India among biggest contributors to the deadly global ‘superbug’ crisis | India News

Similarly, 42 per cent of the articles on gastrointestinal infections were from two countries — China and Islamic Republic of Iran — of the 18 countries with data, while 42 per cent of those on urinary tract infection were from four countries — India, Iraq, Islamic Republic of Iran, and Pakistan — of the 74 countries, from where data was recorded.

What is antimicrobial resistance?

Antimicrobial resistance (AMR) refers to the bacteria’s ability to evolve and stop responding to the drugs designed to kill them. The WHO considers AMR to be one of the top ten global health threats, which undermine the effectiveness of essential treatments, placing millions at risk of untreatable infections.

The WHO, in its report, pointed out that increasing antibiotic resistance trends in Gram-negative bacterial pathogens posed a growing threat.

Common in water, food, the environment and the human gut, Gram-negative bacteria cause infections such as urinary tract infections (UTIs), pneumonia and food poisoning, BBC reported.

In the five years leading to up 2023, antibiotic resistance increased in over 40 percent of the monitored antibiotics, with an average annual rise of between 5 and 15 percent, the report noted.

Moreover, for urinary tract infections, resistance to antibiotics was typically higher than 30 percent globally, it showed.

The global health agency also warned that more than 40 percent of E. coli infections and 55 percent of K. pneumoniae infections globally are now resistant to third-generation cephalosporins — the first-choice treatment for these infections.

The report pointed out that the global levels of antibiotic resistance are high and unevenly distributed across regions, with low- and middle-income countries and countries with weak health systems, being the most affected.

What are superbugs?

Superbug is a common term used to describe strains of bacteria that is resistant to at least one or more commonly used antibiotic, according to the article, Superbugs: An invicible threat in post antibiotic era, published in Science Direct.

It is typically a bacterial strain that would become resistant, following the exposure to an antibiotic.

Antimicrobial-resistant (AMR) superbugs directly cause over a million deaths and contribute to nearly five million every year, according to the WHO.

Global calls against superbugs

Global leaders at the 79th United Nations General Assembly (UNGA) meeting on AMR in September 2024 pointed out the urgent need for global action against superbugs.

In 2007, researchers at the University of Gothenburg, Sweden had published a series of studies showing massive pollution with antibiotics from pharmaceutical factories in India.

The UNGA declaration, after 17 years in September 2024, underlined the associated risks, and called for measures to reduce this pollution.

Study on resistance exhibited by superbugs in India

Earlier this year, a study by the Global Antibiotic Research and Development Partnership (GARDP) looked at access to antibiotics for nearly 1.5 million cases of carbapenem-resistant Gram-negative (CRGN) infections across eight major low- and middle-income countries, including India, Brazil and South Africa.

The report highlighted that treating CRGN bacterial infections are doubly difficult because they are resistant to some of the most powerful antibiotics.

CRGN bacteria are superbugs resistant to last-line antibiotics – yet only 6.9 per cent of patients received appropriate treatment in the countries studied.

As per the Lancet Infectious Diseases journal, India bears one of the world’s heaviest burdens of antimicrobial resistance, alongside treatment efforts, procuring 80 per cent of the full courses of studied antibiotics but managing to treat only 7.8 per cent of its estimated cases.

Challenges to tackling India’s burden of AMR

The fight against the superbugs proves to be quite difficult in India, given a combination of biological, social, and systemic issues, a Nature report highlighted.

India’s higher consumption of antibiotics, owing to their over-the-counter availability, leads to widespread misuse. Overcrowding, poor sanitation, and a tendency to over-prescribe antibiotics, in hospitals and clinics located in rural areas in India, become thriving grounds for drug-resistant bacteria.

Antibiotics are also misused in agriculture and poultry farming. Socio-economic inequalities, and climate change are worsening the crisis, as per the Nature report.

A journal article published by The Lancet suggests that “improved infection prevention and control, access to clean water and sanitation, and vaccination coverage can offset the selection effects of increased antibiotic use in low-income settings.”

1 in 6 bacterial infections globally caused by bacteria-resistant antibiotics

In 2023, approximately one in six laboratory-confirmed bacterial infections worldwide were caused by bacteria resistant to antibiotics, according to the WHO report.

As per the report, antimicrobial resistance was most frequent in the South-East Asia and Eastern Mediterranean regions (almost 1 in 3 infections), followed by the African Region (1 in 5 infections), all of them above the global median of 17.2 per cent.

Median resistance was most commonly reported in urinary tract infections (approximately 1 in 3) and bloodstream infections (1 in 6) and less so in gastrointestinal (1 in 15) and urogenital gonorrhoeal infections (1 in 125).

Four-fold increase in countries participating in GLASS

The countries participating in the WHO’s Global Antimicrobial Resistance and Use Surveillance System (GLASS) has increased four-fold since 2016, although regional gaps persist, the report highlighted.

By the end of 2024, 130 countries, including three territories and areas, enrolled in GLASS.

Of these, 104 countries, covering over 70% of the world’s population, reported AMR data for 2023 – a more than 300% increase from only 25 countries in 2016.