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Call to Action on Preserving the Power of Antibiotics

Despite having one of the fastest growing economies in the world, India continues to lag in terms of both antibiotic access and controlling antibiotic resistance, according to the 1st Global Forum on Bacterial Infections: Balancing Treatment Access and Antibiotic Resistance that is being held in the capital. The Global Forum has brought together Health Ministers and Public Health experts from across the globe to share path-breaking research on bacterial infections and antibiotic resistance, which together lead to lakhs of preventable deaths. The meeting’s inaugural session, which featured speeches from health officials including Hon. Dr Ghulam Nabi Azad, Minister of Health and Family Welfare of the Government of India, also saw the release of the New Delhi Call to Action on Preserving the Power of Antibiotics, a document acknowledging the high toll of antibiotic resistance while supporting strategies to contain it. The Global Forum was co-organised by the Public Health Foundation of India (PHFI) and the Center for Disease Dynamics, Economics & Policy (CDDEP).

“Antibiotic use is increasing in the developing world in countries like India and China, which is a positive sign as it indicates that there is increased access to life-saving treatments. No one should be denied antibiotics to cure a bacterial infection, but the drugs are also used inappropriately, which drives antibiotic resistance,” said Dr Ramanan Laxminarayan, Vice President for Research and Policy at the Public Health Foundation of India and Director of the Center for Disease Dynamics, Economics & Policy. “We have to expand access while making sure that these valuable drugs are available for future generations.”

Every use of antibiotics contributes to the development of antibiotic-resistant bacteria, and inappropriate use speeds their evolution. Between 2005 and 2009, antibiotic consumption in India rose by about 40%. How much of this increase was due to unnecessary use is not known, but the sharp increase in resistance during this period highlights the need to ensure that antibiotic effectiveness is not depleted.

Research discussed at the Global Forum highlighted opportunities to expand access to treatment while preserving the effectiveness of first-line drugs. “At the same time that Kenya is experiencing higher levels of antibiotic resistance, pneumococcal disease still accounts for 20 percent of all deaths of children under five,” said Hon Professor Peter Anyang’ Nyong’o, Minister of Medical Services of the Republic of Kenya. “Most of these deaths are preventable with appropriate antibiotic treatment, and we take seriously our responsibility to make sure these children have access to affordable, effective antibiotics, now and in the future.”

The need to develop sensible antibiotic policies inspired the creation of the Global Antibiotic Resistance Partnership (GARP) which works in countries around the world to help create national policies to fight drug resistance.

The GARP-India working group revealed at the meeting that India is experiencing a growing problem with antibiotic resistance. GARP-India research estimates that of the approximately 190,000 neonatal deaths in India each year due to sepsis – a bacterial infection that overwhelms the bloodstream -, over 30 percent are attributable to antibiotic resistance. In addition, antibiotic resistant hospital infections are also a serious concern in India. Because antibiotics are used intensely in hospitals compared with the community, and frequent use drives the development of highly resistant bacteria, these infections can be especially deadly. Anywhere from 11 percent to 83 percent of hospitalised patients in India acquire these infections.

GARP recommendations include enforcing hospital infection control measures, expanding vaccination efforts, encouraging judicious antibiotic prescribing and regulating the use of antibiotics in livestock, an area where India lags behind. There is no regulation in India on the use of antibiotics even in food animals such as poultry, dairy cows and buffaloes that are raised for domestic consumption. The “Prevention of Food Adulteration Rules, 1995-part XVIII: Antibiotic and other Pharmacologically Active Substances” applies only to the use of antibiotics in certain types of seafood, and the Export Inspection Council of India only prohibits the use of certain antibiotics in the feed and medication of poultry intended for export.

The New Delhi Call to Action issued at the 1st Global Forum on Bacterial Infections acknowledged antibiotics as a shared common resource and put forth a commitment to preserve the power of these drugs through encouraging appropriate drug prescribing, dispensing and use, strengthening and enforcing regulation to ensure drug quality, implementing surveillance for resistant bacteria and for antibiotic use patterns and stimulating R&D for new antibiotics, among other measures.

“This Call to Action is an important stepping off point for India and other nations to take seriously the need to preserve antibiotics to improve public health,” said Dr David Heymann, Chair of the Health Protection Agency, UK. “Antibiotics are a global resource. We need to work together to conserve their effectiveness.”… Read More

via Call to Action on Preserving the Power of Antibiotics

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