Introduction

The Government has introduced the second iteration of the National Action Plan on Antimicrobial Resistance (NAP-AMR) in response to escalating resistance to antibiotics across sectors. While version 1 generated marginal gains and placed AMR on India’s health agenda, its sluggish implementation led to persistent misuse of antibiotics, weak state collaboration, and rising resistance. New evidence, including the 2023 WHO Global Antibiotic Resistance Surveillance report, confirms the urgency for renewed stewardship and a strengthened One Health strategy.

Why in the News?

 India has launched Version 2 of the National Action Plan on AMR amid alarming data that in 2023, one in three bacterial infections in India showed resistance to commonly used antibiotics, against one in six globally. The spike comes despite NAP-AMR (2017–21), revealing that implementation, not intent, is the major roadblock. The new plan is a crucial attempt to arrest a humongous health, veterinary and environmental crisis before last-line antibiotics become fully ineffective.

Why did Version 1 of NAP-AMR fall short?

1. Sluggish implementation: Raised the profile of AMR nationally but failed to translate into coordinated ground-level action.
2. Weak state participation: Only a few states formulated policies; Kerala alone implemented effectively, registering a slight drop in AMR levels.
3. Narrow ecosystem focus: Neglect of veterinary, environment, agriculture and aquaculture vectors.
4. Enforcement gaps: Despite a ban on Colistin as a growth promoter in the husbandry sector, misuse continued in varying degrees.

How serious is AMR in India today?

1. High disease burden: High infectious disease load increases antibiotic exposure and accelerates resistance.
2. Overuse and misuse: Indiscriminate use in healthcare and self-medication remain widespread.
3. Critical pathogens advancing: E. coli and Klebsiella pneumoniae show high resistance to critical antibiotics, rendering last-line drugs ineffective.

Why has AMR become a multi-sectoral challenge?

1. Agriculture & husbandry: Growth promoters and preventive antibiotic usage fuel microbial resistance.
2. Veterinary medicine: Improper prescription and uncontrolled access to antibiotics.
3. Soil & water contamination: Antibiotic residues affect ecosystems and re-enter human food chains.
4. Aquaculture & food processing: Residues facilitate community-level resistance.

Why is One Health no longer optional?

1. Integrates human, animal and environmental health to handle widespread resistance emerging across the food chain and biosphere.
2. Breaks inter-sectoral silos to ensure synchronised surveillance and regulation.
3. Guides community-level resistance mitigation, not just tertiary hospitals.

What must Version 2 achieve to succeed?

1. Strong antibiotics stewardship programmes across community and hospital settings.
2. Reliable nationwide surveillance network beyond pandemic-led laboratory expansion.
3. State partnership and compliance mechanisms rather than voluntary policy uptake.
4. Accountability measures for misuse in human healthcare, veterinary practice and agriculture.

Conclusion

India stands at a critical point where policy intent must translate into enforceable implementation. The success of NAP-AMR (Version 2) depends on strong stewardship, inter-state coordination, and an uncompromising One Health approach. Without systemic commitment, antibiotic resistance risks becoming the defining public health disaster of the decade.

PYQ Relevance

[UPSC 2014] Can overuse and free availability of antibiotics without Doctor’s prescription, be contributors to the emergence of drug-resistant diseases in India? What are the available mechanisms for monitoring and control? Critically discuss the various issues involved.

Linkage: This question is directly relevant as India faces one of the world’s highest AMR burdens driven by misuse and over-the-counter sale of antibiotics. It links to National Action Plan on AMR (Version 2), antibiotic stewardship, surveillance gaps, and public health governance.

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