Antimicrobial Resistance (AMR) is a fast-rising medical concern, one that needs the global community’s immediate attention. Yet, awareness regarding the issue and the potential threats it carries are just being understood. Further, large pockets of the world are still oblivious to the problem. So while policy measures shape the world slowly and substantively, awareness and information should take leaps and bounds to prevent potential mishaps.
The United Nations defines AMR as the ability of a microorganism to stop an antimicrobial such as an antibiotic from working against it. As a result, standard treatments become ineffective, and infections persist and spread to others. Ever since the advent of antibiotics back in the early 1940s, the way we understand sickness has changed. Life-threatening diseases became commonplace conditions that could be cured with some pills and a few days of rest.
Yet, as the drug companies produced stronger antibiotics, the infecting bacteria also became stronger. Not only do resistant bacteria survive and multiply, but they also spread the resistant gene to other bacteria. In effect, conditions that could previously be cured using antibiotics can become life-threatening. And for many people (up to 10 million a year by 2050), AMR will prove fatal.
The causes of AMR are several, of which, only a few have been understood. Yet, as a recent study points out, AMR is such a big concern that the United Nations 2030 Sustainable Development Goals will depend on how well the global community can address this problem.
It is well-known that excessive antibiotic consumption can cause AMR. This can happen because of a poorly-regulated market, such as the one in India where prescription drugs are sold over the counter. It can also happen because of misinformed medical practitioners prescribing potent antibiotics for commonplace fevers. Another reason can be that patients themselves seek potent antibiotics to heal quickly. This trend is particularly marked in the lower middle-classes where missing a day’s work can have a palpable effect on the family’s income.
Human consumption of antibiotics is not the only cause of AMR. These drugs are fed to livestock to prevent them from falling ill, and to help them grow faster. Chickens pumped with antibiotics grow to thrice the size of an average chicken. They also never fall sick. When these chickens are slaughtered and sold to the meat market, the resistant bacteria from the animals are transferred to the human gut.
This doesn’t end here. The environmental implications of AMR are substantial. Animal faeces, especially from the cow, are used as manure for crops. This manure carries resistant bacteria which then proliferate inside the plant and subsequently enters the human gut. Water that comes in contact with such soil also becomes contaminated. Large-scale dumping of antibiotic waste into water supplies by big pharmaceuticals also contributes to the problem. Thus, one way or another, we are surrounded by potential AMR triggers, and with each passing day, the threat is getting worse.
One important step is stringent oversight on prescription-based medication to reduce over-the-counter purchases and increased awareness campaigns to inform people of the deleterious consequences of AMR. The Indian Council of Medical Research provides guidelines to prevent AMR by stepping up hospital sanitation which is also a concrete measure taken towards addressing the problem. While the government takes measures to address AMR, the real challenge will be to address it on a community level. Without a clear sense of responsibility on the individual level, AMR cannot be curbed in a hasty manner.
This means that every community needs to take upon itself the mandate to understand the nuances of AMR, and the ways it proliferates. Making regular checks of open drainage sources around the house, avoiding antibiotic use unless prescribed by the doctor, thoroughly washing vegetables and fruits before consuming them, and consuming boiled water, are some immediate measures that can be taken on an individual level.
As a community, it is imperative to think as a unit, and not simply for oneself. Organizing awareness campaigns to educate people around is an effective way to precaution people of potential threats of AMR. Tying up with local NGOs who provide support to underprivileged individuals is yet another measure that can lead to greater community engagement and awareness. Creating a database of medical shops that sell the prescription-based medication over the counter will go a long way in identifying defaulting shops that push the rise of AMR.
While solutions are innumerable and highly effective, we have to take the initiative and make the change. Otherwise, all our efforts will be too little, too late.