Charting a National Course of Action ๐Ÿ“œ

India is one of the highest antibiotic consuming countries in the world.
Indian Impact: In India, nearly 60,000 neonatal deaths per year stem from antibiotic-resistant infections.

AMR as a National Priority๐Ÿ‡ฎ๐Ÿ‡ณ

The Indian Priority Pathogen List (IPPL) guides antibiotic research in India. Created by WHO Country Office and Department of Biotechnology, Government of India, it categorizes bacteria by priority: critical, high, or medium. Prioritization depends on resistance severity, health impact, and treatment alternatives.

Prime Minister's Perspective  ๐Ÿ”ฌ๐Ÿ’Š Antibiotics revolutionized disease treatment, but their misuse is diminishing their ๐Ÿ’” effectiveness. ๐Ÿ‡ฎ๐Ÿ‡ณ India recognizes AMR as a grave global health threat and is dedicated to tackling it. ๐Ÿ“‹ Steps Taken: National program against AMR implementation. National Centre of Disease Control and Indian Council of Medical Research engaged in AMR surveillance. Antibiotic sale restrictions through statutory changes. Awareness campaign and antibiotic use guidelines introduced. ๐Ÿค Multisectoral collaboration required for AMR prevention and containment. ๐ŸŒ India fully committed to global AMR prevention efforts. ๐Ÿ‡ฎ๐Ÿ‡ณ Prime Minister Narendra Modi's commitment underscores the urgency of addressing AMR to avert a crisis with dire public health and economic ramifications. ๐Ÿš€

๐Ÿ” Delving into the Priority Tiers 

(โŒ) Resistant; (โ“) Non-Susceptible; MRSA: Methicillin-Resistant Staph. aureus; AVISA: Heterogeneous Vancomycin-Intermediate Staph. aureus

(Note: Mycobacteria, including Mycobacterium tuberculosis, were not included in this prioritization exercise as they are well-established global and national priorities requiring innovative treatments.) ๐Ÿงช

Non-susceptible means that the antibiotic doesn't work well against the bacteria, but it may still have some effect.
Resistant means that the antibiotic doesn't work at all against the bacteria, and they continue to grow and make you sick.

1.Enterobacteriaceae (Klebsiella pneumoniae and Escherichia coli)

Carbapenem - R โŒ
Tigecycline - R โŒ
Colistin - R โŒ

2. Non-fermenting bacteria (Acinetobacter baumannii and Pseudomonas aeruginosa)

Carbapenem - R โŒ
Colistin - R โŒ

1.Staphylococcus aureus

MRSA, AVISA, Daptomycin - NS โ“
Linezolid - R โŒ

2.Enterococcus species

Vancomycin - R โŒ
Linezolid - R โŒ
Daptomycin - NS โ“

3. Salmonella species (Typhoidal and Non-typhoidal)

Azithromycin - NS โ“
Third generation cephalosporins - NS โ“
Carbapenem - NS โ“

1.Streptococcus pneumonia

Cephalosporin - R โŒ
Fluoroquinolones - R โŒ
Linezolid - R โŒ

2.Staphylococcus, coagulase-negative

Vancomycin - R โŒ
Linezolid - R โŒ

3.Shigella species

Third generation cephalosporins - R โŒ
Azithromycin - R โŒ

4.Haemophilus influenzae

Third generation cephalosporin - NS โ“
Carbapenem - NS โ“

5. Neisseria meningitidis

Fluoroquinolones - NS โ“
Third generation cephalosporins - NS โ“

Charting a National Course of Action ๐Ÿ—บ๏ธ๐ŸŒ๐Ÿ“œ

Recognizing the gravity of AMR, the National Health Policy 2017 has underscored the imperative of stringent guidelines, judicious antibiotic use, and a united front against resistance. The Ministry of Health & Family Welfare, Government of India, has established pivotal governance mechanisms โ€“ including intersectoral coordination committees and expert groups โ€“ all culminating in the National Action Plan on Antimicrobial Resistance (NAP-AMR). Collaboratively, they have endorsed the Delhi Declaration on Antimicrobial Resistance, uniting policymakers and stakeholders in the fight.

PM Modi Pledges Support Against AMR Global Economic Impact Could Reach $100 Trillion by 2050๐Ÿ’ฐ

Acknowledging the severity of AMR,
National Health Policy 2017 emphasizes strict guidelines, prudent antibiotic usage, and collective resistance efforts. 
Global Threat Intensifies

The challenge of anti-microbial resistance (AMR) is worsening as existing drugs become less effective and new ones are not being developed adequately.

Alarming Projections

Without timely intervention, the consequences by 2050 could include 10 million annual deaths and an economic toll of approximately $100 trillion.

Current Scenario

An initial report from December 2014 estimated around 700,000 yearly deaths due to drug-resistant strains of common infections, including HIV, TB, and malaria. However, this is likely an underestimation due to reporting gaps. Over 200,000 fatalities occur annually due to multidrug-resistant and extremely drug-resistant tuberculosis (TB) alone

Indian Impact

In India, nearly 60,000 neonatal deaths per year stem from antibiotic-resistant infections. In the 18 months following the initial report, over a million lives have been lost to drug-resistant infections.

Diminished Solutions

Previously manageable infections are now harder to cure. For instance, drug-resistant gonorrhoea strains are emerging, and there's a lack of rapid diagnostic tests for prescription guidance. As a result, last-line antibiotics are being employed, with no further treatment options available afterward.

Economic Toll

 The economic repercussions are evident, with the US experiencing over two million yearly infections resistant to primary antibiotics. This costs the US healthcare system an additional $20 billion annually.


The global costs, if we do not take action now, could be 10 million people dying every year by 2050, and a cumulative economic cost of around $100 trillion.


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