Rapidly rising antimicrobial resistance (AMR) poses the threat of the next health crisis if not addressed with urgency. The article examines the severity of the issue.

The severity of the antimicrobial resistance (AMR)

• Globally, about 35% of common human infections have become resistant to available medicines.
• About 700,000 people die every year because available antimicrobial drugs — antibiotics, antivirals, antiparasitic and antifungals — have become less effective at combating pathogens.
• Resistance to second- and third-line antibiotics — the last lines of defence against some common diseases — are projected to almost double between 2005 and 2030.
• In India, the largest consumer of antibiotics in the world, this is a serious problem.

Responsible factors

•  Microorganisms develop resistance to antimicrobial agents as a natural defence mechanism.
• Human activity has significantly accelerated the process.
• The misuse and overuse of antimicrobials for humans.
• Livestock and agriculture but other factors also contribute.

Research points  to role of environment and pollution

• Once consumed, up to 80% of antibiotic drugs are excreted un-metabolised, along with resistant bacteria.
• Their release in effluents from households and health and pharmaceutical facilities, and agricultural run-off, is propagating resistant microorganisms.
• Wastewater treatment facilities are unable to remove all antibiotics and resistant bacteria.
• In India, there is capacity to treat only about 37% of the sewage generated annually.
• Water, then, may be a major mode for the spread of AMR, especially in places with inadequate water supply, sanitation and hygiene.
• Wildlife that comes into contact with discharge containing antimicrobials can also become colonised with drug-resistant organisms.

Initiative to tackle the AMR

• The United Nations Environment Programme (UNEP) identified antimicrobial resistance as one of six emerging issues of environmental concern in its 2017 Frontiers Report.
• UN agencies are working together to develop the One Health AMR Global Action Plan (GAP) that addresses the issue in human, animal, and plant health and food and environment sectors.
• The Ministry of Environment, Forest and Climate Change (MoEF&CC) issued draft standards which set limits for residues of 121 antibiotics in treated effluents from drug production units.
• The Ministry of Health and Family Welfare and MoEF&CC constituted the inter-ministerial Steering Committee on Environment and Health, with representation from WHO and UNEP.

Way forward

• The Centre and State governments in India can strengthen the environmental dimensions of their plans to tackle antimicrobial resistance.
• It is important to promote measures that address known hotspots such as hospitals and manufacturing and waste treatment facilities.

Consider the question “Being the largest consumer of antibiotics in the world, India faces a grave threat from growing anti-microbial resistance. What are the factors responsible for it? Suggest the ways to deal with it.”

Conclusion

We saw how quickly a pandemic can spread if we are not ready. This is an opportunity to get ahead of the next one.

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