“AMR Declaration Trust”– a public charitable trust – is founded on the principles of the “Chennai Declaration” and aims to tackle the challenge of AMR( Antimicrobial Resistance) by collaborating with various relevant Governmental and Non-Governmental Organizations. Only with the collaborative work we can successfully tackle AMR’s complex challenge. We should ensure professionals of different specialities, bureaucrats, political leaders and, more importantly, the public need to come together to find a sustained solution to the AMR issue. In addition, we need serious and collaborative efforts to develop new antibiotics, diagnostics, vaccines, and other technologies that help us tackle the challenge of AMR.

The global challenge of AMR (Antimicrobial Resistance)

Antimicrobial resistance (AMR) is a serious and complex challenge expected to cause millions of lost human lives in the immediate future. AMR is a silent, slow, but steadily spreading pandemic that has not yet received the due attention of the stakeholders. As per the GRAM (Global Research on Antimicrobial Resistance) report, over 1.2 million are estimated to have died in 2019 due to AMR per se. This death toll is much higher than malaria and HIV/AIDS deaths. Deaths due to AMR are highest in South Asia and Sub-Saharan Africa. As per a study done by the Center for Disease, Dynamics, Economics & Policy, an estimated 2 million deaths are expected to occur in India due to AMR. The primary driver of antibiotic resistance is antibiotic use (rather misuse) in various settings. Irrational antibiotic use is further fueled by the high burden of infectious diseases in low-middle income countries, which demands early initiation of antibiotic therapy in many clinical situations. Antibiotic use in humans accounts for only a minuscule of the total antibiotics consumed in the world. Antibiotics are used as growth promoters in the cattle and animal husbandry industry, leading to a high burden of antibiotic exposure in the environment. Besides this, antibiotics, and other antimicrobial chemicals such as disinfectants in municipal and industrial wastewater make AMR a problem that sets its roots deep into our system.

On the other hand, the inadequate investment by the pharmaceutical industry in developing new antibiotics has led to a dry antibiotic pipeline. Vaccines that prevent bacterial and viral infections can significantly reduce antibiotic prescriptions. We urgently need new antibiotics and rapid diagnostics. We need to step up laboratory facilities. A multi-pronged approach is required to tackle the complex challenge of AMR. Over the last two decades, we have witnessed various prominent initiatives to handle this issue. National policy for the containment of antimicrobial resistance was released in 2011.” Jaipur Declaration” by the health Ministers of the WHO Southeast Asian region was one of the first WHO-Govt collaborative efforts. “Chennai Declaration”, an initiative with the participation of various medical societies and multiple other Organizations in India- formulated in 2012, was one of the first collaborative steps that made a significant impact at the national and international levels. NCDC and ICMR also have an AMR surveillance network involving more than two dozen centres. In collaboration with WHO, Union Health Ministry prepared the National AMR Action plan in 2017. A significant political commitment came in 2016 when the Prime Minister of India announced the “red line” campaign. A red line on the antibiotic packaging is aimed to draw public attention to the dangers of its misuse and has been lauded internationally. With the collaboration of the Indian division of WHO, the Union Health Ministry is now helping various states prepare and implement state-level AMR action plans. These steps are welcoming and encouraging, but more is needed to understand and defeat the demon of AMR.