G7 meet over Antimicrobial Resistance AMR

In News

• Recently, Group of Seven (G7) countries met at Berlin to join hands against antimicrobial resistance (AMR). 

Major Highlights of the meeting

• Antimicrobial resistance as a bigger threat: Health ministers from the Group of Seven (G7) highly industrialised countries recently recognised antimicrobial resistance was a bigger threat to low- and middle-income countries (LMIC) even though fighting it was a shared responsibility.
• Death and effect on GDP: Nearly 700,000 people die of AMR every year. The toll can rise to as many as 10 million by 2050 and eat up 3.8 per cent of annual global gross domestic product (GDP).
• The G7 committed to establish new international integrated surveillance systems and improve existing ones to monitor AMR and antibiotics use among humans, animals and plants and the effect on the environment.
  • This will be in cooperation with the World Health Organisation, Food and Agriculture Organisation, World Organisation for Animal Health and the United Nations Environment Programme.
• The aim is to enhance the scientific basis to inform risk assessments and identify opportunities for mitigation.
• The group also committed to promote prudent and appropriate use of antimicrobials through 2023 by defining national measurable targets on AMR in line with domestic authorities, including antibiotic usage in human health.

Antimicrobial Resistance (AMR)

• According to WHO, Antimicrobial resistance (AMR) is the ability of a microorganism (like bacteria, viruses, and some parasites) to stop an antimicrobial (such as antibiotics, antivirals and antimalarials) from working against it. As a result, standard treatments become ineffective, infections persist and may spread to others.

Factors Causing AMR in India

• Antibiotic Consumption: Inappropriate consumption of broad-spectrum (last resort) of antibiotics is high because of changing prescription practice in the healthcare system due to the non-availability of a narrow spectrum of antibiotics.
• Social Factor: inappropriate antibiotic use among the general public like
  • Self-medication to avoid the financial burden
  • Doctors may perceive that they are compelled to give antibiotics as patients come with a preconceived idea of quick relief.
  • Nexus between doctors and pharmaceutical companies put pressure on doctors and pharmacists to prescribe new 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.

Challenges Posed by AMR

• Antibiotic resistance is emerging as the threat to successful treatment of infectious diseases, organ transplantation, cancer chemotherapy and major surgeries.
• The issue of AMR causes out of pocket expenditure on health care, especially on medicines. The use of high order drugs or second-line expensive antibiotics pushing treatment cost high.
• Neonates and elderly both are prone to infections and are vulnerable.

Global Concerns

• It is a global health and development threat.
• WHO has declared that AMR is one of the top 10 global public health threats facing humanity.
  • AMR is already responsible for up to 7,00,000 deaths a year.
• Unless urgent measures are taken to address this threat, we could soon face an unprecedented health and economic crisis of 10 million annual deaths and costs of up to $100 trillion by 2050.
• Antibiotics are becoming increasingly ineffective as drug resistance spreads globally leading to more difficult to treat infections and death.

o   All these effects will be felt globally, but the scenario in the low- and middle-income countries (LMICs) of Asia and Africa is even more serious. 

o   LMICs have significantly driven down mortality using cheap and easily available antimicrobials. In the absence of new therapies, health systems in these countries are at severe risk of being overrun by untreatable infectious diseases.

Global Efforts in this Aspect

• Global Action Plan on Antimicrobial Resistance (GAP): Globally, countries committed to the framework set out in the Global Action Plan1 (GAP) 2015 on AMR during the 2015 World Health Assembly and committed to the development and implementation of multisectoral national action plans. 

• Tripartite Joint Secretariat on Antimicrobial Resistance: Tripartite joint secretariat (FAO, OIE and WHO) has been established and is hosted by WHO to drive multi-stakeholder engagement in AMR. 

• Interagency Coordination Group (IACG) on AMR: It was convened by the Secretary-General of the United Nations after the UN High-Level Meeting on Antimicrobial Resistance in 2016. 
  • The IACG brought together partners across the UN, international organisations and individuals with expertise across human, animal and plant health, as well as the food, animal feed, trade to formulate a plan for the fight against antimicrobial resistance.

• World Antimicrobial Awareness Week (WAAW): WAAW was previously called the World Antibiotic Awareness Week. From 2020, it will be called the World Antimicrobial Awareness Week. 
  • 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. 
  • GLASS has been conceived to progressively incorporate data from surveillance of AMR in humans, surveillance of the use of antimicrobial medicines, AMR in the food chain and the environment. 

• 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. 

• By 2025, the partnership aims to develop and deliver five new treatments that target drug-resistant bacteria identified by WHO as posing the greatest threat.

• 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 trialling 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 behaviour, 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 not only led to a significant reduction in the prevalence of resistant microbes in animals, but also improved the efficiency of farming.

India’s Initiative

• To prevent the Over the counter sales of antibiotics, the central drug standard control organisation (CDSO) prohibits medical stores from selling 24 key antibiotics without a doctor’s prescription.
• 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 Health Policy, 2017, terms antimicrobial resistance as one of the key healthcare issues and prioritises the development of guidelines regarding antibiotic use and check on restricting the growth of antibiotics.
• The National Action Plan on Antimicrobial Resistance (NAP-AMR) 2017 has assigned coordinated tasks to multiple government agencies involving health, education, environment, and livestock to change prescription practices and consumer behaviour and to scale up infection control and antimicrobial surveillance.
• FSSAI has set certain guidelines limiting the antibiotics in food products such as fish and honey.

Way Forward

• Infection prevention and control: It will also aim to prepare the upcoming report on infection prevention and control and present it at the World Health Summit.
• The health ministers called on WHO to develop guidance on a cost core package of AMR interventions that all countries, especially LMICs could include to strengthen primary healthcare initiatives.
• A pandemic preparedness pact supported by the G7 health ministers focusing on collaborative surveillance and predictable rapid response is also awaited.
• The ministers also pledged other actions to mitigate climate change and for healthcare.
• Though 90 per cent of countries have developed a multi-sectoral national action plan for AMR, only 20 per cent have identified funding for implementing and monitoring these plans.

Source: DTE