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India is facing a grim paradox at the heart of its public health crisis: while antibiotics are being overused to the point of ineffectiveness, millions are dying because they cannot access these life-saving drugs when they are most needed. This dual threat is fueling the rise of deadly superbugs and exposing critical weaknesses in the nation’s healthcare system.
The Alarming Spread of Drug-Resistant Infections
A new study by the Global Antibiotic Research and Development Partnership (GARDP), published in The Lancet Infectious Diseases, has revealed that nearly a million people die each year in India from drug-resistant infections, many of which go untreated due to a lack of access to appropriate antibiotics. The study examined nearly 1.5 million cases of carbapenem-resistant Gram-negative (CRGN) infections across eight low- and middle-income countries, including India. CRGN bacteria are resistant to last-line antibiotics, making them particularly deadly.
Despite India procuring 80% of the full courses of antibiotics studied, only 7.8% of estimated CRGN cases were appropriately treated in 2019. This stark gap highlights the country’s struggle to provide effective care even as it remains one of the world’s largest markets for antibiotics.
Why the Treatment Gap?
Gram-negative bacteria, common in water, food, and the environment, cause infections such as urinary tract infections, pneumonia, and food poisoning. They are especially dangerous for newborns, the elderly, and hospital patients with weakened immune systems, often spreading rapidly in intensive care units and proving difficult—sometimes impossible—to treat.
Physicians point to several barriers preventing patients from receiving the right antibiotics:
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Difficulty reaching appropriate health facilities
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Limited access to accurate diagnostic tests
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High costs of effective antibiotics, often putting them out of reach for poorer patients
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Weak regulation leading to both overuse and underuse of crucial drugs
“Those who can afford these antibiotics often overuse them; those who can’t, don’t get them at all,” says Dr. Abdul Gaffar, an infectious disease consultant in Chennai.
Overuse and Underuse: A Deadly Double Bind
While global efforts focus on curbing antibiotic overuse to prevent resistance, the tragedy in India is that many die from treatable infections simply because the right drugs are unavailable or unaffordable. The over-the-counter sale of antibiotics and lack of prescription oversight further fuel resistance, while the poor are left vulnerable to infections that could be cured.
The Way Forward: Smarter Policies, Stronger Safeguards
Experts agree that both access and stewardship are critical. Making antibiotics more affordable, improving diagnostic infrastructure, and enforcing stricter regulations on antibiotic prescriptions are essential steps. Some hospitals have begun requiring a second sign-off by infection specialists for antibiotic prescriptions, but this is not yet standard practice.
India’s robust pharmaceutical sector and emerging innovations, such as new locally developed antibiotics and advanced diagnostics, offer hope for the future. States like Kerala are piloting new models to improve access and reduce costs, such as pooled procurement of antibiotics across hospitals.
The Stakes: Modern Medicine at Risk
Without effective antibiotics, routine surgeries, cancer treatments, and even common infections become life-threatening. As Dr. Gaffar notes, “When we get new antibiotics, it’s important to save them on one hand—and save them for the right patients”.
India, bearing one of the world’s heaviest burdens of antimicrobial resistance, could also lead the global fight against superbugs by investing in data-driven policies and innovative healthcare model.
Disclaimer:
This article is based on recent studies and expert commentary as referenced above. The information is intended for general awareness and should not be used as a substitute for professional medical advice. For diagnosis or treatment of any health condition, please consult a qualified healthcare provider.
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