Though the problem of anti-microbial resistance (AMR) has been discussed for long, its impact has not been clearly estimated till now. This is because it was difficult to clearly separate and distinguish the casualties and impairment caused by it from those caused in other ways. But the first comprehensive study of its impact at the global level and its conclusions are cause for serious concern. A study conducted in 204 countries and territories and published in Lancet estimates that AMR directly caused 1.27 million deaths and played a role in 4.95 million deaths in 2019 worldwide. It is now a leading cause of death, taking more lives than HIV/AIDS and malaria. The threats to health from AMR and conventional diseases have not received much attention during the Covid pandemic, but they need to be taken seriously now.
Anti-microbial resistance is, in simple terms, the immunity gained by disease-causing microbes to the drugs used to fight them. When they acquire such ability, drugs are no longer effective against them. Sometimes the dosage of the drugs will have to be increased and there might come a stage when they can no longer fight the disease-causing pathogens. AMR is caused by the indiscriminate use of antibiotics, their use in farming and poultry, and the absence of best practices in hospitals and the lack of hygiene and sanitation. The report has for the first time shown the impact of a range of pathogens and estimated the number of deaths caused by them. It has produced a wealth of data that will be useful for medical practitioners, analysts and authorities to formulate appropriate responses to the problem. The study found that drug-resistance in pulmonary infections had the greatest impact in terms of deaths and young children were particularly at risk.
Deaths caused directly by AMR and associated with it were the highest in sub-Saharan Africa and South Asia. The risk is particularly great in India which has a poorly functioning healthcare system. The central government formulated an AMR action plan in 2017 and some states are said to be making a similar plan. Some isolated decisions and actions like the ban on a particular drug have been taken. But the fight against AMR is yet to become a part of medical practices. Treatment ethics and habits have to undergo changes. The sale and use of antibiotics need to be regulated and processes that can counter AMR have to be put in place. There is also the need for more research into the problem. But it is clear that steps have to be taken at local, national and international levels to tackle it.