India, with a population of 1.4 billion and vast agricultural landscape, faces a multifaceted environmental AMR challenge. The scale of agricultural production, along with diverse practices in allied sectors, intensifies the risk of antimicrobial resistance in the environment. Antibiotics are commonly used to treat and prevent infections in the livestock and fishery sectors, but they also have the potential to contaminate the environment, contributing to the spread of AMR. Contaminated soil and water allow resistant bacteria to spread from farms to the food supply chain thus infecting humans and animals with resistant pathogens. Fish farms that operate in unhygienic conditions further fuel the spread of resistance.

Pharmaceutical pollution adds to the problem, as untreated effluents from pharmaceutical factories contaminate rivers, leading to high levels of antibiotics in water. Similarly, hospital waste and sewage, often containing antibiotics and resistant bacteria, pose additional health risks when untreated waste enters the environment. Poor sanitation and waste management systems in densely populated areas facilitate the transfer of resistant bacteria between humans, animals, and the environment, deepening the crisis.

The indiscriminate use of antibiotics poses a direct threat not just to human health but also to food security, as infections among plants, livestock and aquaculture species become harder to treat, risking animal health and reducing productivity. In human health, as bacteria become resistant to common treatments, infections like pneumonia and urinary tract infections become difficult to treat, leading to prolonged hospital stays and expensive treatments. AMR also threatens medical advancements, impacting treatments like cancer therapy, organ transplants, and surgeries, which depend heavily on effective antibiotics. The impact on food production is equally alarming, as antibiotic resistance in livestock and aquaculture may lead to its decline, threatening both nutritional security and livelihoods.

During the 79th session of the United Nations General Assembly in September 2024, AMR received special attention with the goal of reducing AMR-related deaths by 10 percent by 2030. The session also emphasized that addressing AMR requires coordinated action from all sectors of society. India has acknowledged the importance of addressing AMR through initiatives like the National Action Plan on Antimicrobial Resistance, developed in alignment with the WHO Global Action Plan 2015. Additionally, programmes such as Swachh Bharat and Mission Amrut focus on improving sanitation and water management to prevent contaminated runoff into water bodies.

The Food and Agriculture Organization of the United Nations (FAO) plays a critical role in supporting governments, producers, and stakeholders to ensure the responsible use of antimicrobials. In collaboration with the Indian Council of Agricultural Research (ICAR), FAO recently published the first nationally representative report on AMR surveillance in the livestock and fisheries sectors for the period 2019-2022. This report serves as a crucial baseline for understanding the extent of AMR and will guide future interventions. By fostering shared responsibility among farmers, prescribers, policymakers, and other stakeholders, FAO promotes preventive measures that provide economic benefits and help avert potential losses posed by AMR as a global health crisis.

The theme for World AMR Awareness Week 2024—”Educate. Advocate. Act Now.”—reminds us that AMR is a critical global health issue with significant public health and economic consequences. Rationalizing antibiotic use and prioritizing safer, sustainable practices for disease prevention are essential steps in combating AMR. FAO’s commitment to the “Four Betters”—Better Production, Better Nutrition, a Better Environment, and a Better Life—not only supports these efforts but also strengthens our path toward achieving the Sustainable Development Goals, creating a resilient and healthier future for all.

Takayuki Hagiwara is the FAO Representative in India, part of Team UN in India.