India’s Action Plan on antibiotic resistance (AMR) has made limited progress, finds CSE study

The country must beef up efforts to contain AMR from animal and environmental sources. The Centre for Science and Environment (CSE) assesses India’s Action Plan on Antimicrobial Resistance (AMR); highlights that limited progress has taken place on only a few critical activities to contain AMR from animal and environmental sources

Antimicrobial resistance
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The CSE assessment states that by now:

  • Laws and systems should have been in place to control use of antibiotics as growth promoters through feed and to track sale and use of antibiotics in food animal production
  • Roadmap should have been finalised to phase out use in animals of antibiotics that are critically important for humans, and to stop antibiotic misuse happening in the name of mass disease prevention in livestock and fisheries

A lot of ground should have been covered in strengthening laboratories, developing capacity and finalising mechanisms and modalities for nation-wide AMR surveillance in food, animals and environment sectors

Calls for stringent limits on antibiotic discharge in pharmaceutical effluents; regulations and measures to ensure appropriate farm waste management, drug take-back and disposal

Seeks greater clarity on costs involved, dedicated budget for AMR and status of the National Authority for Containment of Antimicrobial Resistance

Urges states to come forward with their state action plans as Kerala has done – without active participation by states, implementation on the ground would be impossible.

As the world observes the ‘World Antibiotic Awareness Week’ from November 12-18, aimed at increasing global awareness of antibiotic resistance (AMR), Centre for Science and Environment (CSE) has done an assessment of India’s National Action Plan on Antimicrobial Resistance (2017-21) – the assessment finds limited progress on only a few critical activities to contain AMR from animal and environmental sources.

“Even after a year and a half after India’s National Action Plan on Antimicrobial Resistance (2017-21) came into being, there is at best limited progress on only a few critical activities to contain AMR from animal and environmental sources. Many of these were planned to be completed within a year. India is going to be heavily impacted by the AMR crisis and we cannot afford such delays,” says Chandra Bhushan, deputy director general, CSE.

The Indian action plan was released in April 2017 along with the ‘Delhi Declaration on Antimicrobial Resistance’ endorsed by 12 stakeholder ministries.

Antimicrobial Resistance (AMR): A clear and present danger

  • Resistance to antibiotics is now recognised as a public health threat of an unprecedented scale.
  • Antibiotics are increasingly becoming ineffective. Common infections and diseases, which were earlier treatable, are now becoming difficult to treat.
  • Globally, it is expected to lead to a 3.8 per cent loss in GDP and 10 million deaths annually by 2050.
  • Besides antibiotic use in human health, overuse and misuse of antibiotics in producing food from animals such as chicken meat, eggs, milk and fish is a key cause behind rising AMR.
  • India will be heavily impacted by it due to its huge burden of infectious diseases, large-scale food animal production using antibiotics, and inadequate healthcare systems.

CSE researchers also point out that poor management of waste — which can contain antibiotics, antibiotic-resistant bacteria or genes transferring resistance – from farms, pharmaceutical factories, healthcare settings and households adds to the emergence and spread of AMR.

Many countries – such as those in the European Union – have already set up the necessary regulatory frameworks to address antibiotic misuse in animals. “India still does not have laws and systems to control use of antibiotic growth promoters in animal feed, or those which would help track the sale and use of antibiotics in food animals. All we have so far is a Central government advisory, which cannot be enforced in states,” says Amit Khurana, programme director, food safety and toxins, CSE.

“What India also needs is a clear roadmap for two things – one, to phase out use in animals of antibiotics which are critically important for humans, and two, to stop antibiotic misuse for mass disease prevention,” adds Khurana.