The overuse and unrestricted access to antibiotics without a doctor’s prescription have emerged as significant contributors to the rise of drug-resistant diseases in India. This concerning trend stems from a combination of factors, including self-medication practices, inadequate regulation of antibiotic sales, and cultural beliefs that encourage the unnecessary use of antibiotics for various ailments. As a result, bacterial strains are evolving to resist the effects of commonly used antibiotics, rendering once-effective treatments ineffective. This poses a grave threat to public health as it limits the options available for treating infections and increases the likelihood of prolonged illness, higher healthcare costs, and mortality rates.
To address these challenges, several mechanisms for monitoring and controlling antibiotic use have been implemented. These include stringent regulations on antibiotic sales, educational campaigns to promote responsible antibiotic use, and surveillance systems to track antibiotic consumption patterns and the prevalence of drug-resistant bacteria. Additionally, initiatives such as antibiotic stewardship programs in healthcare settings aim to optimize antibiotic use and minimize the development of resistance.
Decoding the Question:
- In intro, try to write about drug resistance.
- In Body,
- The first part of the answer discusses factors behind drug resistance and AMR, especially overuse and free availability of antibiotics without Doctor’s prescription.
- In the second part of the answer discuss available tools for monitoring and mechanism tools for overuse and free availability of Antibiotics.
- Try to conclude with some suggestions.
Answer:
In India, a lot of medicines are available over the counter and most medications can be procured without producing a doctor’s prescription. Also, self-medication by persons unaware of medical intricacies is widely prevalent in India. Both these factors have contributed to the emergence of drug-resistant diseases in India because it allows persons to freely take medication without a doctor’s supervision.
Overuse and free availability of antibiotics as reason for Drug resistance in India:
- Easy availability and Over the counter sale: Bacteria and fungi do have adaptation mechanisms to avoid the effects of the antibiotics used to treat the infections they cause. Prolonged and frequent use only enables them to develop resistance.
- Poultry and cattle farming: In India use of antibiotics in poultry and cattle farming is one of the highest. The same animal products consumed by human beings drive drug resistance in them also. Scientists have found drug-resistant bacteria in meat and food crops
Mechanisms and tools to control drug resistance:
- Improve Sanitation and Prevent the Spread of Infection: Prevention is better than cure – by improving healthcare systems and living standards we can markedly reduce the demand for antibiotics and therefore give less chance for new resistance strains to develop. It is estimated that improving sanitation in India would decrease the use of antibiotics to treat diarrhea by 60%. Example Swachh Bharat Mission.
- Reduce Unnecessary Use of Antimicrobials in Agriculture and Their Dissemination into the Environment: The vast majority of global antimicrobial consumption comes from agriculture and aquaculture. In India medically important antibiotics are largely used in agriculture. The use of antibiotics solely for infection prevention and more importantly, growth promotion, should be considered dangerous and unnecessary.
- Improve Global Surveillance of Drug Resistance and Microbial Consumption: For scientists and physicians to elucidate the mechanisms of acquiring new resistance, monitor the cases already present and to anticipate future threats, they need to have better insight into current and past AMR-related data. Therefore, three areas require better structure and information: antibiotic consumption among humans and animals, resistance rates for the available drugs and research knowledge on the molecular foundations of AMR.
- Promote Development and Use of Vaccines and Alternatives: With increasing vaccination, the number of infected people needing antibiotic treatment would reduce. Although there are currently no licensed vaccines against the most urgent pathogens, there are promising clinical candidates coming up against Clostridium difficile and Pseudomonas aeuroginosa.
- Improve the Number and Recognition of People Working with Infectious Disease: Addressing AMR requires a qualified workforce to implement them. There is a shortage of key professional figures such as microbiologists, infectious disease specialists, infection control specialists, pharmacists, nurses, veterinarians, and epidemiologists, for example. Therefore, India needs to invest in training and rewarding these specialists.
- Better Incentives to Promote Investment for New Drugs and Improving Existing Ones: The development of new antibiotics is not very attractive for pharmaceutical companies since there are still (relatively) effective antimicrobial compounds on the market. It is difficult to predict exactly how and when AMR will develop, leaving pharmaceutical companies in uncertainty when making business decisions. The challenge is to introduce rewards for successful introductions of new antibiotic therapies on the market.
- Build a Global Coalition for Real Action: Global action is essential to make meaningful progress in tackling AMR. Putting AMR on the international political agenda and tackling it using “ONE HEALTH APPROACH” is important for impacting change. For example, actively engaging with the G20 or the United Nations could help to put AMR on the political agenda.
- Redline campaign: red campaigns have been running in India to stop using drug resistance through awareness generation.
- Online drugs: Now increasing digitisation and increasing platforms drugs selling need to be monitored with proper mechanism to avoid misuse of antibiotics. Need to make law to regulate online drug selling will also help in monitoring their sell and consumption related data.
Creating awareness regarding the repercussions of excessive usage of antibiotics is the need of the hour. The government should conduct aggressive advertisement campaigns enlightening the public about the issue, and also rope in doctors who can disburse pamphlets explaining the adverse effects to all their patients.
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