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Anti-microbial Resistance

Posted 14 Nov 2024

Updated 16 Nov 2024

4 min read

Why in the News?

In the 79th United Nations General Assembly (UNGA) High-Level Meeting on Antimicrobial Resistance (AMR), Global leaders have approved a political declaration on antimicrobial resistance (AMR).

More on the News

  • The declaration establishes clear actions and targets aimed at reducing the estimated 4.95 million annual human deaths linked to bacterial AMR by 10% by 2030.
    • Declaration also calls for sustainable national funding and an additional US$100 million in catalytic funding to combat AMR.
  • Declaration called for following:
    • Global multisectoral action that needed to reach targets by 2030.
    • On human health: at least 70% of antibiotics used for human health globally should belong to the WHO Access group antibiotics.
  • On agriculture and animal health: meaningfully reduce the quantity of antimicrobials used globally in the agri-food systems by 2030.
  • On the environment: declaration underscores the need to prevent and address the discharge of antimicrobials into the environment.

What is Anti-Microbial Resistance (AMR)?

An infographic image titled "Data Bank: Impact of AMR" highlights the severe consequences of antibiotic resistance (AMR). It presents key figures from various studies, including:  Estimated deaths: ~39 million deaths globally by 2050, with 2 million annual deaths projected in India alone (The Lancet study). Death increase: A ~70% increase in AMR-related deaths by 2050 compared to 2022, with South Asia, including India, facing the greatest impact. Economic loss: A cumulative loss of $100 trillion in global economic output by 2050 due to AMR (World Bank).
  • AMR is a condition when microorganisms such as bacteria, viruses, fungi, and parasites change in ways that render the medications used to cure the infections they cause ineffective.
  • Major factors contributing to AMR:
    • Pharmaceutical Manufacturing: Industrial waste from production of Active Pharmaceutical Ingredients (APIs) for antibiotics.
    • Agriculture: Overuse of antibiotics for growth in sectors like livestock, aquaculture, etc.
    • Healthcare Facilities: Improper management of unused medications, patient excretion, and disposal of expired drugs.
    • Waste Management: Landfill leachate, untreated wastewater, and sewage effluents.

Why AMR is a Global Health threat?

  • Economic cost: The World Bank estimates that AMR could result in US$ 1 trillion additional healthcare costs by 2050.
    • Drug-resistant infections also impact the health of animals and plants, reduce productivity in farms, and threaten food security.
  • Gains of modern medicine at risk: It makes infections harder to treat and makes other medical procedures and treatments – such as surgery, caesarean sections and cancer chemotherapy – much riskier.
  • Widespread environmental contamination: Improper disposal of antibiotics leads to environmental contamination, creating reservoirs for resistance genes.
  • Impact on Vulnerable Populations: Individuals with weakened immune systems, the elderly, and children are particularly vulnerable to AMR-related infections.
  • Limited R&D for alternatives: There is an inadequate research and development pipeline for alternative treatments in the face of rising levels of resistance.

Way Forward

An infographic image outlining various initiatives taken globally and in India to address the issue of Antimicrobial Resistance (AMR). It highlights key global efforts like the Global Action Plan on AMR, Global Antimicrobial Resistance Surveillance System (GLASS), and the One Health Global Leaders Group. In India, initiatives include the National Program on AMR containment, National Action Plan on AMR, National AMR surveillance network, Red Line campaign, ban on inappropriate FDCs, and Operation AMRITH. These initiatives aim to combat AMR through surveillance, awareness, and regulatory measures.
  • Implementing WHO Guidance on Wastewater and Solid Waste Management for Antibiotic Manufacturing: It sets targets for liquid effluent, solid waste and Zero Liquid Discharge (ZLD) from pharmaceutical manufacturing. It also makes following recommendations such as–
    • Use established tools like hazard analysis etc., along with internal audits and public communication. 
    • Conduct external audit and certification to ensure robust implementation of risk management plans and to verify performance against targets.
  • One Health Approach: Recognize the interconnectedness of human, animal, and environmental health and address AMR in a holistic manner.
  • Strengthening Regulations: Environment (Protection) Amendment Rules, 2019, which impose stringent limits on residues of 121 antibiotics in treated effluents from drug production units, should be effectively implemented.
  • Agriculture Operations: Sustainable farming practices such as organic farming can be promoted to limit the use of antibiotics in livestock and aquaculture.
  • Promoting Responsible Use: Healthcare facilities should implement antibiotic stewardship programs for responsible antibiotic use.

Antibiotics in the definition of New Drugs

  • Drugs Technical Advisory Board (DTAB) has recommended the inclusion of all antibiotics in the definition of new drugs in the New Drugs and Clinical Trial (NDCT) Rules, 2019.
    • DTAB is the highest statutory decision-making body on technical matters related to drugs in the country under the Central Drugs Standard Control Organization (CDSCO).
  • Under Rule 122 E of the Drug and Cosmetic Rules, 1945, a new drug is defined as one that has not yet been used in the country.
    • Additionally, it has not been recognized as safe and effective by the licensing authority for the proposed claims.
  • DTAB recommendations were made to curb AMR caused by the misuse of antibiotics.  
  • Tags :
  • AMR
  • Antimicrobial Resistance
  • DTAB
  • One Health Approach
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