The looming threat of antimicrobial resistance
Action against AMR is a race against time and we all must work together to assure and preserve the longevity of antibiotics.
Antimicrobial resistance (AMR) is a growing threat to global public health as disease-causing germs (micro-organisms) develop resistance to life-saving antibiotics. As per a Lancet study, in 2019, five million human deaths were associated with bacterial antimicrobial resistance worldwide, including nearly 1.3 million human deaths attributable to bacterial AMR.
AMR occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial agents (commonly known as antibiotics), resulting in treatments becoming ineffective. The Food and Agriculture Organisation of the United Nations (FAO) in 2015 and 2019 underscored the importance and urgency of addressing the growing global threat of AMR.
FAO observed the World Antimicrobial Awareness Week (WAAW) between November 18 and 24 to educate, engage and collaborate with various stakeholders to tackle the emergence and spread of drug-resistant pathogens. The theme for WAAW 2023 was ‘Preventing Antimicrobial Resistance Together’, which underscored the need for collaborative efforts across sectors to safeguard the efficacy of these indispensable medicines.
It’s important to recognise that AMR knows no borders; it can afflict anyone, irrespective of age or nationality. Besides affecting humans, animal and plant health also faces the risk of AMR. The availability and judicious use of effective antimicrobials are indispensable for the health and welfare of terrestrial and aquatic animal production. However, the use of antimicrobials in animal health has surged due to the increasing burden of animal diseases, efforts to expand animal production, and inadequate investments in veterinary services.
Antimicrobials are being used as cheap alternatives to biosecurity, sanitation, and vaccination. This creates resistance and the antimicrobial-resistant microorganisms can swiftly move across communities and borders. AMR can infiltrate the general population through the food chain and spread by extending into agricultural products and the environment, contaminating waterways, wildlife, and soil. Overusing and misusing antimicrobials in animals can cause production losses and food insecurity eventually impacting human health.
India played a leadership role in creating awareness amongst policymakers and political leadership in 2011 through the Jaipur Declaration on Antimicrobial Resistance during the annual meeting of the World Health Organisation (WHO) Regional Committee for Southeast Asia. The declaration was signed by the health ministers of all 11 member countries of WHO’s region for Southeast Asia.
The sixty-eighth World Health Assembly in May 2015 endorsed a global action plan to tackle the growing problem of AMR. The primary objective of this plan is to enhance awareness, strengthen surveillance, assure rational use of antibiotics, strengthen infection prevention and control activities and promote innovation and investments to combat AMR through multisectoral actions. Between 2015 and 2017, India, through a process of extensive multi-sectoral national consultations developed its National Action Plan (NAP) on AMR (2017-2021) with the overarching goal to effectively contain AMR in India. India’s NAP is in alignment with the objectives and strategic approaches enunciated by the WHO Global Action Plan and was shared with the global community in April 2017.
India, under the leadership of the Indian Council of Agricultural Research (ICAR) and with technical support from FAO and USAID, has established a network of laboratories from the fishery and livestock sectors, known as the Indian Network for Fisheries and Antimicrobial Resistance (INFAAR) to undertake surveillance of AMR. Currently, eight fisheries research institutes and 11 livestock research centres including three universities, are actively engaged in AMR surveillance in food and aquatic animals.
FAO plays a pivotal role in assisting governments, producers, and stakeholders to responsibly use antimicrobials. Keeping in line with the theme of ‘Preventing Antimicrobial Resistance Together’, FAO works to ensure that responsibilities are shared among livestock and aquaculture farmers, prescribers, policymakers in food and agriculture, and other sectors. Together, preventive measures offer economic benefits, as against substantial GDP losses that could result from the widespread emergence of AMR as a global public health emergency.
FAO undertakes a coordinated, multisectoral, One Health approach in all countries in the context of the 2030 Agenda for Sustainable Development to address AMR. FAO under its quadripartite arrangement works closely with the WHO, World Organisation for Animal Health and the United Nations Environment Programme. The One Health response to AMR, spanning all sectors, can rescue millions of lives, safeguard antimicrobials for future generations, and secure our future against drug-resistant pathogens. Action against AMR is a race against time and we all must work together to assure and preserve the longevity of antibiotics.
Takayuki Hagiwara is FAO representative in India. The views expressed are personal