Overcoming Resistance: India’s Second National Action Plan on Antimicrobial Resistance

Context:

• India has introduced its second National Action Plan on Antimicrobial Resistance (NAP-AMR) in response to the slow and uneven implementation of the first plan and the rapid rise in antibiotic-resistant infections.

• The revised plan strengthens the ‘One Health’ approach, recognising AMR as a human, animal, and environmental health challenge.

Key Highlights:

AMR Burden in India

• In 2023, nearly one in three bacterial infections in India showed resistance to commonly used antibiotics.

• High resistance observed in:

  • E. coli

  • Klebsiella pneumoniae

• These pathogens are resistant to critical and last-resort antibiotics, raising treatment costs and mortality risks.

Limitations of the First National Action Plan

• Successfully raised awareness on AMR.

• Expanded national AMR surveillance networks.

• Banned Colistin as a growth promoter in animal husbandry.

• However, implementation was weak due to:

  • Inadequate Centre–State coordination

  • Limited inter-sectoral collaboration

One Health Approach Strengthened

• Recognises AMR spread across:

  • Human health systems

  • Veterinary practices

  • Agriculture and aquaculture

  • Soil and water ecosystems

• Promotes integrated surveillance and policy action across sectors.

State-Level Evidence

• Kerala recorded a modest decline in AMR levels after implementing state-specific antibiotic policies, demonstrating the value of decentralised action.

Relevant Prelims Points:

• Issue: Escalating antimicrobial resistance threatening public health.

• Causes:

  • Overuse and misuse of antibiotics

  • High infectious disease burden

  • Weak surveillance and regulation

• Government Initiatives:

  • National Action Plan on AMR

  • Ban on Colistin in animal feed

• Key Concepts:

  • AMR: Microorganisms resisting antimicrobial drugs

  • One Health: Integrated human–animal–environment health approach

• Impact:

  • Increased treatment failures

  • Higher healthcare costs

Relevant Mains Points:

• Science & Public Health Dimension:

  • AMR undermines gains of modern medicine, surgeries, and immunocompromised care

  • Threatens achievement of Sustainable Development Goals (SDG 3)

• Governance & Social Justice Perspective:

  • Poor and vulnerable populations disproportionately affected due to limited access to advanced treatment

  • Need for strong regulatory oversight on antibiotic sales and prescriptions

• Environmental Dimension:

  • Antibiotic residues in water bodies and soil accelerate resistance development

  • Calls for stricter waste management in pharma and hospital sectors

• Way Forward:

  • Strengthen antibiotic stewardship programmes in hospitals

  • Mandate state-level AMR action plans

  • Improve surveillance through digital integration

  • Promote public awareness and rational drug use

  • Enforce One Health coordination mechanisms institutionally

UPSC Relevance (GS-wise):

• GS 3: Science & Technology, Public Health, Environment

• GS 2: Governance, Social Justice, Health Policy

• Prelims: AMR, One Health, Antibiotic Stewardship