Antibiotics Resistance

The challenge of Antimicrobial Resistance (AMR), and how to confront it effectively


From UPSC perspective, the following things are important :

Prelims level: Antimicrobial Resistance and various diseases caused by pathogens

Mains level: Rising Antimicrobial Resistance, concerns and measures

What’s the news?

  • Antimicrobial Resistance (AMR) is today reckoned among the most ominous threats confronting Global Public Health. There is an urgent need for a collective and comprehensive approach to address the global threat of AMR and the role of various stakeholders in prevention, control, and surveillance efforts is crucial.


  • Antimicrobial resistance, means that certain drugs that were once effective in treating infections caused by bacteria, viruses, fungi, or parasites no longer work because the pathogens have become resistant to them.
  • In simpler terms, it is when the germs that make us sick become “immune” to the medicines we use to treat them.

Prevalence of AMR

  • According to recent estimates, in 2019, 1.27 million deaths were directly attributed to drug-resistant infections globally. By 2050, up to 10 million deaths could occur annually.
  • If unchecked, AMR could shave US$ 3.4 trillion off GDP annually and push 24 million more people into extreme poverty in the next decade.
  • A 2022 study by the Indian Council of Medical Research (ICMR) revealed that resistance to broad-spectrum antimicrobials increases by 5% to 10% every year.

AMR: A concern for global public health

  • Rising Resistance: The infections caused by the pathogens including bacteria, viruses, fungi, and parasites, are increasingly developing resistance to antimicrobial drugs which is becoming more challenging to treat effectively.
  • Treatment Failures: AMR can lead to treatment failures, as commonly used antibiotics, antivirals, antifungals, and antiparasitic drugs may no longer be effective against resistant strains.
  • Healthcare Impact: AMR increases the complexity and cost of treatment, prolongs hospital stays, and requires the use of stronger and more expensive drugs. Healthcare-associated infections caused by drug-resistant pathogens are a particular concern.
  • Limited Drug Pipeline: The development of new antimicrobial drugs has slowed down in recent years. There is a lack of new effective treatments to replace those that are losing effectiveness due to resistance.
  • Global Spread: AMR is a global issue that knows no boundaries. Resistant pathogens can spread between countries through travel and trade, and international cooperation is crucial.

Current Scenario of AMR prevention and National Action Plans

  • Over the last ten years, the prevention, control, and response to AMR has been a high priority for most national governments, international organisations (such as the WHO, FAO, OIE), healthcare communities, and civil society, etc.
  • The WHO’s global action plan (GAP) was adopted by member nations in 2015.
  • National action plans have been prepared by many countries.
  • India’s NAP was approved in 2017. It is understood that NAP 2.0 is now envisaged.
  • In 2015, the WHO launched the Global Action Plan (GAP) on AMR, which provides a strategic framework for countries to develop their national action plans.
  • AMR is an important priority in the G20 health agenda under India’s presidency.

India’s national action plan to combat AMR

  • Coordinated Action: India’s NAP emphasizes coordinated action by the government and non-government sectors. It involves a whole of government approach, involving sectors like Health, Animal Husbandry, Fisheries, Agriculture, Dairy, Pharmaceuticals, and Biotechnology.
  • Advocacy and Awareness: The plan focuses on advocacy and awareness-building activities to educate healthcare professionals, policymakers, and the general public about responsible antimicrobial use and AMR prevention.
  • Community Involvement: India’s NAP It emphasizes engaging and empowering communities to promote responsible use of antimicrobials.
  • Infection Prevention and Control: The NAP emphasizes infection prevention and control measures to reduce the spread of AMR. This includes promoting appropriate hygiene practices and implementing infection control protocols in healthcare settings.
  • National AMR Surveillance Network (NARS Net): India has established the National AMR Surveillance Network to monitor and track the prevalence and patterns of AMR across the country. This surveillance system helps in generating data for evidence-based interventions.
  • Research and International Collaboration: India’s NAP emphasizes the importance of research on AMR and encourages international collaboration in this field.

Need for a concerted, combined effort to address AMR

  • One Health Approach: AMR requires a One Health approach, recognizing the interconnectedness of human health, animal health, and the environment. Collaborative efforts among human and veterinary healthcare sectors, agriculture, environmental agencies, and other stakeholders are necessary to tackle AMR comprehensively.
  • Stakeholder Involvement: The sectors responsible for food, drinking water, and the environment should share equal ownership in addressing AMR. Regulating antibiotic access and usage in non-human consumption sectors, such as animal husbandry and poultry, is vital.
  • State and Local Engagement: Implementation of infection control measures, regulation of pharmacies, treatment of sewage and pharmaceutical effluents, and AMR surveillance are primarily implemented at the state level.
  • Environmental Considerations: Efforts should be made to prevent the contamination of the environment by untreated wastewater and effluents, including those from antibiotics manufacturing units and healthcare facilities. Effective sanitation and waste treatment infrastructure are necessary to combat AMR.
  • Surveillance and Data: Robust surveillance systems are crucial to monitor AMR patterns and trends. Collecting and analyzing data on antimicrobial use, resistance prevalence, and treatment outcomes helps inform evidence-based interventions.

What’s more?

  • Parallel efforts on a war footing are needed for the discovery and commercialisation of new antibiotics and new antimicrobials. Such efforts must be incentivised.
  • Social media and its numerous platforms have captured the imagination of people around the world. The influence of social media on our mind and behaviour cannot be denied. We
  • Considering its influence on our mind and behaviour, social media and its numerous platforms must be leveraged to spread the message of AMR.
  • Objective should be to inculcate community realisation for rational and correct use of antimicrobials.


  • Addressing the global challenge of AMR demands a collective and coordinated effort involving various stakeholders. Embracing novel solutions, such as new diagnostics, alternative treatments, and technology-driven interventions, is essential. By embracing these measures, we can protect public health, alleviate economic burdens, and secure a healthier future for all.

Also read:

Antimicrobial Resistance (AMR): An Invisible Pandemic

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