DAW 14th November 2025, Mains Answer Writting 2026

DAW 14th November 2025, Mains Answer Writting 2026

Question

Discuss the major reasons behind the rapid growth of AMR(Antimicrobial Resistance) in India. Highlight the effectiveness of India’s policy interventions in tackling AMR. (250 Words, 15 Marks).

Model Answer

Approach: Introduction:

  • Define AMR and relate it with India.

Body:

  • Key Reasons for the Rise of AMR in India

  • Challenges Posed by AMR

  • India’s Policy Interventions to Tackle AMR

  • Way Ahead to Reduce AMR

Conclusion:

  • AMR is a growing public health threat requiring coordinated One Health action, strong regulation, and awareness.

  • Urgent steps are essential to curb resistance and uphold SDG-3 and SDG-12 goals.

Introduction:

  • Antimicrobial Resistance (AMR)—the ability of microbes to withstand antimicrobial drugs—has emerged as a major global health threat. India, with its high disease burden and extensive antibiotic use, has become a key hotspot for rising AMR. The spread of these “superbugs” undermines routine treatment and threatens public health security, making it vital to examine the drivers of AMR and the effectiveness of India’s policy response.

Body: Key Reasons for the Rise of AMR in India:

  • Irrational & Excessive Antibiotic Use:

  • Widespread misuse- OTC(Over The Counter) access, self-medication, incomplete courses, and use for viral illnesses.

  • Example: In 2022, 59% of India’s antibiotics were from WHO “Watch” group, meant only for severe infections.

  • Weak Diagnostics & Limited Lab Capacity:

  • Lack of routine culture tests- doctors rely on broad-spectrum antibiotics. Surveillance limited mostly to tertiary hospitals.

  • Example: WHO’s Global antibiotic resistance surveillance report 2025 shows 1 in 3 infections in India is resistant, but community-level data is largely missing.

  • Poor Infection Prevention & Control (IPC) in Hospitals:

  • Overcrowded wards, inadequate sanitation, poor sterilisation- rapid spread of resistant pathogens.  Example: Frequent ICU outbreaks of Klebsiella, Acinetobacter, and Candida auris.

  • Extensive Antibiotic Use in Agriculture & Animal Husbandry:

  • High antibiotic use for growth promotion in poultry, aquaculture, and livestock.  Example: Pre-2019 colistin use in poultry created colistin-resistant superbugs.

  • Environmental Contamination & Poor Waste Management:

  • Pharmaceutical effluents, untreated hospital waste, and sewage contamination create resistance hotspots.

  • Example: The contamination near pharma manufacturing clusters, spreading resistant microbes.

  • Limited Availability of New Antibiotics:

  • Big pharma’s exit from antibiotic R&D- dependence on older drugs with rising resistance.  Example: Only recently India approved new agents like Nafithromycin (2024), but the global pipeline remains thin.

  • Weak Regulation & Enforcement of Antibiotic Controls:

  • Poor monitoring of prescriptions, and OTC antibiotic sales.

  • Example: Only Kerala’s AMRITH (2024) has effectively cracked down on pharmacy violations, showing early dip in AMR trends.

Challenges Posed by AMR:

  • Undermines Modern Healthcare

  • Surgeries, chemotherapy, transplants become risky.

  • Ex: Rising ICU resistance to E. coli / Klebsiella.

  • High Mortality & Morbidity

  • Infections become harder to treat; deaths rise.

  • Ex: India saw ~3 lakh AMR-attributable deaths (IHME).

  • Economic Burden

  • Longer hospital stays, higher treatment cost, productivity loss.

  • Ex: World Bank warns USD 1T global health cost by 2050.

  • Threat to Food Security

  • Resistant infections in poultry/livestock spread to humans.

  • Ex: Colistin-resistant E. coli in Indian poultry.

  • Risk of Future Superbug Pandemic

  • Fast-spreading resistant microbes can cause outbreaks.

  • Ex: Candida auris hospital outbreaks.

India’s Policy Interventions to Tackle AMR:

  • National Action Plan on AMR (2017):

  • Aligns with WHO Global Action Plan; focuses on awareness, surveillance, rational antibiotic use, IPC, and research.

  • Delhi Declaration on AMR:

  • High-level inter-ministerial commitment to address AMR in mission mode, involving research institutes, civil society, SMEs, and promoting PPP models.

  • AMR Surveillance Networks (NARS-Net) National Antimicrobial Surveillance Network) & GLASS):

  • India monitors nine priority pathogens; participates in WHO-GLASS to standardise national and global AMR data.

  • Antimicrobial Stewardship Programs (AMSP):

  • ICMR’s AMSP piloted in 20 tertiary-care hospitals to curb overuse in ICUs and wards; hospitals promote rational antibiotic protocols.

  • One Health Approach:

  • Promotes integrated action across human–animal–environment sectors; focuses on zoonoses, food safety, AMR containment.

  • Colistin Ban in Animal Feed:

  • ICMR + ICAR + DCGI banned colistin as a growth promoter in poultry to stop transmission of colistin-resistant superbugs.

  • Integrated One Health AMR Surveillance:

  • ICMR + ICAR building a network to integrate veterinary labs into national AMR surveillance.

  • Research & Innovation Support:

  • Platforms like C-CAMP AMR Challenge support startups; Indian companies like Wockhardt, Bugworks, Orchid Pharma develop next-gen antimicrobials.

  • Public Awareness Initiatives:

  • Red Line Campaign warns against irrational antibiotic use; NAP mandates mass awareness programmes on AMR.

Way Ahead to Reduce AMR:

  • Strengthen Sanitation & Infection Control

  • Improve hospital hygiene, sterilisation, and hand-washing to prevent resistant infections.

  • Example: WHO’s “Clean Care is Safer Care” model reduces hospital-acquired infections.

  • Enforce Strict Antibiotic Regulations

  • Implement Schedule H1 rules to curb OTC sales and irrational prescriptions.

  • Example: Kerala banned OTC sale of antibiotics in 2024.

  • Invest in Public Health & Lab Infrastructure

  • Build strong surveillance labs, trained staff, and quality hospitals to detect AMR early.

  • Example: States with robust systems (as per NCDC) report lower AMR levels.

  • Improve Environmental & Pharma Waste Governance

  • Regulate sewage, pharma effluents, and antimicrobial waste entering water bodies.

  • Example: Involving MoEFCC to curb antibiotic discharge from pharma hubs.

  • Adopt One Health Approach

  • Integrate human, animal, and environmental health action.

  • Example: Reducing antibiotic use in livestock and limiting agricultural fungicides.

  • Boost R&D for New Antibiotics

  • Encourage public–private investment and use global funds.

  • Example: AMR Action Fund supports new antimicrobial development.

  • Public & Patient Awareness Campaigns

  • Educate communities on avoiding unnecessary antibiotics.

  • Example: Peru’s patient-education model reduced demand for antibiotics.

Conclusion:

  • AMR is a silent public health crisis that threatens routine treatment and global health security. A strong push for One Health collaboration, tighter regulation, improved diagnostics, robust R&D, hospital stewardship, and greater public awareness is essential. Coordinated action across sectors can curb resistance and help India advance its commitments under SDG 3 (Good Health) and SDG 12 (Responsible Consumption).