates to medical and healthcare training programs on AMR and integrated health strategies.
6. Focus on Resource Allocation:
   • Ensure equitable distribution of resources for AMR strategy implementation.

Conclusion:

Addressing AMR is vital for sustaining global health progress and achieving the Sustainable Development Goals (SDGs). India’s initiatives, such as the One Health Mission and AMR surveillance, provide a strong foundation, but further progress requires overcoming regulatory, social, and infrastructural gaps through a collaborative, multi-sectoral approach.

Previous Year Question:

Which of the following are the reasons for the occurrence of multi-drug resistance in microbial pathogens in India?
(UPSC-2019)

1. Genetic predisposition of some people
2. Taking incorrect doses of antibiotics to cure diseases
3. Using antibiotics in livestock farming
4. Multiple chronic diseases in some people

Select the correct answer using the code given below.

(a) 1 and 2
(b) 2 and 3 only
(c) 1, 3 and 4
(d) 2, 3 and 4