Overcoming resistance: On the National Action Plan on Antimicrobial Resistance (2025–29).
Version 2 of the National Action Plan on Antimicrobial Resistance requires fresh commitment.
The introduction of the second iteration of the National Action Plan on Antimicrobial Resistance is an acknowledgement that, but for some marginal gains, implementation of version 1 was, at best, sluggish. In a welcome move, the Centre has released a further version of the policy, though the details are not yet available in the public realm, to give the nation a booster shot at trying to fix the rather humongous AMR problem that the country has had to contend with, increasing volumes to boot. In October, WHO released its Global antibiotic resistance surveillance report, which recorded that in 2023, approximately one in three bacterial infections in India were resistant to commonly-used antibiotics. Globally, it was one in six confirmed infections. It spelt out why India was disproportionately affected — factors included a high infectious disease burden, overuse and misuse of antibiotics and gaps in the surveillance and healthcare infrastructure. E.coli and Klebsiella pneumoniae have exhibited high resistance to critical antibiotics, making the very last line of drugs ineffective. But human health is not the sole footprint AMR possesses; there is scarcely a field in the food chain where its cold arms have not touched — from veterinary practices to contaminating soil and water health and, thereby, agriculture and aquaculture. This ubiquitous spread of AMR has spurred scientists to push the One Health technique — it integrates the prisms of human health, animal health and environmental health — to handle growing resistance in communities.
The time is, no doubt, ripe for India to take AMR seriously and push for an enhanced, committed antibiotics stewardship programme. While the first National Action Plan played a key role in raising the profile of AMR, the actual implementation suffered. It is true that the country expanded its national surveillance programme by adding a solid laboratory network (thanks, in part, to the COVID-19 pandemic), it also scored a win with the ban on Colistin as a growth factor in the animal husbandry sector. However, the programme flailed as it failed to secure potent collaborations with States. A few States drew up their own policies, but only Kerala implemented it well enough to see a slight drop in AMR levels in the community, recently. This policy will have to tackle every aspect of AMR’s causative factors, including the rampant overuse and misuse of antibiotics. The One Health approach will have to be strengthened, and better co-ordination with States ensured. This time around, the policy will have to be the real deal and deliver, against resistance.