Chennai: Nearly 13 billion pills were popped by Indians in the past years taking the country to the top of the list of pill popping nations of the world. This startling finding was a result of research by the Washington-based Centre for Disease Dynamics, Economics and Policy (CDDEP). Tamil Nadu too is not far behind as it witnessed an increase of nearly 35 per cent in consumption of over the counter drugs and anti biotics.
“Paracetamol, multi-vitamin tablets, zyntac, omeprazole capsules are the ones consumed heavily. As retailers, we know these are the highest selling drugs that are being bought over the counter. Consumption of these tablets in the past five years has definitely increased by nearly 30 to 35 per cent. Every year, pharma market growth rate is between seven to 10 percent. This is all due to high rate of consumption among the people of TN “, said K.K. Selvan, secretary , Tamil Nadu Chemists & Druggists Association.
“Indians need to change their behavioral approach or else chances are high that India might continue to remain as the highest pill consuming country in the world”, said, A. J. Tamhankar, national co-ordinator, Indian initiative for management of antibiotic resistance (IIMAR). “
In technical terms, it is behavior modification which can actually help India reduce its dependency on pills and prevent deadly viruses and bacteria becoming resistant to antibiotcs”, he said. After the State of the World’s Antibiotics Report (2015) was released by CDDEP, it was revealed that there was an increase in the presence of superbugs. Particularly in India, 57 per cent of infections in 2014 was caused by ‘Klebsiella pneumoniae’, a dangerous superbug found in hospitals, which was resistant to a type of antibiotics. This figure is against 29 per cent in 2008.
“There is currently no proper policy at the national level to regulate antimicrobial resistance in India. The policy introduced in 2011 has been put on hold. There is no restriction on over the counter (OTC) sale of antibiotics without prescription. Antibiotics can be purchased OTC without the need of a prescription which is a serious problem and needs to be addressed. For this a law is also needed. “ said N. Ramesh, scientist, Vellore Insitute of Technology.
The statistics brought out by CDDEP also made it clear that treatment options were slowly and steadily running out, he added. Explaining that antibiotic resistance is a direct result of antibiotic use, Tamhankar said, “More the patients use antibiotics, higher are the chances of antibiotic-resistant bacteria and viruses developing.”
He said, “ In India when people fall sick due to fever or stomach ache they randomly pop pills. When it doesn’t work, there is a common perception that people are becoming resistant to certain antibiotics and which is why there is no proper result. Later, they switch over to some other pills. However, it is the bacteria which are becoming resistant and awareness on this needs to be raised.”, he added.
“ The maximum misuse happens in self-limiting diseases like cough and cold, stomach aches and throat irritation among others. So improving hygiene and staying clean are some ways these infectious diseases can be kept away. This will reduce the dependency on pills” , Tamhankar said. Further, he also stressed on upgrading and enforcing the existing laws on sale of medicines to curb over-the-counter drug sale.
He also explained how lack of knowledge among medical representatives is another hindrance. “Small pharmaceutical companies have a huge spread across India and they hire medical representatives who are only interested in achieving their target and are hardly concerned on the social issues concerning anti-biotics and its misuse and side effects. Their qualification and understanding of the issues are also low.”
“Lifestyle, work pressure of Indians is such that nobody has time to get treated. People just want quick results as they hardly get sufficient time to get treated. So a lot of onus is on organisations to grant proper and sufficient medical leave to people who are not well.”, Tamhankar added.
Another interesting aspect was the curricula of MBBS courses across the country. There was no adequate focus upon the aspect of drug resistance, he explained. Meanwhile, Ram Subramanian, Apollo Hospitals, Chennai has a few solutions. “ Proper regulation of over the counter sale of antibiotics, strict monitoring of antibiotic usage inside hospitals and a proper scrutiny at the national level on antimicrobial resistance can go a long way to help solve this issue”.
Arvind Singh , national coordinator, Emerging Anti-Microbial Resistance Society (EARS) said a national policy for containment of antimicrobial resistance is needed. In the wake of threat of dengue in Tamil Nadu, the TN Chemists & Druggists Association is also sticking posters across the state asking people not to indulge in self medication and approach doctors, as rise in body temperature may just not be fever alone.
