Antimicrobial Resistance (AMR): A Silent Pandemic Threatening Global Health

What is Antimicrobial Resistance?

Antimicrobial Resistance (AMR) occurs when microorganisms such as bacteria, viruses, fungi, and parasites evolve to resist the effects of medications that once killed them or halted their growth. This phenomenon leads to standard treatments becoming ineffective, prolonged illnesses, higher healthcare costs, and increased mortality.

Antibiotics, which once revolutionized medicine, are now under threat due to the relentless rise of resistance. Misuse and overuse of these life-saving drugs in humans, animals, and agriculture have accelerated the spread of AMR globally.

The Global Burden of AMR

The statistics are alarming:

• In 2019, AMR was directly responsible for 1.27 million deaths and contributed to 4.95 million deaths worldwide.

• If unchecked, AMR could kill up to 10 million people annually by 2050, surpassing the mortality of diseases like cancer and diabetes.

WHO's Global Initiatives Against AMR

To counter this global crisis, the World Health Organization (WHO) has initiated several key programs:

1. Global Action Plan (GAP) on AMR (2015)
   Encourages all countries to develop National Action Plans under the One Health approach, linking human, animal, and environmental health.

2. Global Antimicrobial Resistance and Use Surveillance System (GLASS)
   As of 2024, 130 countries had enrolled, with 104 submitting national AMR data. This initiative helps track and understand global AMR trends.

3. Bacterial Priority Pathogens List (BPPL) – 2024 Update
   Identifies 15 bacterial families in three priority groups (critical, high, and medium), guiding global R&D in developing new antibiotics.

4. World AMR Awareness Week (WAAW)
   Celebrated every year from November 18–24. The 2024 theme was “Educate. Advocate. Act now.”—stressing the urgency of AMR action.

5. United Nations AMR Declaration (2024)
   In a historic step, global leaders at the UNGA committed to reducing AMR deaths by 10% by 2030 through stronger surveillance, stewardship, and investment.

India and AMR: A Critical Frontline

India bears a disproportionate burden of AMR due to:

• Widespread antibiotic misuse in both humans and livestock.

• Lack of regulation on over-the-counter antibiotic sales.

• Inadequate sanitation and infection control in healthcare settings.

Shocking Data

• In 2019, approximately 297,000 deaths in India were directly attributable to AMR.

• A 2024 study in Ahmedabad revealed 18 drug-resistant typhoid strains—the largest ceftriaxone-resistant cluster recorded in India to date.

India’s Response: Policies, Innovations & Partnerships

National Action Plan on AMR (NAP-AMR), 2017

India’s NAP-AMR follows WHO’s One Health vision and includes 6 core strategic areas:

1. Improve Awareness and Education

2. Strengthen Surveillance

3. Improve Sanitation and Hygiene

4. Optimize Antibiotic Use

5. Promote R&D for AMR Solutions

6. Strengthen National and International Cooperation

 Scientific Innovations

• Nafithromycin: India’s first indigenous antibiotic developed to treat drug-resistant respiratory infections.

• Phage Therapy: Dr. Jyot Antani at Yale University, originally from Ahmedabad, is pioneering bacteriophage research to target superbugs using microscopic viruses.

• Microscopic Phage Adsorption (MPA) Assay: A new test developed by Dr. Antani’s team to assess the efficiency of phage therapies against drug-resistant bacteria.

Global and Regional Partnerships

• India has signed bilateral agreements with countries like Denmark to strengthen AMR surveillance, stewardship, and innovation.

• Collaboration with WHO and FAO to address AMR across agriculture, water, sanitation, and human health sectors.

The Way Forward: What We Must Do

For Policymakers:

• Enforce strict antibiotic prescription policies.

• Expand AMR surveillance and diagnostic capabilities.

For Healthcare Providers:

• Follow rational antibiotic use protocols.

• Implement strong infection prevention practices.

For the Public:

• Avoid self-medication with antibiotics.

• Maintain good hygiene and complete prescribed antibiotic courses.

AMR is not just a medical issue; it's an environmental, agricultural, economic, and societal challenge. While India has taken strong steps—from policy to innovation—the road ahead requires sustained action, global cooperation, and mass public awareness.

Let us commit to preserving the power of antibiotics—for ourselves, and for future generations.