Measures Taken to Rising Anti-Microbial Resistance in The Country

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The Union Government of India, aware of the challenges posed by anti-microbial resistance (AMR) in the country, has taken the following measures to address the issue:

The national program on AMR containment was launched during 12^th FYP in 2012-17. Under this programme, AMR Surveillance Network has been strengthened by establishing labs in State Medical College. 30 sites in 24 states have been included in this network till 30^th March 2021.

National Action Plan on Antimicrobial Resistance (NAP-AMR) focusing on One Health approach was launched on 19^th April 2017 with the aim of involving various stakeholder ministries/departments. Delhi Declaration on AMR– an inter-ministerial consensus was signed by the ministers of the concerned ministries pledging their support in AMR containment. In the line with NAP-AMR, three states have launched their state action plan
1. Kerala has launched KARSAP
2. Madhya Pradesh has launched MP-SAPCAR
3. Delhi has launched SAPCARD

AMR Surveillance Network: ICMR has established AMR surveillance and research network (AMRSN) in 2013, to generate evidence and capture trends and patterns of drug-resistant infections in the country. This network comprises of 30 tertiary care hospitals, both private and government.

AMR Research & International Collaboration: ICMR has taken initiatives to develop new drugs /medicines through international collaborations in order to strengthen medical research in AMR.

ICMR along with the Research Council of Norway (RCN) initiated a joint call for research in antimicrobial resistance in 2017.
ICMR along with the Federal Ministry of Education and Research (BMBF), Germany has a joint Indo-German collaboration for research on AMR.

Initiatives to control overuse or misuse of antibiotics:

 ICMR has initiated an antibiotic stewardship program (AMSP) on a pilot project basis in 20 tertiary care hospitals across India to control the misuse and overuse of antibiotics in hospital wards and ICUs.

 On the recommendations of ICMR, DCGI has banned 40 fixed-dose combinations (FDCs) which were found inappropriate.

 ICMR worked in collaboration with the Indian Council of Agriculture Research, the Department of Animal Husbandry, Dairy and Fisheries, and the DCGI to ban the use of Colistin as a growth promoter in animal feed in poultry.

Guidelines issued

National Guidelines for Infection Prevention and Control in Healthcare Facilities have been released by MoHFW in Jan 2020. (https://ncdc.gov.in/showfile.php?lid=431)
ICMR has developed evidence-based treatment guidelines for the treatment of ten syndromes of infections. It aims to rationalize the usage of antibiotics on Essential Medicines Formulary (EMF) and to establish consistency in the treatment of various infectious conditions.
Further, ICMR has also issued the Treatment Guidelines for Antimicrobial Use in Common Syndromes” in 2019. (https://www.icmr.nic.in/sites/default/files/guidelines/Treatment_Guidelines_2019_Final.pdf)

IEC Activities

Media material has been developed to create awareness among various stakeholders regarding AMR and the appropriate use of antibiotics.

Yes. The government is working on the One Health approach by encouraging interdisciplinary collaboration at the human-animal-environmental interface.

The key priority areas include zoonotic diseases (emerging and re-emerging), food safety and antibiotic resistance.

Program for Strengthening Inter-sectoral Coordination for Prevention and Control of Zoonotic Diseases’ was launched in the 12th Five-year plan (2012-17) which is still continuing as “National One Health Program for Prevention and Control of Zoonoses” in 15^th Finance Commission (2021-26) period.

This scheme aims to operationalize “One Health” Mechanisms for the prevention and control of Zoonoses by strengthening inter-sectoral coordination among all stakeholders. In this regard, the National Institute of One Health is being established at Nagpur which will house the BSL IV laboratory.

ICMR has undertaken a project on an “Integrated One Health Surveillance Network for Antimicrobial Resistance” in collaboration with the Indian Council of Agriculture Research (ICAR) to assess the preparedness of Indian Veterinary laboratories to participate in an integrated AMR surveillance network. ICMR has also created veterinary standard operating procedures (Vet-SOPs) for enabling the comparison of antimicrobial resistance patterns in animals and humans. (https://main.icmr.nic.in/sites/default/files/guidelines/SOP_Bacteriology_Veterinary_2019.pdf)