India is yet to regulate antibiotic use and it serves as a cause of concern.
What are the recent happenings?
A recent investigation found that the world’s largest veterinary drug-maker, Zoetis, was selling antibiotics as growth promoters to poultry farmers in India.
It had stopped the practice in the U.S, since the U.S. banned the use of antibiotics as growth-promoters in early 2017.
Even then, India is yet to regulate antibiotic-use in poultry.
Technically, the drug-maker was doing nothing illegal and complying with local regulations in both countries.
But such reasoning is self-defeating, because antibiotic-resistance does not respect political boundaries.
What is the status of India?
India stands to lose the most from antibiotic resistance is India, given that its burden of infectious disease is among the highest in the world.
According to a 2016 PLOS Medicine paper, 416 of every 100,000 Indians die of infectious diseases each year.
This is more than twice the U.S.’s crude infectious-disease mortality-rate in the 1940s, when antibiotics were first used there.
Thus if these miracle drugs stop working, no one will be hit harder than India.
This creates a need for a tighter regulatory regime in the country.
What are the steps taken so far?
There are three major sources of antibiotic resistance –
Overuse of antibiotics by human beings
Overuse in the veterinary sector
Environmental antibiotic contamination due to pharmaceutical and hospital discharge.
To tackle the first source, India classified important antibiotics under Schedule H1 of the Drugs and Cosmetics Rules 1945.
Under the Rules, drugs specified under Schedule H and Schedule X are required to be sold by retail on the prescription of a Registered Medical Practitioner only.
Even then, Schedule H1 drugs are freely available in pharmacies, with state drug-controllers unable to enforce the law widely.
To tackle the second source, India’s 2017 National Action Plan on Antimicrobial Resistance did talk about restricting antibiotic use as growth promoters.
But the lack of progress on this front allows companies to sell last-resort drugs to farmers over the counter.
To tackle the third source, the same national action plan spoke about regulating antibiotics levels in discharge from pharmaceutical firms.
For instance, Hyderabad’s pharmaceutical industry has been pumping massive amounts of antibiotics into local lakes, rivers and sewers.
This has led to an explosion in resistance genes in these waterbodies.
Still, India is yet to introduce standards for antibiotics in waste water, which means antibiotic discharge in sewage is not even being monitored regularly.
What should be done?
Antibiotics lose their efficacy against deadly infectious diseases worldwide.
According to a 2013 estimate, around 58,000 newborns die in India each year due to sepsis from resistant bacteria.
As the country takes its time to formulate regulations, the toll from antibiotic-misuse is growing at an alarming rate.
The issue also seems to be business as usual for governments, private corporations and individuals who have the power to stall a post-antibiotic health complication.
Thus there is a need for stricter regulations and regulated monitoring, else India will have no one to blame but itself.
