Context

• Antimicrobial resistance (AMR), often also called antibiotic resistance, is a global health challenge and a looming public health crisis. 
• The WHO has declared it as one of the top 10 health threats facing humanity. 

What is AMR?

• Antimicrobial Resistance occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicines making infections harder to treat and increasing the risk of disease spread, severe illness and death. 
• As a result of drug resistance, antibiotics and other antimicrobial medicines become ineffective and infections become increasingly difficult or impossible to treat.
• Microorganisms that have antimicrobial resistance are sometimes called “superbugs”.

What accelerates the emergence and spread of antimicrobial resistance?

• AMR occurs naturally over time, usually through genetic changes. 
• Antimicrobial resistant organisms are found in people, animals, food, plants and the environment (in water, soil and air). They can spread from person to person or between people and animals, including from food of animal origin. 

Other causes

• The main drivers of antimicrobial resistance include: 
  • the misuse and overuse of antimicrobials; 
  • overuse of antibiotics in livestock and fish farming;
  • lack of access to clean water, sanitation and hygiene (WASH) for both humans and animals; 
  • poor infection and disease prevention and control in health-care facilities and farms; 
  • poor access to quality, affordable medicines, vaccines and diagnostics; 
  • lack of awareness and knowledge; and 
  • lack of enforcement of legislation.  

Issues in Tackling AMR

• AMR national action plans (NAPs) have been implemented in several economies including India for human health. However, the development and implementation of antimicrobial plans for animals and the environment that equally impact AMR hasn’t been adequate.
• Though vaccines are a powerful tool to prevent infections and curb the spread of AMR infections, immunization programmes are not comprehensive and exhaustive yet for many infectious diseases. 

How can we effectively fight against AMR?

• Disease prevention and wellness: 
  • Spearheading sanitation drives, ensuring a clean water supply and supporting hospital-driven infection-control programmes can help prevent infections which is equivalent to averting resistance.  
• Appropriate use of antimicrobials: 
  • Reducing AMR also requires prescribing antimicrobials judiciously and only when they are absolutely needed. 
  • Coordination across the animal industry and environmental sectors to prevent the unnecessary use of antibiotics in farms is necessary. 
• Robust surveillance systems: 
  • Development of robust surveillance systems will allow us to detect resistant pathogens of all kinds in the environment and hospitals that would eventually allow containment.
• Research and Development: 
  • It is crucial to invest heavily in research and development through both government and private funding. 

Conclusion

• The cost of AMR to the economy is significant and it is critical to develop policies and implement them through a holistic “One Health” approach.