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Ramesh Shankar
Wednesday, March 27, 2024, 08:00 Hrs  [IST]

One of the major health problems being faced by the country today, for that matter the entire world, is antimicrobial resistance (AMR). And this is not the health crisis of the present generation alone, as it is going to be the biggest health crisis of the next generation too, if not tackled in time. Experts in the field have already red flagged over the looming grim situation of a world without antibiotics, if necessary steps are not taken immediately. Even though AMR also occurs naturally over time, indiscriminate use of antibiotics is one of the major reasons for the emergence of AMR. The hard fact is that misuse and overuse of antibiotics are threatening to undo decades of medical progress. It is often observed that the availability of these life-saving medicines over-the-counter makes matters worse as people tend to purchase antibiotic drugs even for illnesses which are due to a virus rather than a bacterium. When antibiotics are so readily available, there is no imperative for them to be treated with the care they needed. Yet another fact is that the burden of AMR falls disproportionately on low- and middle-income countries, where healthcare systems are overburdened, and resources are stretched. The gravity of the impending situation can be gauged from some reports that nearly 2 million deaths are projected in India due to AMR by the year 2050 as the country has some of the highest antibiotic resistance rates among bacteria that commonly cause infections, both in the community and healthcare facilities.

Quite obviously, the global community has declared AMR as a public health crisis and the regulators world over, including the Indian regulators, have already initiated measures to tackle the issue on war footing as they are seized of the grim scenario.  More recently, the National Medical Commission has taken a decision to frame common module on AMR containment which will improve awareness and understanding of AMR among undergraduate, postgraduate medical students, and teaching professionals of medical colleges. This is a right step as there are some irrational prescriptions by certain doctors who prescribe antibiotics excessively and needlessly. The Commission’s action in this regard is part of its effort to operationalize National Action Plan (NAP) on AMR which is aimed to curtail spread of AMR in the country. Recently, the All India Chemists and Distributors Federation, a body of pharmaceutical distributors and retailers across the country, has given a suggestion to the government that a period of use or an expiry date, on the lines of the use of therapeutics, is necessary for doctors’ prescriptions to prevent spread of AMR due to their overuse. It is a fact that most often, people use old prescriptions for the same symptoms of past ailments and continue to consume the medicines prescribed by a doctor five years or six years ago. A doctor prescribes one antibiotic for a particular disease at a particular time, but even after five years or six years, the same prescription is used by the patient once he gets similar ailments. Surely, the medicine a patient used five years ago may not be effective for his present ailment. As the scenario becomes grimmer, experts have called upon the drug regulators to play a vital role in addressing this menace, as the main reason is due to misuse, overuse and underuse of the antibiotics. The regulators should implement the Schedule H and H1 of the Drugs and Cosmetics Rules in letter and spirit to stop OTC sale of antibiotics. The regulators should not be found wanting in ensuring that the pharmacists in the community and hospital pharmacies are following the laws and selling Schedule H and H1 drug only on prescriptions by a qualified doctor. Dispensing without pharmacists and selling without prescriptions should urgently be stopped as part of curbing the AMR threat. The government should pay heed to all these suggestions and act fast as AMR is a ticking time bomb.

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Ruknoddin Mar 31, 2024 10:29 AM
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