Editorials/Opinions Analysis For UPSC 03 March 2022
- The lingering pandemic
The lingering Pandemic
Improper use of antimicrobials amongst Covid-19 patients have become common since the pandemic stuck. It has raised concerns about drug-resistant infections.
GS-II: Health, Government Policies & Interventions
Dimensions of the Article:
- AMR and COVID-19
- Antimicrobial Resistance in India
- GRAM report
- AMR burden and its control
- Way Forward
AMR and COVID-19:
- The COVID-19 pandemic has raised concerns about the improper use of antimicrobials amongst Covid-19 patients.
- The unnecessary prescription of antimicrobials will lead to a further increase in the already high levels of drug resistance in most parts of the world.
Antimicrobial Resistance in India:
- Insufficient data:
- India, in the past has witnessed alarmingly high resistance rates in pathogens of public health importance
- However, the resistance rates reported by the hospitals and laboratories do not automatically translate to disease burden unless each resistant isolate is correlated with the clinical outcomes in the patients from whom they were isolated.
- This is mainly attributed to the inadequate hospital information systems in most public sector funded healthcare facilities in India and many low-middle income countries.
- The major impediment to AMR containment is that the most affected countries have the least data on the burden posed by this.
- In 2014, economist Jim O’ Neill estimated that 10 million annual deaths from AMR could occur by 2050.
- This study led to the consolidation of Global Action Plan in 2015 and the UN Resolution on AMR in 2016.
- However, significant change is yet to occur.
- National Action Plans against AMR: This initiative in India to combat Antimicrobial Resistance was not been translated into coherent action.
- What are the impediments in its implementation: Too many players, missing governance mechanisms and absence of funding have been recognised as key impediments to the effective rollout of action plans. This was witnessed in other countries as well.
The “Global burden of bacterial antimicrobial resistance in 204 countries and territories in 2019 (GRAM)” report, was released recently.
It provides the most comprehensive estimate of the global impact of antibiotic resistance to date.
- The report finds that AMR is the most burdensome infectious syndrome.
- Bacterial infections:
- Around 4.95 million people died from drug-resistant bacterial infections in 2019, with 3,89,000 deaths in South Asia alone.
- AMR directly caused at least 1.27 million of those deaths.
- Pathogenic Infections:
- Amongst pathogens, E coli was responsible for the most deaths in 2019, followed by K pneumoniae, S aureus, A baumannii, S pneumoniae, and M tuberculosis.
- As per the Indian Council of Medical Research since 2015, India reports a high level of resistance in all these pathogens, especially E coli and K pneumoniae.
- India has been reporting high levels of resistance to fluoroquinolones, cephalosporins and carbapenems across the Gram-negative pathogens that cause almost 70 per cent of infections in communities and hospitals.
- Lower respiratory infections accounted for more than 1.5 million deaths associated with resistance in 2019.
AMR burden and its control:
- There is urgency in containing the resistance as the burden of AMR is higher than that of TB and HIV.
- Since there are no drugs for treating drug-resistant infections, it is crucial to find a quick solution.
- However, this requires a multipronged and multisectoral approach.
- The urgency to develop new drugs should not discourage us from instituting measures to use the existing antimicrobials judiciously.
- Methods to control Antimicrobial Resistance:
- Improved infection control in communities and hospitals,
- Availability and utilisation of quality diagnostics and laboratories and
- Educating people about antimicrobials
- There is a need to launch effective AMR containment plans by fixing responsibility and monitoring progress at the highest levels.
- Various interventions like infection control, improved diagnosis and antimicrobial stewardship are effective in the containment of AMR.
- However, this requires a comprehensive plan, driven by a designated coordinating agency backed with suitable funding.
- A delayed response to contain anti-microbial resistance could prove costly.
-Source: The Hindu