Organ transplants, bone marrow transplants, joint replacements – these are some of the many advances in modern medicine. But all of these leaps mean nothing if we do not tackle the problem of antimicrobial resistance. AMR is a huge problem for the country, and world. A few years ago people who were being admitted to hospitals were the ones developing infections with resistant bacteria. Today though, there are people who’ve had no previous contact with the medical profession who are having infections with resistant bacteria — which means we are harbouring resistant bacteria.
And it’s not just the humans. Irrational use of antibiotics is also polluting our food sources. They are used in animals as growth promoters as these drugs make the chicken, sheep and other animals gain weight fast. A study by the Centre for Science and Environment revealed that 40 per cent of chicken samples collected in India had antibiotics in them. More than one antibiotic was present in 17 per cent and quinolones (a group of synthetic broad-spectrum antibiotic drugs) were detected in 28 per cent of the birds.
We currently have no regulation to control antibiotic use in the poultry industry or to control sales of antibiotics to the industry. It is, according to the study, free for all. India has also not set any limits for antibiotic residues in chicken. There is compelling evidence to suggest that use of antibiotics, including those used in food production leads to resistance. Quinolones — that are being used to boost weight of chickens — are in fact, used to treat serious problems such as urinary tract infections, serious ICU infections and is a major component of management of drug-resistant tuberculosis. Feeding it to birds wastes years of scientific effort.
In 2012, the Clinical Infectious Diseases society gathered stakeholders from medical societies, government bodies, media, academics and international representatives and came up with a consensus document called the “Chennai Declaration”. The declaration was a roadmap that could’ve been used to tackle the threat but four years on, little has changed. A recent report commissioned by the British High Commission estimates about 7,00,000 deaths globally due to antimicrobial resistance. The estimated cost of this crisis is projected at a whopping $100 trillion and more importantly, it could cause “a return of the dark age of medicine”. There could be a way out though.
The UN, in its most recent assembly, made a pledge to fight antibiotic resistance. Dr Margaret Chan, Director General of the World Health Association, in her remarks called it a crisis and world leaders approved a wide-ranging declaration aimed at addressing rising AMR. However, equal attention must be paid to the “drug-addicted” food industry. Use of antibiotics in food must be banned. Today, it is difficult to obtain meat which is antibiotic free. Surprisingly, antibiotic-free animal product is more expensive.
The writer is Infectious Diseases Consultant, Apollo Hospitals, Hyderabad
