Antibiotics are one of most revolutionary discoveries of modern science. Ever since their accidental discovery by Alexander Fleming (1928), antibiotics have completely transformed medicine. By virtue of their lethal and selective action against pathogenic microbes, they have contributed to the dramatic extension of human lifespan. But in recent years pathogens have advanced their defences to fight against antibiotics. Thus even our powerful arsenal of antibiotics weapons accumulated over decades seems to fall short in this war against pathogens. Superbugs or microorganism with antibiotic resistance has emerged as a new threat to humanity. The world is now transitioning into a “post-antibiotic era” where common infections and minor injuries will become deadly once again, due to increasing “Anti-Microbial Resistance” (AMR) of microbes. As a result, many lives are being lost due to deadly infections caused by continuously evolving strains which are beyond our capabilities to eradicate or to prevent their spreading.
A superbug, also called multi resistant, is a bacterium that carries several resistance genes. These are resistant to multiple antibiotics and are able to survive even after exposure to one or more antibiotics.
The WHO defines antimicrobial resistance as a microorganism’s resistance to an antimicrobial drug that was once able to treat an infection by that microorganism.
The natural resistance in certain types of bacteria.
The genetic mutation.
By one species acquiring resistance from another
Like all other living organisms, bacteria can mutate and evolve as they multiply. So, over time, a select few will mutate in particular ways that make them resistant to antibiotics. And thus, when antibiotics are introduced, only the bacteria that can resist that treatment can survive to multiply further, proliferating the line of drug-resistant bugs.
The rising consumption of antibiotics is a major contributor. The microbes can develop drug resistance when people take incorrect doses of antibiotics. Resistant strains can then be contracted directly from animals, water, air or other people.
India is presently facing a dual challenge of overconsumption of antibiotics breeding drug-resistant bacteria while ensuring that the poor and vulnerable have easy access.
The lack of access or delayed access to effective antibiotics is causing more deaths in India than from drug-resistant bacteria.
What are the reasons for the recent increase in the use of antibiotics in India?
The reasons for the sharp increase in antibiotic use are as follows:
India has one of the world’s highest infectious disease burdens and inappropriate and irrational use of antimicrobial agents against these diseases, leading to increasing in development of antimicrobial resistance.
The health sector in India suffers from gross inadequacy of public finance which will result in the conditions favourable for the development of drug resistance. The burden of poor sanitation and malnutrition exacerbates these conditions.
In India, around 5% of GDP is spent on health out of which public health sector contributes to 0.9% and rest is covered by the private health sector. Again around 80% share of private health sector contribution comes from out of pocket expenditure mostly for medicines.
On top of it, AMR can further increase out of the pocket expenditure and accelerate the incidence of poverty. The patient remains sick for a longer period thus requiring prolonged treatment usually with expensive and at times toxic drugs which results in increased morbidity and mortality. Thus the burden on the health system also increases.
Hospital-acquired infection (NOSOCOMIAL INFECTIONS) in vulnerable patients with resistant strains is another major threat in the Indian context. This can undermine the thrust toward achieving SDG.
Various laboratories in India reveal an increasing trend of development of resistance to commonly used antimicrobials in pathogens like Salmonella, Shigella, Vibrio cholerae, Staphylococcus aureus, Neisseria gonorrhoeae, N. meningitis, Klebsiella, Mycobacterium tuberculosis, HIV, Plasmodium and others.
In India, 60,000 newborns die each year of Antibiotic-Resistant Neonatal Infections. Around 70 percentage of diarrhoeal illness is caused by viral infections, against which antibiotics are ineffective. But for diarrhoea treatment antibiotics are used frequently. Nearly 500 million antibiotics courses are used each year to treat diarrhoea in India, Indonesia, Nigeria and Brazil. The Universal access to improved water and sanitation could reduce this by 60 per cent.
What has India done to tackle the problem of AMR?
In line with the WHO’s GLOBAL ACTION PLAN ON AMR, India has formulated a NATIONAL ACTION PLAN ON ANTIMICROBIAL RESISTANCE with following components :
The NAP-AMR outlines the priorities and interventions planned to be implemented over 2017 –2021 to tackle the public health challenge of AMR in India
It is estimated that the prevalence of Multi-Drug-Resistant Tuberculosis (MDR-TB) in India is 2-3%among the new pulmonary TB patients and around 15% for re-treatment pulmonary TB patients. There are numerous challenges that we need to overcome in order to cope up with the menace of antimicrobial resistance in superbugs. Some of them being: strengthening of surveillance data, the establishment of standard operating guidelines, improving antibiotic prescription practices and stopping self-medication and over the counter sale of antibiotics, addressing poor sanitation, endemic infections, malnutrition and limited public awareness & government commitment, lack of coordination & fragmentation of effort etc.
Way out lies in effectively overcoming the above-mentioned challenges to tide over the looming destructive consequences. We also need to focus on research related to public health aspects of AMR at community and hospital level. India will need a revamped healthcare system in place to provide optimum treatment to its population and manage the extensive risks posed by the superbugs. Nations all over the world need to come together and urgently address the indiscriminate use of antibiotics as superbugs are being transmitted across international borders. The research on the next generation of drugs is also required to be fast-tracked in the meantime.
We provide quality UPSC Coaching in Chandigarh. For all your queries regarding the class structure, material and mentorship for our programmes concerned with PCS Coaching in Chandigarh, HCS Coaching in Chandigarh and similar civil services coaching in Chandigarh region and beyond, you can contact us directly at o2iasacademy to avail professional quality IAS Coaching in Chandigarh. O2iasacademy wishes you all the best for your preparation