From UPSC perspective, the following things are important :
Prelims level : Antimicrobial resistance (AMR)
Mains level : Antimicrobial resistance, challenges and preventive measures
- 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 antimicrobial resistance (AMR)?
- AMR is the ability of a microorganism (like bacteria, viruses, and some parasites) to stop and survive exposure to an antimicrobial (such as antibiotics, antivirals and antimalarials) from working against it. As a result, standard treatments become ineffective, infections persist and may spread to others.
How AMR occurs?
- Improper use of antimicrobials: Antimicrobials, chemicals or molecules that kill harmful bugs, are the backbone of modern medicine. Improperly used antimicrobials create selective pressure on bugs.
- Resilient bugs survive the exposure to antimicrobials: The bugs most vulnerable to the drugs die quickly, while the most resilient ones survive, replicate and become superbugs. AMR occurs when superbugs develop and antimicrobials stop working.
- For example: Microorganisms (bugs) are everywhere with some being helpful like the yoghurt-making lactobacillus and some being harmful like the typhoid-causing salmonella.
What are superbugs?
- Microorganisms that become resistant to most antimicrobials are often referred to as superbugs.
- Superbugs makes medical procedures such as organ transplantation, cancer chemotherapy, and other major surgeries very risky.
- Research has shown that the use of certain types of antimicrobials in animal feed can lead to the development of antimicrobial-resistant bacteria in food-producing animals.
- These resistant bacteria can then be transmitted to humans through the food supply, leading to the spread of AMR.
- The first prescription is prevention: Disease prevention and wellness are key to public health and thus preventing infections whenever and wherever possible is equivalent to averting resistance. We need to spearhead sanitation drives, ensure a clean water supply and support hospital-driven infection-control programmes.
- Judicious prescription of antimicrobials: Reducing AMR also requires prescribing antimicrobials judiciously and only when they are absolutely needed.
- Effective coordination and management: There is also a need for more cohesion within management strategies. Coordination across the animal industry and environmental sectors to prevent the unnecessary use of antibiotics in farms these nurtures drug-resistant organisms in our food supply is necessary.
- Robust surveillance systems to detect resistant pathogens of all kinds: Other prescription closely connected with prevention is the development of robust surveillance systems that allow us to detect resistant pathogens of all kinds in the environment and hospitals that would eventually allow containment.
- Heavy investment in research and development: There is an urgent need for a strong pipeline of new antibiotics; an essential component in restoring the balance and ensuring that we have new tools in the fight against AMR. Bringing a new antibiotic from basic research through clinical trials takes more than a decade and requires upward of $1 billion. So there is need to invest heavily in research and development through both government and private funding.
- New financial incentives to make it profitable keeping in mind the social value: Profits on these drugs are negligible. Hence, there is need to formulate new types of financial incentives to measure return on investment and measure profitability by the social value of the antibiotic, breaking the conventional link between sales and profits.
- Bringing in the collective moral vision: Last but not least, we need to bring a collective moral vision to AMR and start thinking of antibiotic/antimicrobial drugs as limited resources that should be available to all.
- Although seemingly distant and abstract, AMR is in the air and potentially catastrophic for those burdened by it. The success of modern medicine, women’s health, infectious diseases, surgery and cancer would be at increased risk for lack of working antimicrobials. 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.
Q. What is Antimicrobial Resistance (AMR)? Given that AMR is an impending health disaster, discuss what measures can be taken to reduce AMR?