June 11, 2019, Thiruvananthapuram, Kerala: Representatives of several states of the country discussed how to develop and implement State action plans on antimicrobial resistance (AMR). The deliberations were held at a two-day national workshop in Thiruvananthapuram, Kerala, which was jointly-organized by the Centre for Science and Environment (CSE), a public interest organisation based out of New Delhi and the Department of Health and Family Welfare, Kerala.
“States have a critical role in India’s fight against AMR. They know the ground realities and are responsible for managing human health, animal husbandry and environment. What they need is a comprehensive and implementable action plan on AMR”, said Chandra Bhushan, deputy director, CSE
Antimicrobial resistance is a global public health crisis of an unprecedented scale, which apart from huge health and economic losses to individuals and nations, is expected to impact the attainment of several sustainable development goals. As a result of growing AMR, the world is running out of antibiotics as they are becoming ineffective. Infectious diseases are getting difficult to treat or untreatable. There are no new antibiotics in the market and those used as a last-resort are also failing. AMR is known to acceleratedue to overuse and misuse of antibiotics in human health, food-animal production and agriculture along with inadequate waste management from households, farms, factories and healthcare settings.
In response to the global momentum, India’s National Action Plan on AMR was released in April 2017 along with the ‘Delhi Declaration on AMR’. All States and Union Territories of the countrywere called upon to develop their own action plans and make AMR a state level priority. So far,Kerala is the only state which in October 2018 released its plan – ‘Kerala Antimicrobial Resistance Strategic Action Plan’.
“Kerala’s action plan includes all necessary aspects to contain AMR. We are happy that we could share our learnings with other states through this important workshop”,said Rajan Khobragade, principal secretary, department of health and family welfare, Kerala.
The workshop saw participation from states such as Uttar Pradesh, Madhya Pradesh, Maharashtra, Telangana, Tamil Nadu, Karnataka, Odisha, Andhra Pradesh, Kerala and Delhi. Representative from various departments such as of health, animal husbandry, fisheries, food, drug, agriculture and pollution control attended the workshop. The importance of a multi-departmental plan with ownership and commitment was emphasized.
“Efforts to contain AMR will only succeed if they are multi-sectoral. The plans should aim to limit antibiotic misuse in human health and food animals and ensure adequate waste management from households, farms, factories and healthcare settings”,said Amit Khurana, programme director, food safety and toxins, CSE
The experts deliberated upon the need to check antibiotic prescription practices and over-the-counter availability of antibiotics. They also discussed the significance of limiting antibiotic use as growth promoters and disease prevention as well preservingcritically important antibiotics for humans, apart from focusing on addressing wasteand working towards integrated AMR surveillance.
India is expected to be heavily impacted by AMR unless a coordinated action is taken timely. On one hand, it has a huge burden of infectious diseases including drug-resistant tuberculosis. On the other,it is a big producer of antibiotics, milk, chicken, meat and fish and the share of food from intensive production systems – characterized by high chemical inputs and stocking densities – is increasing. There has been limited focus on waste management from farms and factories.
“We need to get our act together to stop the misuse of antibiotics in humans and animals. The experts at the meeting have shown how we can do this.We have a roadmap for Kerala under which antibiotics used for growth promotion and disease prevention could be phased-out in 3-5 years. We can also stop the use of antibiotics in animal feed and ban last-resort antibiotics like Colistin immediately. If Kerala can do it, so can other states”, said Chandra Bhushan, deputy director, CSE.
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