Model Question and Answers for APSC | Can overuse and the availability of antibiotics without doctor’s prescription, the contributors to the emergence of drug- resistant diseases in India? What are the available mechanisms for monitoring and control? Critically discuss the various issues involved.

Ans: Antibiotics have been an important discovery in modern medicine, and their use has saved millions of lives. However, their overuse and misuse have contributed to the emergence of drug-resistant diseases or antimicrobial resistance (AMR) worldwide, including India.

The Emergence Of Drug-Resistant Diseases In India:

• The problem of drug-resistant diseases is compounded by the availability of antibiotics without a doctor's prescription in India, which is prevalent in both urban and rural areas.

• One of the major causes of overuse and misuse of antibiotics is the lack of awareness among people about the proper usage of antibiotics.

• Moreover, many people stop taking antibiotics as soon as they feel better, even if the entire course of treatment is not completed, leading to the development of drug-resistant bacteria.

• Another factor contributing to the emergence of drug-resistant diseases in India is the widespread use of antibiotics in agriculture and animal husbandry, which can spread to humans through food consumption.

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

• National programme on AMR containment was launched during 12th FYP in 2012-17. Under this programme, AMR Surveillance Network has been strengthened by establishing labs in State Medical College.

• National Action Plan on Antimicrobial Resistance (NAP-AMR) focusing on One Health approach was launched on 19th April 2017 with the aim of involving various stakeholderministries/departments. Delhi Declaration on AMR– an inter-ministerial consensus was signed by the ministers of the concerned ministries pledging their support in AMR containment.

• 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 30 tertiary care hospitals, both private and government.

• The Union health ministry’s Antimicrobial Resistance awareness campaign urges people not to use medicines marked with a red vertical line, including antibiotics, without a doctor’s prescription.

• 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 has initiated antibiotic stewardship program (AMSP) on a pilot project basis in 20 tertiary care hospitals across India to control 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 Indian Council of Agriculture Research, Department of Animal Husbandry, Dairy and Fisheries and the DCGI to ban use of Colistin as growth promoter in animal feed in poultry.

Other measures to contain AMR include:

• Through the Swachh Bharat program, the Government has taken active steps to improve hygiene and sanitation and reduce the environmental spread of pathogens

• Vaccination is an equally important public health measure, and through Mission Indradhanush, India has set itself an ambitious goal of increasing routine immunisation coverage to 90% within just a few years.

In conclusion, overuse and the availability of antibiotics without doctor’s prescription are significant contributors to the emergence of drug-resistant diseases in India. Addressing the issue of AMR requires a multi-faceted approach, involving increased public awareness about the proper usage of antibiotics, prudent use of antibiotics in agriculture and animal husbandry, and strengthening of surveillance and control programs. It is imperative to promote responsible use of antibiotics and implement effective strategies to control the spread of drug-resistant diseases for better health outcomes in India.