National Action Plan on Antimicrobial Resistance (NAP-AMR 2.0)

India’s latest National Action Plan on Antimicrobial Resistance (NAP-AMR 2.0) for 2025-29 has been launched amidst rising concerns about AMR, which affects multiple sectors including human health, veterinary practices, and agriculture. This makes it a One Health challenge, indicating the interconnectedness of health across humans, animals, and the environment.

Significance of AMR

• AMR is not limited to hospital settings but spreads through soil, water, livestock, and food systems.
• The challenge encompasses various sectors from agriculture to waste management.

Progress and Challenges of the First National Action Plan

• The first plan in 2017 raised awareness, improved surveillance, and encouraged multi-sectoral participation.
• Despite progress, implementation was weak at the State level, with limited formal State Action Plans and fragmented sectoral activities.
• Major AMR determinants fall under State jurisdiction, requiring State-specific actions beyond national guidance.

Key Features of NAP-AMR 2.0

• Moves towards an implementation-focused framework with clear timelines and responsibilities.
• Emphasizes private sector participation due to its significant role in healthcare provision.
• Strengthens the scientific base with focus on innovation and One Health perspective.
• Integrated surveillance across human, veterinary, agricultural, and environmental sectors.
• Governance under NITI Aayog with a Coordination and Monitoring Committee to oversee implementation.

Implementation Challenges

• The plan lacks mechanisms for ensuring States develop and implement AMR Action Plans.
• No joint review or statutory requirements for State compliance.
• The absence of financial incentives or conditional grants akin to the National Health Mission (NHM) to promote State engagement.

Recommendations for Effective Implementation

• Establish a national-State AMR council led by the Union Health Minister to facilitate State engagement.
• Propose formal requests for States to prepare and notify AMR Action Plans with timelines and reviews.
• Utilize financial mechanisms under NHM to incentivize improvements in surveillance and infection control.

In conclusion, while NAP-AMR 2.0 provides the strategic framework necessary for combating AMR, its success hinges on the collaboration between national and State systems. Effective implementation is key to transforming it from a technical document into a functional national program. The plan urges enhanced coordination, political commitment, and sustained support across all sectors to make a significant impact on AMR in India.