Lancet Alert on Antibiotics Misuse

Syllabus: GS2/ Health

Context

• According to a Global Research on Antimicrobial Resistance (GRAM) published in Lancet, over 39 crore deaths by antibiotic-resistant infections are estimated to occur worldwide by 2050. 

What is Antimicrobial Resistance?

• Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death. 
• Antibiotic resistance is emerging as the threat to successful treatment of infectious diseases, organ transplantation, cancer chemotherapy and major surgeries.

Key highlights of report

• The report mentioned that in India, bacterial AMR deaths are associated with or attributable to six major superbugs: Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Acinetobacter baumannii, Mycobacterium tuberculosis, and Streptococcus pneumoniae. 
• Each year between 1990 and 2021, more than 10 lakh people died worldwide as a direct result of AMR.
  • However, in the same period, the total number of AMR deaths globally among children under five declined by 50 percent, while that among people aged 70 years and above increased by more than 80 percent. 
• As many as 6,86,908 deaths in India in 2019 were associated (indirectly linked) with these superbugs, and 2,14,461 deaths attributable (directly linked) to them the same year
• In 2019, 2.9 lakhsepsis deaths in India Were directly linked to AMR.
  • Sepsis deaths occur when one’s immune system has a dangerous reaction to a bacterial infection and without treatment, can lead to organ failure.

Causes for Antimicrobial Resistance

• Overuse and Misuse of Antibiotics: The excessive and inappropriate use of antibiotics in humans and animals is a major driver of antimicrobial resistance.
  • A survey on prescribing trends for antibiotics released by the National Centre for Disease Control (NCDC) in 2023 found that 71.9% of patients coming to hospitals were prescribed antibiotics on average.
• Inadequate Dosage and Duration: When antibiotics are not taken in the correct dosage and for the recommended duration, it can lead to incomplete eradication of the targeted microorganisms, allowing the surviving bacteria to develop resistance.
• Self-Medication: Self-prescription without proper medical guidance contributes to the misuse of antibiotics. 
• Antibiotics Consumption in Food-Animals: Use of antibiotics as growth promoters in food animals and poultry is a common practice and later it evolves in the food chain.
• Poor Sanitation: The large proportion of sewage is disposed of untreated into receiving water bodies, leading to gross contamination of rivers with antibiotic residues, antibiotic-resistant organisms.

Global Efforts against Antimicrobial Resistance 

• Global Action Plan on Antimicrobial Resistance (GAP): Globally, countries committed to the framework set out in the Global Action Plan (GAP) 2015 on AMR during the 2015 World Health Assembly and committed to the development and implementation of multisectoral national action plans. 
• World Antimicrobial Awareness Week (WAAW): It is a global campaign that aims to raise awareness of antimicrobial resistance worldwide.
• Global Antimicrobial Resistance and Use Surveillance System (GLASS): WHO launched it  in 2015 to continue filling knowledge gaps and to inform strategies at all levels. 
• Global Antibiotic Research and Development Partnership (GARDP): A joint initiative of WHO and the Drugs for Neglected Diseases Initiative (DNDi), GARDP encourages research and development through public-private partnerships. 
• Country wise initiatives:A multi-sectoral $1 billion AMR Action Fund was launched in 2020 to support the development of new antibiotics, and the U.K. is trialing a subscription-based model for paying for new antimicrobials towards ensuring their commercial viability.
  • Peru’s efforts on patient education to reduce unnecessary antibiotic prescriptions.
  • Australian regulatory reforms to influence prescriber behavior, and initiatives to increase the use of point-of-care diagnostics, such as the EU-supported VALUE-Dx programme.
  • Denmark’s reforms to prevent the use of antibiotics in livestock have led to a significant reduction in the prevalence of resistant microbes in animals.

Measures Taken against Antimicrobial Resistance in India 

• National Action Plan on Antimicrobial Resistance (NAP-AMR): It has a focus on the One Health approach & was launched with the aim of involving various stakeholders ministries/departments.
• AMR Surveillance Network: Indian Council of Medical Research (ICMR) established the AMR surveillance and research network (AMRSN) to generate evidence and capture trends and patterns of drug resistant infections in the country.
• India’s Red Line campaign: Which demands that prescription-only antibiotics be marked with a red line, to discourage the over-the-counter sale of antibiotics– is a step forward.
• National Antibiotic Consumption Network (NAC-NET): The network sites compile data on antibiotic consumption in their respective health facilities and send it to National Centre for Disease Control (NCDC).
• The Kerala Drug Control Department launched Operation AMRITH (Antimicrobial Resistance Intervention for Total Health) to prevent the overuse of antibiotics in the state.

Concluding remarks

• Antimicrobial medicines are one of the cornerstones of modern healthcare, and increasing resistance to them is a major cause for concern.
• Understanding how trends in AMR deaths have changed over time, and how they are likely to shift in future, is vital to make informed decisions to help save lives.

Source: IE