Rohit Shishodia
The Centre for Science and Environment (CSE), a Delhi-based not-for-profit organization and a think tank on environment-development issues in India, has estimated that antibiotic-resistant infections lead to about 700,000 deaths a year globally.

In an interaction during a webinar on Health Action to Preserve Antibiotics, the CSE said that if no action is taken to tackle this problem, this could increase to 10 million deaths every year by 2050 – which would mean about 27,400 lives per day or about 1,140 lives per hour. It said that 90 percent of these deaths can happen in Asia and Africa.

The CSE has recommended banning antibiotics in growth promotion, regulating over-the-counter sales of antibiotics, restricting mass disease prevention strategies (group preventative use) and limiting the use of critically important antibiotics – preserve those with highest priority for human use.

The other recommendations include reducing the need for chemicals by focusing on animal husbandry, bio-security, reducing dependence on intensive systems of food production and managing waste from farms.

The center has also recommended to bring in policies and guidelines on bio-security, sanitation, waste management and increased to initiate surveillance and monitoring of waste and effluents, litter and introducing standards for antibiotics in waste. It recommended that antibiotics in waste from commercial entities must be categorised as hazardous and capacity of environmental regulators must be increased.  

CSE Director General Sunita Narain said: “Antimicrobial resistance, or AMR, has emerged today as a full-blown chronic pandemic. At a time when the world is fighting the Covid-19 crisis, marking a week to build awareness on AMR is a welcome step. It indicates that the world is waking up to this massive health crisis, that it is getting ready, because Covid-19 has taught us what havoc can be wrought by unprepared responses to a pandemic.”

Narain added: “The AMR pandemic is a silent killer, but as grave a threat as climate changes. This explains why it does not invoke panic among people, though the damage it causes is similar in scale to what the world is witnessing these days.”

Mr Amit Khurana, Program Director of CSE’s Food Safety and Toxins Program, said, “What is required here is One-Health action – a collaborative effort by multiple disciplines working at local, national and global level to attain optimal health for humans, animals and the environment.”

“But national AMR action plans are struggling to move as planned, because they have remained largely driven by a human healthcare agenda, controlled by healthcare ministries and sector stakeholders, with very limited involvement or support from other sectors such as animal health and environmental management,” he added.

Khurana points out that animal and food sector stakeholders remain apprehensive of rearing food without antibiotics.

"Farmers still use growth promoters, countries continue to allow the use of antibiotics for disease prevention, use of critically important antibiotics is still a common practice, antibiotics are still available without prescription and waste from farms is still not managed as it should be. The situation is the same in agriculture -- antibiotic misuse in crops continues.” Awareness about how to grow food without antibiotics has not yet been created among farmers and producers, he says.

Sunita Narain has pointed out that it is clear that it is the developing world which is going to be hugely impacted by this threat. The world will never be able to contain AMR unless stakeholders from all sectors such as human health, animal, environment, crops, food and drug come forward and act as one, in the spirit of a true One-Health approach, she added.