For the fourth time in its history, the heads of states gathered for the UN General Assembly meeting will discuss a burning global health issue that needs to be addressed on a war footing. The rising antimicrobial resistance (AMR), seen in new strains of drug-resistant bugs, will be taken up at the General Assembly on September 13, the fourth health concern after Ebola, non-communicable diseases and HIV.
At the UNGA, India, already in the spotlight for misuse of antibiotics, will have to submit and have in place national action plans to combat AMR as outlined in the resolution adopted at the 68th World Health Assembly, held in 2015 (WHA 68.7), which should be accompanied by surveillance data on causes, prevalence and impacts of antibiotic. India formulated its own national policy on tackling drug resistance in 2011. However, according to the public health professionals at the MSF meeting on AMR in Delhi, the implementation leaves a lot to be desired.
The country is one of the largest consumers of antibiotics, with a massive unregulated market, over the counter sale of medicines, contributing significantly to rising resistance to drugs. Speaking to the press this week, the India chapter of Medicines Sans Frontiers drove home the importance of regulating drugs in India and implementing a working system of surveillance.
AMR, which occurs when disease causing organisms become resistant to existing antibiotics, can push the world into a post antibiotic age, if it goes unchecked; a state the world has not known since the introduction of penicillin in 1950s, which markedly increased survival rates of patients. India, New Delhi specifically, has already given to the world a strain of drug-resistant superbug— the New Delhi metallo-β-lactamase (NDM) enzymes—found in the capital in 2008 and now spread worldwide.
According to the science journal PLOS, India was the largest consumer of antibiotics in 2010. The journal points out the lacunae in India’s health systems, trailing immunisation programme, doctors prescribing more antibiotics because of incentives from pharmaceutical companies, and the prevalence of irrational fixed dose combination medicines. The latter, at least, India’s drug regulator has started banning in batches.
As studies by the Centre for Science and Environment showed at the MSF briefing, antibiotics are being introduced in the system not just through poor usage, but also through foods such as honey and chicken. MSF and CSE said that there was not country-level surveillance programme to monitor these practices, neither for humans nor animals.
