The One Health approach is a collaborative, multidisciplinary strategy recognizing that human, animal, and environmental health are interconnected, aiming to sustainably balance and optimize health for all by tackling shared threats like zoonotic diseases and antimicrobial resistance. The Manhattan principles, formulated in 2004, laid the groundwork for this by calling for a holistic “One World, One Health” perspective, urging collaboration to address health threats to life on Earth, including biodiversity loss, pollution, and emerging infectious diseases

 Challenges Associated with India’s NAP-AMR 2.0 (2025–2029)

India launched the National Action Plan on Antimicrobial Resistance 2.0 (NAP-AMR 2.0) on November 18, 2025. While it builds on the 2017–2021 plan with stronger governance and accountability, several critical challenges remain for its 2026 implementation

• Weak State-Level Implementation: Health is a “state subject” in India, yet most states lack formal AMR Action Plans or dedicated “AMR Cells”. Unlike programs for TB or maternal health, there are currently no financial incentives or penalties to motivate states to meet AMR targets.
• Enforcement vs. Regulation: While regulations exist, enforcing “prescription-only” sales of antibiotics and stopping over-the-counter (OTC) misuse remains difficult, especially in rural and underserved areas.
• Siloed Data Systems: Clinical, veterinary, and environmental data are often collected in different formats and stored in separate ministerial silos, hindering the “real-time” national dashboard needed for One Health surveillance
• Private Sector Gaps: A significant portion of healthcare and veterinary services in India is private. Engaging these labs and hospitals in data reporting and stewardship audits is a persistent hurdle.
• Environmental Neglect: Monitoring antibiotic residues in pharmaceutical effluents, hospital sewage, and farm runoff is technically complex and remains the weakest link in the current surveillance network.
• Economic & Behavioral Drivers: Factors like patient demand for “quick cures,” aggressive pharmaceutical marketing, and the economic use of antibiotics for growth in poultry/fisheries continue to drive irrational use

 “Given the accelerated rate of antimicrobial resistance, it is high time to implement a ‘One Health’ approach coupled with a robust surveillance system. Furthermore, the use of phage therapy should be promoted as a natural alternative treatment.”