Tackling the silent pandemic of Antimicrobial Resistance

(Mains GS 3 : Recent developments and their applications and effects in everyday life)

Context:

• Antimicrobial resistance (AMR), the phenomenon by which bacteria and fungi evolve and become resistant to presently available medical treatment, is one of the greatest challenges of the 21st century. 
• According to World Health Organization Director-General Tedros Adhanom Ghebreyesus “AMR is a slow tsunami that threatens to undo a century of medical progress”. 

Need collaborative approach:

• While the world is emerging from the acute phase of the COVID-19 pandemic, the very harmful but invisible pandemic of Antimicrobial Resistance (AMR) is unfortunately here to stay. 
• Most countries understood in 2020 the clear and present danger of COVID-19, forcing governments, including India’s, to respond with speed and accuracy. 
• The rapidly rising AMR rates also need an accelerated, multi-sectoral, global and national response.

Misuse and overuse of drugs:

• In recent decades, while new drugs have revolutionised human health care, health experts have been struggling with disease-causing microbes that have become resistant to drugs. 
• Global public health response has been threatened due to rising misuse and overuse of antibiotics in humans and animals.
• Microbial resistance to antibiotics has made it harder to treat infections such as pneumonia, tuberculosis (TB), blood-poisoning (septicaemia) and several food-borne diseases. 
• AMR also imposes a huge health cost on the patient in the form of longer hospitalisation, health complications and delayed recovery. 
• It puts patients undergoing major surgeries and treatments, such as chemotherapy, at a greater risk. 
• Many times, patients recover from advanced medical procedures but succumb to untreatable infections.

Through statistics:

• In 2019, AMR was associated with an estimated 4.95 million human deaths. 
• A 2018 report by the Organisation for Economic Co-operation and Development (OECD) warned of a phenomenal increase, by 2030, of resistance to back-up antibiotics (second and third-line).
• AMR adds to the burden of communicable diseases and strains the health systems of a country. 
• An Indian Council of Medical Research (ICMR) study in 2022 showed that the resistance level increases from 5% to 10% every year for broad-spectrum antimicrobials. 
• An Indian Network for Surveillance of Antimicrobial Resistance (INSAR) study indicated a high rate of resistance to commonly used drugs such as ciprofloxacin, gentamicin, co-trimoxazole, erythromycin and clindamycin.

Muscat conference:

• As the current G-20 president, and as a country vulnerable to this silent pandemic, India’s role is critical in ensuring that AMR remains high on the global public health agenda.
• India’s commitment to the cause was evident at the Third Global High-Level Ministerial Conference on Antimicrobial Resistance (November 24-25, 2022) held in Muscat, where over 30 countries adopted the Muscat Ministerial Manifesto on AMR.
• The Muscat Manifesto recognised the need to accelerate political commitments in the implementation of One Health action for controlling the spread of AMR. 
• It also recognised the need to address the impact of AMR not only on humans but also on animals, and in areas of environmental health, food security and economic growth and development.
• The conference focused on three health targets: reduce the total amount of antimicrobials used in the agri-food system at least by 30-50% by 2030; eliminate use in animals and food production of antimicrobials that are medically important for human health; and ensure that by 2030 at least 60% of overall antibiotic consumption in humans is from the WHO “Access” group of antibiotics.

Response to the AMR crisis:

• The Muscat Manifesto appears to respond to the AMR crisis by setting these three ground-breaking targets. 
• The manifesto encourages countries to prioritise their national action plans for AMR keeping the One Health approach. 
• The One Health approach requires all stakeholders to work together towards an integrated programme linking challenges of humans, terrestrial and aquatic animal, plant health, food and feed production and the environment. 
• This approach will enable the world to effectively prevent, predict and detect the health crisis induced by AMR. 
• Tackling AMR requires constant monitoring of antibiotic consumption, identifying the types and quantities of antibiotics being used.

Conclusion:

• The various G-20 health summits spread through 2023 offer an opportunity for India to ensure that all aspects of AMR are addressed and countries commit to progress.