What should states in India do to contain and prevent antimicrobial resistance?

National consultation jointly organised by CSE and WHO throws up suggestions

  • One Health action in states critical to prevent and contain AMR in India 
  • Over 50 One Health stakeholders from 15 states came together at a national consultation to discuss and outline key action needed 
  • Event organised as part of Centre for Science and Environment’s (CSE) initiatives to mark the World AMR Awareness Week 2023 – new report on “One Health Action to Prevent and Contain AMR in Indian States and Union Territories” released on the occasion 

New Delhi, November22, 2023: “Our response to the crisis of antimicrobial resistance or AMR is now not just limited to human health. The action that is needed from stakeholders of the food, animal, crop and waste sectors is now becoming clear,”  said CSE director general SunitaNarain, here yesterday while inaugurating a national consultation jointly organised by CSE and World Health Organization (WHO)-India. 

The consultationwas part of a series of initiatives planned by CSE to mark the World AMR Awareness Week (WAAW), observed every year from November 18-24.Over 50 stakeholders from more than 15 states in India came together to discussthe action required in states to prevent and contain antimicrobial resistance (AMR), a ‘silent pandemic’ with severe known impacts on health, livelihood and development. 

Speaking at the consultation, Dr Roderico H Ofrin, WHO Representative to India, said: “It is critical for all states and Union territories to develop their State Action Plans for Containment of Antimicrobial Resistance (SAPCAR)… using a One Health approach that engages all key stakeholders across sectors.” 

Amit Khurana, director, sustainable food systems programme, CSEechoed Dr Ofrin’s views. “As concerns related to health, animal husbandry, fisheries, agriculture, pollution control, water and sanitation are best addressed at the state level, states should take the lead in multi-sectoral action in India,” he said. 

The consultation also saw the release of a joint CSE-WHO report, ‘One Health Action to Prevent and Contain AMR in Indian States and Union Territories’, which has been put together based on suggestions received from experts and stakeholders in state government departments of health, animal husbandry, agriculture, pollution control, food and drugs. 

The report details out cost-effective, implementable and impactful policy and on-the-ground interventions across human health, livestock, fisheries, crops and environment sectors. The actions are aligned to key areas such as awareness building and education, surveillance, AMR prevention and control, and optimised antibiotic use. 

“For countries like ours, the agenda should be about development without much use of chemicals in food production. It should be about prevention as we cannot afford the cost of AMR. It should also be about conserving the last-resort antibiotics and managing the waste well to contain the AMR spread,” concluded Narain. 

Key suggestions by states to contain AMR across One Health sectors 

Building awareness and understanding

  • Identification of target audiences for awareness creation and education, and developing precise and clear messaging (through slogans, films, jingles, survivor stories and case studies)
  • Leveraging different mediums and platforms for building awareness, preferably in local languages.The platforms could include social media, department websites, information, education and communication (IEC) materials and advertisements
  • Observing the AMR Week and running continuous awareness, education and training programmes
  • Mainstreaming AMR understanding in education
  • Livestock, fisheries and crops sector: Focus on preventing infections/diseases through biosecurity, vaccination, infection prevention and control, use of alternatives etc
  • Environment sector: Awareness on point-non point sources of AMR pollution, how waste management can help reduce such pollution, and what measures or solutions are in place. 

Laboratories and surveillance — AMR and AM residues

  • Periodic monitoring and reporting of antibiotic resistance and antibiotic residues
  • Identification of state-level or reference laboratories and creation of state-level surveillance networks
  • Strengthening of microbiology laboratories and training human resources for conducting surveillance
  • Make monitoring data available publicly
  • Livestock, fisheries and crops sector: Developing species-specific surveillance strategies,harmonisation of SOPs across lab-networks (apex lab to district level), leveraging existing laboratory facilities/data/studies within each sector as well as from other sectors 

Infection prevention and control

  • Livestock sector: Development of state-level IPC action plans, ensuring regular vaccination, developing SOPs on biosecurity, correct disposal of dead animals or compliance with biomedical waste disposal methods at farms, veterinary facilities etc.
  • Fisheries sector: Development of inventory of fish diseases, SOPs for water quality and good farm management, adoption of appropriate biosecurity and waste management measures, promoting Integrated MultiTrophic Aquaculture (IMTA) with caution
  • Crops sector: Preventing diseases through timely weed control and plant nutrient management; preventing AMR spread from animal farms to crop farms by avoiding crop application of undecomposed/untreated organic manure (eg, poultry litter)
  • Environment sector: Drug take-back policy or programme for disposal of unused/expired antibiotics at household and farm levels, and encouraging adoption of process control measures and good waste management practices in pharmaceutical manufacturing 

Optimisingantimicrobial use

  • Livestock sector: Developing standard treatment guidelines, monitoring antibiotic usage in different sectors, regulating antibiotic use (discontinue antibiotic use as growth promoters, discourage their disease preventative use and conserve critically important ones), regulate feed containing antibiotics and registering feed, feed manufacturers and dealers, revise and/or clarify the definition of “drug” in the D&C Act which includes the word “prevention”, and promote use of alternatives to antibiotics
  • Fisheries sector:Developing an action plan on fish health, inventory of chemicals/aqua drugs (including antibiotics) used for the treatment of different diseases in fish, registering aqua drug dealers/sellers under state fisheries act
  • Crops sector:Developing antibiotic use guidelines and ensuring use of only approved antibiotics, soil treatment and vector control measures to limit diseases, develop low-cost affordable tools to detect antibiotics in crop produce  

For access to the consultation presentation and the new CSE-WHO report, please visit: https://www.cseindia.org/national-stakeholder-consultation-11947 

For any additional information, please contact Sukanya Nair of The CSE Media Resource Centre, sukanya.nair@cseindia.org, 8816818864.