Addressing Antimicrobial Resistance and Rational Use of Antibiotics – Prelims Specific

Introduction

Antimicrobial Resistance (AMR) is a global biological phenomenon where pathogens like bacteria, viruses, and fungi evolve to survive exposure to antimicrobial medicines. This reduces the efficacy of standard medical treatments, complicating common surgeries and increasing mortality rates. In India, factors such as easy access to antibiotics and their non-therapeutic use in livestock are significant drivers of this public health crisis.

Why in News?

Recent health reports have identified a concerning surge in multi-drug resistant infections in India. This has led to renewed policy calls for stricter implementation of prescription-only drug regulations and enhanced surveillance of antibiotic use across clinical and agricultural sectors to combat the growing silent pandemic of AMR.

Static Link

AMR is a critical topic in Science and Technology related to Biotechnology. It involves the biological process of genetic mutation and horizontal gene transfer in bacteria. UPSC often tests the conceptual understanding of these processes and the One Health framework. A common trap is assuming AMR only affects the patient, ignoring the environmental contamination and agricultural (livestock) contributions.

Institutional Link

• National Centre for Disease Control (NCDC): Under the Ministry of Health and Family Welfare, it coordinates the National Action Plan on AMR (NAP-AMR).
• Central Drugs Standard Control Organisation (CDSCO): Regulates the safety, efficacy, and sale of drugs, including the enforcement of prescription norms (Schedule H/H1).
• World Health Organization (WHO): Manages the Global Antimicrobial Resistance and Use Surveillance System (GLASS).
• Tripartite Alliance: Comprising WHO, FAO, and WOAH, it promotes the One Health approach.

Core Prelims Facts

• AMR is one of the top ten global public health threats identified by the WHO.
• The One Health approach recognizes that human health is inextricably linked to the health of animals and the environment.
• India’s NAP-AMR was launched in 2017 to improve awareness, infection control, and rational use of antibiotics.

Important Terms and Concepts

• Rational Use of Medicines: The condition where patients receive medications appropriate to their clinical needs, in doses that meet their individual requirements.
• Prophylactic Use: The use of antibiotics in healthy livestock to prevent potential diseases or promote growth, rather than to treat an existing infection.
• Broad-spectrum Antibiotics: Antibiotics that act against a wide range of disease-causing bacteria, which can be misused for viral infections.

Bodies / Organisations / Institutions

• Food Safety and Standards Authority of India (FSSAI): Sets regulations for antibiotic residues in food products.
• National Action Plan on AMR (NAP-AMR): The policy framework guiding India’s strategy against resistant pathogens.

Schemes / Laws / Reports / Conventions

• Red Line Campaign: A government-led awareness campaign highlighting the danger of misusing antibiotics, marked by a red line on the medicine packet.
• Schedule H and H1 Drugs: Categories of drugs under the Drugs and Cosmetics Rules, 1945, that must be sold only against a prescription from a registered medical practitioner.

Possible UPSC Prelims Traps

• Misidentifying the Ministry: Often, regulatory roles are incorrectly linked (e.g., attributing drug pricing or sale regulations to the Ministry of Chemicals and Fertilizers instead of the Ministry of Health).
• Nature of AMR: UPSC may frame statements suggesting AMR is a disease rather than a biological phenomenon of pathogen evolution.
• One Health Scope: Traps may include limiting the One Health approach only to hospitals or humans, excluding the critical agricultural and environmental components.
• Absolute Terms: Statements claiming "all antibiotics are under Schedule H" or "AMR can be completely eliminated by banning antibiotics" are typically incorrect.

One-Minute Revision Notes

• AMR involves the biological evolution of pathogens against antimicrobial drugs.
• The One Health framework integrates human, animal, and environmental health.
• NAP-AMR is India’s core strategy to combat the spread of resistance.
• Schedule H/H1 drugs require strict prescription for sale in India.
• The Red Line Campaign focuses on creating public awareness against antibiotic self-medication.

Practice MCQ for Prelims

1. With reference to the 'One Health' approach, consider the following statements:

1. It is a collaborative effort to improve health for people, animals, and the environment.

2. It is currently being promoted globally by the WHO, FAO, and the World Organisation for Animal Health.

3. It aims to address the challenge of Antimicrobial Resistance (AMR) through cross-sectoral surveillance.

Which of the statements given above are correct?

A. 1 and 2 only

B. 2 and 3 only

C. 1 and 3 only

D. 1, 2 and 3

Answer: D

Explanation: All three statements accurately describe the One Health approach, which is the gold standard for managing zoonotic diseases and AMR by integrating human, animal, and environmental sectors.