Through mutation and selection, bacteria can develop defence mechanisms against antibiotics. For example, some bacteria have evolved to produce enzymes to inactivate the antibiotic. E.Coli remains the most isolated pathogen in India that's resistant to most antibiotics, accounting for nearly 33% of the surveillance data in 2022.

AMR is already a leading cause of death globally, directly responsible for 1.27 million deaths annually, one in five of which occur in children under the age of five, mainly in low- and middle-income countries, according to the World Health Organisation (WHO). Uncontrolled AMR is expected to lower life expectancy and lead to unprecedented health expenditure and economic losses.

AMR's financial impact

The Global Leaders Group (GLG) recently said that the "staggering human toll of antimicrobial resistance will be compounded by a catastrophic hit to the global economy unless bolder and more urgent action is taken." With current levels of action, AMR is expected to impose much greater health expenditures, with total expenses to treat resistant bacterial infections alone reaching $412 billion globally per year leading up to 2035, according to a recent economic impact study. Increased mortality from these infections could lead to lower workforce participation and productivity losses of $443 billion per year, the study estimates. The study also estimates that without a stronger response, there would be an average loss of 1.8 years of life expectancy globally by 2035.

A solution to curb AMR

Experts have advised there is a need for improved quality of data on antimicrobial resistance through surveillance and monitoring and that countries should strengthen their human resources and crucial infrastructure capacity. Effective measures against AMR are expected to cost an average of $46 billion per year but will yield up to $13 for every dollar spent by 2050, the GLG underlined. "We have the tools to mitigate the AMR crisis and the data points to a devastating future if we do not take bolder action now”, said Mia Amor Mottley, prime minister of Barbados, and chair of the GLG.

What’s India doing?

According to the Institute for Health Metrics and Evaluation, there were 297,000 deaths attributable to AMR in 2019 and 1,042,500 deaths associated with AMR in India.

In 2017, the Union health ministry launched the National Action Plan on Antimicrobial Resistance to deal with this menace. In June last year, the then health secretary, Rajesh Bhushan, chaired an inter-sectoral coordination committee for tackling AMR. The initiatives discussed included establishing of an infection prevention and control unit at the National Centre for Disease Control; developing a digital platform to collect and collate national and state-level data on antimicrobial resistance; and duly converging human, animal, environmental and food sectors, focusing on the creation of state-specific action plans. The country’s apex food regulator— Food Safety and Standards Authority of India— also plans to carry out surveillance on anti-microbial susceptibility in the food matrix, to ensure what reaches consumers is safe in the long run.

During a workshop hosted by Ashoka University. Last week, experts agreed there was an imminent need for Unified Data Systems and Standard Operating Procedures for AMR surveillance in India.

“AMR is a global threat that requires people who have historically not worked together to cooperate and work towards a common goal. This goes beyond simple interdisciplinary to cross-sectoral...” said Anurag Agrawal, dean of biosciences, Trivedi School of Biosciences, Ashoka University, during the workshop.

Rhythma Kaul, national deputy editor, health, analyses the impact of the most significant piece of news this week in the health sector