Ending antimicobial resistance is the lynchpin to #endTB

Dr Tedros Adhanom Ghebreyesus, WHO's Director General, calls AMR a global health emergency that will seriously jeopardize progress in modern medicine. It is creating superbugs that are making it impossible to treat many previously curable diseases, including TB.

While reaffirming their commitment to end TB by 2030, the draft Political Declaration in the fight against tuberculosis by governments at the first UN High-Level Meeting on TB (#UNHLM to #endTB) acknowledges that TB, including its drug-resistant forms, is a critical challenge and the leading infectious disease cause of death, the most common form of antimicrobial resistance (AMR) globally.

Dr Tedros Adhanom Ghebreyesus, WHO's Director General, calls AMR a global health emergency that will seriously jeopardize progress in modern medicine. It is creating superbugs that are making it impossible to treat many previously curable diseases, including TB. While the call for accelerating research and development for new treatments is rightly getting more attention, we are also losing on the efficacy of existing drugs with more and more disease causing microorganisms becoming resistant to them.

AMR already contributes to an estimated 700,000 deaths a year globally, and the figure could rise to 10 million deaths a year and $100 trillion in lost global productivity by 2050 if nothing is done to stop its spread.

What is AMR?

Dr Manica Balasegaram, of Global Antibiotic Research and Develpment Partnership (GARDP) explains that AMR happens when micro-organisms - like bacteria, virus, fungi, other parasites - undergo genetic changes making them resistant to the medicines that they responded to earlier. This is an evolutionary change but the process can be accelerated due to overuse and misuse of drugs in human, animal and agricultural use, as well as due to lack of infection control.

Key actions to stem AMR

In an interview given to CNS (Citizen News Service), Dr Soumya Swaminathan, Deputy Director General for Programmes at the World Health Organization (WHO) and a globally recognised researcher on TB and HIV, underlined the importance of infection control in all healthcare settings so that all healthcare personnel follow standard guidelines for the use of antibiotics. Stopping irrational veterinary and agricultural use of antibiotics as crop promoters or for prevention of disease and using them only for treatment where needed will help. Also, antibiotics listed under reserved category in WHO's classification of antibiotics should be reserved for humans and not used for animals. It is also important to have systems in place for production and disposal facilities of antibiotics so that they do not contaminate water and soil and do not spread the resistant mutations to bacteria which are in the environment, she reportedly said.

What is India doing to stem AMR?

Dr Kamini Walia, a Senior Scientist at the Indian Council of Medical Research (ICMR) who is currently leading the setting up of Antimicrobial Surveillance Network in India, pointed out that ICMR started its antimicrobial resistance initiative in 2012 as no nationwide data on AMR was available in the country. Its AMR surveillance network focused on six pathogenic groups that were causing a large number of drug resistant infections in the hospitals and in the communities. ICMR has 20 hospitals in its network and uses data gathered from these hospitals to guide treatment interventions. ICMR has also brought out hospital infection control policy as well as treatment guidelines which are based on ICMR data. She reportedly said that our data shows that antibiotic pressure is driving a lot of drug resistance that one sees in India's hospitals. So to reduce antimicrobial resistance, overuse of antibiotics needs to be controlled, along with reducing hospital infections, because it is the large denominators of hospital acquired infections which are giving actually rise to drug resistant infections.