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.
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.