What began as an ordinary and persistent fever and stomach ache turned into a life-threatening infection when a young man, instead of going to the doctor, took ciprofloxacin on his own. The antibiotic failed to work because the bacteria had become resistant. By the time the patient reached the hospital, he had severe intestinal bleeding and a perforated intestine that required surgery.
This is a documented case of Antimicrobial Resistance. In India, according to the most recent data,1.04 million deaths were associated with AMR between the years 1990-2021 and around 1 out of 3 sepsis deaths are linked to AMR, according to a 2024 Lancet Analysis 2024.
WHY INDIA IS AT HIGH RISK
There are a number of reasons why India is considered one of the countries most vulnerable to AMR. This happens because, in an Indian household, self-medication is common; instead of going to the doctor to get yourself checked, people treat antibiotics as quick fixes. For instance, some people, instead of taking the complete course, just take it until they feel better. One of the major issues remains cost; going to the hospital is still not accessible to low-income families. In this economy, health is not treated as a priority. One of the other reasons we are ahead of other countries is the over-the-counter access to antibiotics; without prescriptions, we can get medicines at the chemist.
AMR SURVEILLANCE AND RESEARCH NETWORK (AMRSN)
The Indian Council of Medical Research (ICMR) launched the AMR Surveillance and Research Network in 2013, which every year publishes reports based on data from hospitals across India, and these consistently show that E. coli, Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa are among the most drug-resistant pathogens.
AMRSN has created the first national database on this issue. Instead of capturing one-time snapshots, the network continuously monitors resistance patterns; it supports genomic research by using molecular techniques and whole-genome sequencing to understand how bacteria develop resistance, how resistance spreads between hospitals and communities and whether outbreaks are caused by the same bacterial clones, helping scientists detect emerging superbugs earlier and design targeted interventions.
NATIONAL ACTION PLAN ON AMR 2.0 (2025-2029)
This was launched by the Ministry of Health and Family Welfare. The National Action Plan on AMR builds on the first national action plan (2017-2021). It has been designed to be aligned with the WHO Global Action Plan and adopts a One Health approach.
The One Health approach states that this issue is not just a hospital problem but rather something which involves other dimensions such as Animal Husbandry, Agriculture, Fisheries and Environment by bringing in these ministries as well.
NAP-AMR 2.0 encourages development of rapid diagnostic tests, research into new antibiotics and alternative therapies and greater collaborations between research institutions. Many supporting initiatives have also taken place, one of the major ones being the Hospital Antibiotic Stewardship Programme; these programmes review antibiotic prescriptions, recommend the most appropriate drug and dosage, restrict unnecessary use of last resort antibiotics and monitor resistance trends within hospitals.
While these initiatives represent a moving trend and hope for a better future with controlled AMR cases, records of implementation suggest that the above statement might just be an overestimation of governments’ powers, as we see that certain rules like prescription-only rules are not always enforced, surveillance coverage in rural India remains a question mark, and public awareness about antibiotic use remains limited. So, in conclusion, these steps have given us some hope for betterment, but whether these policies will translate into measurable betterment or not is yet to be seen.
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