In News:

• Department of Biotechnology, Ministry of Science & technology, & Biotechnology Industry Research Assistance Council Jointly launched “Mission AMR”
• This call aims at finding innovative solutions to the growing threat of Antimicrobial Resistance (AMR) by supporting the development of new antibiotics and alternatives to antibiotics with well – established proof – of – concept.

About:

Proposals are invited in the areas of:
Development of New antibiotics

• New Drugs
• Repurposing of existing drugs
• New Combinations

Development of alternatives to antibiotics

• Therapeutic antibodies
• Phage Therapy
• Anti – Biofilm Products

Anti microbial resistance:

• “WHO” DEFNITION: Antimicrobial resistance happens when microorganisms (such as bacteria, fungi, viruses, and parasites) change when they are exposed to antimicrobial drugs (such as antibiotics, antifungals, antivirals, antimalarial, and anthelmintic).
• Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”.

Why is AMR a global concern?

• New resistance mechanisms are emerging and spreading globally, threatening our ability to treat common infectious diseases, resulting in prolonged illness, disability, and death.
• Without effective antimicrobials for prevention and treatment of infections, medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery (for example, caesarian sections or hip replacements) become very high risk. Antimicrobial resistance increases the cost of health care with lengthier stays in hospitals and more intensive care required.
• Antimicrobial resistance is putting the gains of the Millennium Development Goals at risk and endangers the achievement of the Sustainable Development Goals.
• Although accurate estimates of the overall burden of resistance are not available, it is estimated that 58,000 neonatal deaths are attributable to sepsis caused by drug-resistance to first-line antibiotics each year.
• Microorganisms that develop antimicrobial resistance are sometimes referred to as “superbugs”. As a result, the medicines become ineffective and infections persist in the body, increasing the risk of spread to others.
• The overall burden of resistance is hard to assess for the general population but is likely focused on neonates and the elderly, both of whom are more prone to infections and vulnerable to ineffective treatment

Background:

• Antibiotics in human medicine and agriculture, such as their use to make animals grow faster rather than treat disease, are major contributors to growing levels of resistant bacteria
• The problem in India is that antibiotics can be bought without a prescription
• WHO, the World Organization for Animal Health (OIE) and the Food and Agriculture Organization (FAO) have called for a worldwide ban on the use of antibiotics to fatten farm animals a practice already banned in the EU and U.S. in an attempt to stem the rising threat of resistance. But it still not banned all over in India. The practice of using antibiotics to make animals grow faster was banned completely in the EU in 2006.
• Animals reared for meat in the major emerging economies of Brazil, Russia, India, China and South Africa are expected to consume double the amount of antibiotics in 2030 than they did in 2010 which shows us that we are heading towards a doomsday
• Medical societies together and the Indian government in 2012 created a plan to tackle antibiotic resistance, known as the Chennai Declaration.
• It is estimated 1, 00,000 babies a year in the country die from infections from resistant bugs. WHO has called antibiotic resistance one of the greatest threats to public health.
• Experts are concerned about the widespread use of a ‘last hope’ (colistin) antibiotic on Indian poultry farms. Colistin is often used to treat a seriously ill person with infections that have become resistant to almost all other drugs and is deemed one of the “highest priority, critically important” antibiotics by WHO as it is so crucial to human medicine.
• Growth promoting antibiotics, including colistin, remain widely available to Indian farmers through a number of international and domestic pharmaceutical companies

Way Forward:

• A practical approach will be to formulate a list of antibiotics with strict monitoring on the dispensing of these drugs.
• Step- by- step introduction of other drugs to the restricted list could be tried once the success of the first stage is ensured. Another option would be banning OTC (over the counter) without prescription of all antibiotics in metros and big cities, where there will be no difficulty for patients to consult registered medical practitioners.
• A more liberal approach in smaller cities and villages, where immediate access to doctors is usually limited, can be utilized. This may not be an ideal approach, but a practical one in the current Indian context.
• It is predicted that colistin as a drug will be dead in 10 years’ time. And given what is in the pipeline, which is next to nothing, and given the plasticity of bacteria and their ability to evolve and adapt and survive and prosper, if this continues there can be no good end to this story at all.”