Antimicrobial Resistance (AMR): WHO’s GLASS 2025 report highlights AMR in India as one of the world’s most severe threats
(UPSC GS Paper II – “Issues relating to development and management of health, healthcare and related services”)
Context (Introduction)
The WHO’s GLASS 2025 report highlights AMR in India as one of the world’s most severe threats, with one in three infections resistant to common antibiotics. This escalating challenge requires urgent surveillance, stewardship, public awareness, and sustained investment.
Main Arguments
- GLASS 2025 confirms India’s AMR burden is among the highest worldwide, driven by high infectious disease load, misuse of antibiotics, and weak regulatory enforcement.
- One in three bacterial infections in India (2023) is resistant to commonly used antibiotics, far above the global figure of one in six.
- Resistance is particularly high in E. coli, Klebsiella pneumoniae, Staphylococcus aureus, especially in ICUs where antibiotic pressure is intense.
- Surveillance gaps persist: Most Indian data come from tertiary-care hospitals, ignoring community and rural infections, thereby producing non-representative, skewed estimates.
- India has surveillance mechanisms (ICMR’s AMRSN/i-AMRSS and NCDC’s NARS-Net) but lacks geographical density and uniform participation.
- Implementation of India’s National Action Plan on AMR (NAP-AMR) has been slow; only Kerala has shown significant results through One Health collaboration, OTC-ban enforcement (AMRITH), and AMR literacy campaigns.
Criticisms / Drawbacks Highlighted
- Surveillance limitations: Tertiary hospitals overrepresent severe infections, exaggerating national averages and masking community-level patterns.
- Regulatory failures: OTC antibiotic sales, incomplete treatment courses, and environmental contamination from pharma and hospital waste remain poorly controlled.
- Slow State-level action: Except Kerala, most States have not operationalised AMR plans; coordination across human, animal, and environmental sectors is limited.
- Public disconnect: AMR feels abstract to citizens; lack of awareness fuels misuse.
- Thin antibiotic pipeline: Only a handful of truly innovative antibiotics exist globally; India has approved a few new agents but LMIC access gaps remain.
- Funding shortages: Minimal investment in surveillance expansion, innovation, diagnostics, and stewardship programmes undermines long-term response capacity.
Reforms and Strategies (from article + India’s broader research)
- Strengthen Nationwide Surveillance
- Expand beyond medical colleges by integrating 500+ NABL labs and building microbiology capacity in district and primary-level facilities.
- Adopt a full-network model for real-time, representative AMR estimates.
- Enhance Antibiotic Stewardship
- Enforce prescription-only sales; scale Kerala’s AMRITH model nationally.
- Implement strict monitoring of hospital antibiotic practices, especially in ICUs.
- Regulate antibiotic discharge from pharma units and hospitals to minimise environmental spread.
- Promote One Health Coordination
- Ensure coordination across human medicine, veterinary sectors, aquaculture, and environment—currently fragmented despite NAP-AMR goals.
- Replicate Kerala’s inter-sectoral model through State Action Plans.
- Improve Public Awareness & AMR Literacy
- Launch national campaigns that humanise AMR impacts, involving large nonprofits, patient advocates, community health workers, and schools.
- Aim for “antibiotic-literate” communities through localised campaigns.
- Boost Innovation, R&D, and Industry Partnership
- Support new antibiotic development with incentives for novel mechanisms of action targeting WHO’s priority MDR pathogens.
- Promote participation in global networks like the AMR Industry Alliance to improve diagnostics, innovation access, and responsible manufacturing.
- Sustained Funding & Policy Commitment
- Increase long-term investment in surveillance systems, antibiotic research, public health labs, and stewardship programmes.
- Develop a national AMR financing window with State–Centre cost-sharing.
Conclusion
India’s AMR crisis represents a slow-burning public health emergency. While Kerala shows that coordinated action, public awareness, and strict enforcement can reverse resistance trends, the national response remains fragmented. To “secure the future,” India must expand surveillance, regulate antibiotic misuse, foster innovation, and build societal understanding—transforming AMR from an abstract technical concept into a national health priority.
Mains Question
- “India’s antimicrobial resistance crisis reflects weaknesses in surveillance, stewardship, and public awareness. In the light of the GLASS 2025 report, evaluate the reforms needed to build a robust AMR response.” (250 words, 15 marks )