Antimicrobial resistance: the silent threat

Excellent study material for all civil services aspirants - begin learning - Kar ke dikhayenge!

Antimicrobial resistance: the silent threat

---

Read more on - Polity | Economy | Schemes | S&T | Environment

---

• The Covid shock: From 2020, the whole world, including the rich countries, has seen how fragile the health systems really are. It is clear from the damage done by Covid-19 pandemic that cross-border cooperation between states is critical for disease surveillance and control. No global health security is possible otherwise.
• The AMR challenge: Just like the pandemic came suddenly, the challenge brewing slowly and steadily has been AMR - Anti Microbial Resistance. Here, microbes (bacteria, fungi) evolve to become more resistant to existing medications. It's the ultimate challenge for 21st century.
• Slow tsunami: The Covid crisis was a sudden tsunami, but the AMR is a slow one, capable of undoing all medical progress since 1940s.

1. Annually, more than 7 lakh die of AMR today, globally
2. The health and economic crises could grow rapidly in near future, unless controlled now

• Nature of problem: If doctors do not have effective antimicrobials to treat infections (bacterial or fungal), the most normal surgical procedures will become impossible, and also chemotherapy. 

1. Neonatal and maternal mortality will rise rapidly, most in low and middle income countries of Africa and Asia
2. If new medicines and therapies don't arrive quickly, untreatable infections will overrun these countries

• Why drug resistance: Microbes develop resistance due to many reasons - (i) Misuse of antimicrobials in medicine, (ii) Excess use in agriculture, and (iii) untreated waste release from pharmaceutical factories (active antimicrobials enter the environment).

1. Microbes face evolutionary pressure and begin evolving into resistant strains
2. If in parallel new antibiotics do not enter the market, a big space is created for the microbes to flourish (large pharma firms have given up on antibiotics for the moment, and only small ones are trying)

• What to do: First, develop new antimicrobials. Then, ensure infection control measures (so fewer antibiotics are needed). Use only appropriately in clinics. Ensure these reach those who actually deserve it (perhaps 57 lakh die annually due to no access). Constant surveillance of evolving AMR in hospitals, livestock, wastewater and farm run-offs needs to be done. And invest in newer (and newer) antimicrobials because microbes will never stop evolving.
• AMR Action Fund: This was launched in 2020 with a $1 billion funding, for developing new antibiotics. UK govt. is paying upfront for new ones that get developed (thereby giving incentives before actual production, to ensure that R&D happens). Peru is educating patients about the right way to use antibiotics, and avoid when not needed. Australia is regulating prescriptions. Denmark has hugely reduced unnecessary use in livestock. India is regulating to minimise waste discharge that carries such active antibiotics.
• Siloed approach: Sadly, all these are disconnected, individual initiatives. So in India, if clinical prescriptions are regulated harshly, it won't matter much as the patient demand is so high, that these antimicrobials are freely available over-the-counter (OTC). So consumer education is a must, in parallel. 
• Policy alignment: While focus is on clinics, it has to be integrated with surveillance in agriculture, animal health, and environment. So it's not only the health authorities, but others like those in agriculture, and trade & commerce, that have to get involved.
• Summary: The world knows there's a real problem called AMR, and this silent pandemic needs a strong cure urgently.

Read more on - Polity | Economy | Schemes | S&T | Environment

Join UPSC Self Prep course | Online Course (PT Gurukul)  | Covid Special Course | Join PT courses

* Content sourced from free internet sources (publications, PIB site, international sites, etc.). Take your own subscriptions. Copyrights acknowledged.