ARTICLE ON ANTIMICROBIAL RESISTANCE (AMR):- occurs when bacteria, viruses, fungi, and parasites change over time
and no longer respond to medicines making infections harder to treat and increasing the risk of
disease spread, severe illness, and death. Also, known as AR (Antibiotic Resistance).
Antibiotic resistance is one of the biggest public health challenges of our time. Each year at
least 4.8 million people get an antibiotic-resistant infection, and more than 95,000 people die.
Fighting this threat is a public health priority that requires a collaborative global approach across

Antibiotic resistance happens when germs like bacteria and fungi develop the ability to defeat
the drugs designed to kill them. That means the germs are not killed and continue to grow. Infections
caused by antibiotic-resistant germs are difficult and sometimes impossible, to treat.

Antibiotic resistance does not mean the body is becoming resistant to antibiotics; it is that
bacteria have become resistant to the antibiotics designed to kill them. Antimicrobial resistance
(AMR) is a potential pandemic of the future. It is silent and slow-moving and can have a devastating
impact on all of us.

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The causes of AMR include antimicrobial misuse or overuse, self-medication, prescription sharing,
over-the-counter sale of antimicrobials, non-compliance with the prescribed treatment, poor
sanitation and hygiene in hospitals and the community, poor infection prevention and control, as well
as overuse and misuse in food animals and crops.
Reasons for Spread of AMR Antibiotic consumption in humans
Unnecessary and injudicious use of antibiotic fixed-dose combinations could lead to the emergence of
bacterial strains resistant to multiple antibiotics.

Social factors
  • Include self-medication.
  • Access to antibiotics without prescription.
  • Lack of knowledge about when to use antibiotics.
Cultural Activities
  • Mass bathing in rivers as part of religious mass gathering occasions.
  • Antibiotic Consumption in Food Animals
  • Antibiotics that are critical to human health are commonly used for growth promotion in poultry.

Pharmaceutical Industry Pollution
• The wastewater effluents from the antibiotic manufacturing units contain a substantial amount
of antibiotics, leading to the contamination of rivers and lakes.

Environmental Sanitation
• Untreated disposal of sewage water bodies – leading to contamination of rivers with antibiotic
residues and antibiotic-resistant organisms.
• Infection Control Practices in Healthcare Settings a report on hand-washing practices of
nurses and doctors found that only 31.8% of them washed their hands after contact with patients.

Way Forward

  • Addressing this public health issue requires a collaborative, multi-sectoral, and transdisciplinary ‘One Health’ approaches at the local, regional, national, and global levels.
  • The engagement of sectors outside human health — such as animal health, food, agriculture, and the environment — had been a challenge that is slowly being addressed through the ‘One Health’ collaborations on AMR.
  • WHO India has been engaging with all health partners including the India offices of the Food and Agriculture Organization (FAO) and United Nations Environment Programme (UNEP) to address the complex multi-factorial public health challenge of AMR.
  • The WHO India has supported the MoHFW in establishing the governance mechanisms on AMR— the Intersectoral Coordination Committee, Technical Advisory Group, and the Core Working Group on AMR
  • India has a National Action Plan on Antimicrobial Resistance, as well as the Delhi Declaration on Antimicrobial Resistance, which was endorsed at the Inter-Ministerial Consultation on Antimicrobial Resistance in April 2017.
  • Health is a state subject, the focus of action should also include the development of State Action Plans for Containment of Antimicrobial Resistance or SAP CAR in all states and Union territories (UTs) of India.

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