A looming crisis: India's urgent need for novel anti-infectives

Antimicrobial resistance (AMR) is no longer a distant threat; it's a ticking time bomb, and India stands precariously close to the epicentre. According to the Global Research on Antimicrobial Resistance (GRAM) Project recently published in The Lancet, there were 1,042,500 deaths associated with AMR in 2019 in India.The country which has often been referred to as ‘the AMR capital of the world,needs to take urgent action before we reach a point of no return.

Several factors contribute to India's vulnerability to this crisis. Overuse and misuse of antibiotics, absence of retail laws & regulations often stemming from a lack of awareness and limited access to qualified healthcare professionals, have extremely fuelled the rise of drug-resistant bacteria. This issue is further exacerbated by the widespread availability of antibiotics without prescriptions, making it easier for individuals to self-medicate, often inappropriately. Adding to this challenge is the inadequate sanitation infrastructure and limited access to clean water and hygiene facilities, creating a fertile breeding ground for infections.

This storm of contributing factors has resulted in higher mortality rates, longer hospital stays, and a significant strain on India's already overburdened healthcare system. The economic burden of AMR is substantial, leading to loss of productivity and increased healthcare costs for individuals and the nation. It is estimated that the high incidence of AMR in India coupled with a substantial out-of-pocket expenditure among India’s population can translate to a reduction of USD 100-210 trillion on the expected global GDP by 2050.

More importantly, infections once easily treatable with readily available antibiotics are becoming increasingly difficult, even impossible, to manage. This alarming trend threatens to undo decades of progress in healthcare and plunge us back to an era where a simple infection could prove deadly.

The development and widespread access to novel anti-infectives are crucial to turning the tide against this looming crisis. These new drugs, designed to target resistant bacteria with different mechanisms of action than existing antibiotics, offer a beacon of hope for countless patients. Investing in research and development of these life-saving treatments is not just a medical imperative, but a fundamental societal responsibility.

However, this path is not without its challenges. Research and development processes are lengthy, complex, and expensive, demanding substantial financial investment and global collaboration. Ensuring equitable access to these new drugs once available is equally critical, requiring a multi-pronged approach that combines scientific innovation with strategic policy changes. Government subsidies, tiered pricing strategies, and public-private partnerships can help ensure these life-saving medications reach those who need them most, regardless of socioeconomic barriers.

Public awareness campaigns are vital to educate the population about the risks of AMR and the importance of responsible antibiotic use. These campaigns should target both the public and healthcare professionals, emphasizing the importance of accurate diagnosis, appropriate prescribing practices, and completing full courses of antibiotics.

A combination of improving awareness of AMR through effective communication, education, and training, strengthening knowledge and evidence through robust surveillance systems, and reducing the incidence of infection through effective infection prevention and control will help fight the battle against this dreaded killer. The time to act is now!

This article is written by Dr Sanjith Saseedharan, Director Critical Care, SL Raheja Hospital.

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