Antimicrobial Resistance: The Silent Threat

Context: Understanding the silent pandemic, that is, Antimicrobial resistance (AMR) and the criticality of concerted efforts needed to address it.

About Antimicrobial Resistance (AMR)

• What is AMR? Phenomenon by which bacteria and fungi evolve and become resistant to presently available medical treatments.
• Associated threats: Already responsible for up to 7,00,000 deaths a year, could lead to an economic crisis of 10 million annual deaths and costs of up to $100 trillion by 2050.
  • Warning by World Health Organization Director-General: AMR is a slow tsunami that threatens to undo a century of medical progress.
  • Medical risks:
    • Existential threat to modern medicine as common surgical procedures, as well as cancer chemotherapy.
    • Neonatal and maternal mortality will increase.
    • The impact will be biased towards low- and middle-income countries (LMICs) of Asia and Africa.

Causes for the emergence of AMR

• Misuse of antimicrobials in medicine.
• Inappropriate use in agriculture.
• Contamination around pharmaceutical manufacturing sites.
• Compounded by research bias: No new classes of antibiotics have made it to market in the last three decades, largely on account of inadequate incentives for their development and production.

Way forward: Tackling AMR

• Developing new antimicrobials: A multi-sectoral $1 billion AMR Action Fund was launched in 2020 to support the development of new antibiotics, and the U.K. is trialling a subscription-based model for paying for new antimicrobials towards ensuring their commercial viability.
• Need for sustained investments and global coordination: As microbes will continue to evolve and become resistant even to new antimicrobials.
• Incentives and sanctions to encourage appropriate clinical use: For e.g.
  • Peru’s efforts on patient education to reduce unnecessary antibiotic prescriptions
  • Australian regulatory reforms to influence prescriber behaviour and initiatives to increase the use of point-of-care diagnostics, such as EU-supported VALUE-Dx programme.
  • Recognise limitations of siloed approach: Efforts to control prescription through provider incentives should be accompanied by efforts to educate consumers to reduce inappropriate demand.
• Ensure access:7 million people worldwide die annually because they cannot access drugs for infections that are treatable.
• Comprehensive surveillance measures: Expand beyond hospitals, encompassing livestock, wastewater and farm run-offs.
  • For E.g. Denmark’s reforms to prevent the use of antibiotics in livestock led to a significant reduction in the prevalence of resistant microbes in animals and improved efficiency of farming.
• Reforms in the legal framework: India recently proposed a law to curb the number of active antibiotics released in pharmaceutical waste.
• International alignment: Using the Paris Agreement as a blueprint for developing a similar global approach to tackling AMR.