Context
In October 2025, the World Health Organization released the Global Antibiotic Resistance Surveillance Report 2025 (GLASS 2025). The report highlighted that AMR in India is among the highest in the world.
What is AMR?
- Antimicrobial Resistance (AMR) is the ability of microorganisms — such as bacteria, viruses, fungi, and parasites — to resist the effects of medicines designed to kill them.
- As a result, standard treatments become ineffective, infections persist, and the risk of spread, severe illness, and death increases.
- AMR emerges due to overuse, misuse, incomplete courses, poor infection control, and agricultural misuse of antibiotics.
What is the Current AMR Situation in India and Globally?
- Global Picture
- In 2023, globally 1 in 6 infections were resistant to antibiotics.
- Resistance is rising in several high-priority pathogens in many regions.
- India’s Situation
- India faces one of the highest resistance rates worldwide — 1 in 3 infections
- High resistance is seen in major pathogens such as coli, Klebsiella pneumoniae, Staphylococcus aureus — especially in hospital ICUs.
- Drivers include:
- Widespread over-the-counter (OTC) antibiotic access
- Self-medication and incomplete courses
- Environmental contamination from pharma units & hospitals
- Weak regulation and poor stewardship
- Gaps in surveillance and infrastructure
How is AMR Being Tracked and Managed in India?
- Surveillance Systems
- India uses two major networks:
- ICMR-AMRSN / i-AMRSS
- NCDC’s NARS-Net
- Data mainly come from tertiary hospitals, which:
- Treat more severe cases
- Use more antibiotics
- India uses two major networks:
- Hence overestimate national resistance
- Rural/primary-level data is limited, causing incomplete national estimates.
- Policy and Governance
- India joined WHO-GLASS in 2017.
- National initiatives exist (e.g., NAP-AMR), but progress is slow.
- Only a few States have operational State Action Plans — Kerala is the most advanced.
What Are States Doing? — Kerala’s Model
- Kerala’s Key Interventions
- Kerala Antimicrobial Resistance Strategic Action Plan (2018) — India’s first functional State Action Plan.
- Adopted One Health approach integrating human, animal & environmental sectors.
- Launched AMRITH (2024) to curb OTC antibiotic sales.
- Recent State antibiograms show a slight dip in AMR trends.
- Aim: Make the State “antibiotic-literate by December 2025” through public awareness and safe-use campaigns.
- National Step: Colistin Ban (2019)
- India banned colistin in food-producing animals — a major positive step.
- Long-term impact will be visible only through continued surveillance.
How is Innovation Responding?
- Globally, new antibiotics have been introduced, but the pipeline remains thin.
- Only 12 of 32 antibiotics under development meet WHO innovation criteria (new class, novel mechanism).
- India approved four new antibiotic candidates; six others are approved globally.
- Experts emphasize the need for:
- New antibiotics targeting MDR Gram-negative bacteria
- Affordable access in LMICs
- Antibiotics with low resistance potential
- Strong regulatory stewardship
Why does this crisis matter?
- Health Impact: More deaths, longer hospital stays, higher healthcare costs.
- Economic Burden: AMR affects productivity, agriculture, and national income.
- Health System Pressure: ICUs and hospitals face rising treatment failures.
- Societal Risk: Routine infections may become untreatable.
- Governance Impact: AMR threatens national preparedness and global health security.
Challenges and Way Forward
| Challenges | Way Forward |
| Surveillance limited to tertiary hospitals; community and rural data missing | Expand network to include 500+ NABL labs, strengthen labs in primary & district hospitals |
| Over-the-counter antibiotic sales, self-medication | Strict enforcement of prescription-only sales; pharmacy audits |
| Environmental contamination from pharma units and hospitals | Enforce effluent standards; regular environmental AMR monitoring |
| Weak hospital antimicrobial stewardship | Mandatory AMR committees; training; linking stewardship to accreditation |
| Slow progress on NAP-AMR and weak State Action Plans | Dedicated funding; inter-sectoral One Health governance |
| Low public awareness of AMR | Mass awareness campaigns; school curriculum integration |
| Thin antibiotic pipeline | Incentivise R&D; global partnerships; ensure affordable access to new antibiotics |
Conclusion
AMR is escalating into one of India’s most urgent public health threats. Surveillance gaps, misuse of antibiotics, and slow policy implementation continue to worsen resistance. Yet Kerala’s example demonstrates that coordinated action — combining regulation, public awareness, stewardship, and One Health strategies — can reverse trends.
| EnsureIAS Mains Question
Q. Explain the key drivers of Antimicrobial Resistance (AMR) in India and briefly suggest measures to strengthen surveillance and antibiotic stewardship at the national level. (250 Words) |
| EnsureIAS Prelims Question
Q. With reference to Antimicrobial Resistance (AMR) in India, consider the following statements: 1. Most of India’s AMR surveillance data currently comes from tertiary hospitals, which may overestimate national resistance levels. 2. Kerala’s AMRITH initiative aims to curb over-the-counter sales of antibiotics. 3. Colistin continues to be widely used as a growth promoter in India’s poultry and livestock sectors. 4. India joined the WHO Global Antimicrobial Resistance Surveillance System (GLASS) in 2017. Which of the statements given above are correct? a. 1, 2 and 4 only Answer: (a) 1, 2 and 4 only Explanation: Statement 1 is Correct: India’s AMR data mainly comes from tertiary centres (ICMR AMRSN / NARS-Net), giving an incomplete, higher-end picture. Statement 2 is Correct: Kerala’s AMRITH (2024) specifically targets OTC antibiotic sales as part of its state AMR strategy. Statement 3 is Incorrect: India banned colistin as a growth promoter in food-producing animals in 2019. Statement 4 is Correct: India joined the WHO GLASS surveillance system in 2017. |
