Lok Sabha Question No. 1244 (UNSTARRED), answered on 2017-12-22
Subject: Multi Medicine Resistance
Ministry: HEALTH AND FAMILY WELFARE
Asked by: ARJUNLAL MEENA, OM BIRLA, SUNIL KUMAR SINGH, NISHIKANT  DUBEY

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

LOK SABHA UNSTARRED QUE STION NO. 1244 TO BE ANSWERED ON   22ND  DECEMBER, 2017

## MULTI MEDICINE RESISTANCE

## 1244. SHRI ARJUN LAL MEENA:

SHRI OM BIRLA:

SHRI SUNIL KUMAR SINGH:

SHRI NISHIKANT DUBEY:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a)  the  aims,  objectives  and  salient  features  of  the  National  Action  Plan  on  Antimi Resistance (NAP -AMR);
- (b)the progress and the current status of the action plan;
- (c) whether the Government has established any mechanism for effective implementation a surveillance of the NAP -AMR and if so, the details thereof;
- (d) the national as well as State - wise data of deaths due to infectious diseases in India; and
- (e) whether the Indian Medical Association has asked the doctors to minimise prescript antibiotic drugs, if so, the details thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE ( SMT. ANUPRIYA PATEL )

- (a) : National Action Plan on Antimicrobial Resistance (NAP - AMR) has 6 strategic priorities as under:
- i.Improve awareness and understanding of AMR through effective communication, education and training
- ii.Strengthen knowledge and evidence through surveillance
- iii. Reduce the incidence of infection through effective infection prevention and control
- iv. Optimize the use of antimicrobial agents in health, animals and food
- v. Promote investments for AMR activities, research and inno vations

Contd……….

- vi. Strengthen India's leadership on AMR

(b) : The progress and the current status of the action plan is as u nder:

- Under the programme , a National AMR surveillance lab network has been established which currently includes 21 laboratories. Currently AMR surveillance is being done for a total  of  seven  pathogens.  The  National  AMR  surveillance  network  SoP  has  also  bee finalized.
- On  21 st Jul y  2017  NCDC  successfully  enrolled  in  Global  AMR  surveillance  system (GLASS) under World Health Organization (WHO).
- The Strategic National Action Plan for containment of AMR was developed involving stakeholders from various ministries/ sectors.
- National  Tr eatment  Guidelines  for  antimicrobial  use  in  infectious  diseases  have  b developed and uploaded on NCDC website ( www.ncdc.gov.in ). Also, an interim concise guideline on infection control has been uploaded on NCDC web site.
- Schedule H - 1 has been incorporated in Drug and Cosmetic rules to regulate the sale antimicrobials in the country

(c) : Government  has  established  following  mechanism for  effective  implementation  and surveillance of the NAP -AMR;

a. Intersectora l Coordination Committee on AMR under the Chairmanship of Secretary (Ministry of Health & Family Welfare), b. Technical Advisory Group on AMR under the Joint Chairmanship of Director General of Health Services, Ministry of Health & Family Welfare and Secretary, Department of Health Research & DG, ICMR

c. Core Working Group on AMR under the Chairmanship of Director, National Centre for Disease Control

Delhi Declaration - an inter - ministerial consensus on AMR, was signed by the Ministers of the concerned ministries pledging their whole hearted support in AMR containment.

Further, NCDC in partnership with Indian Medical Association is involved in  vario AMR  activities  such  as  antimicrobial  stewardship,  Traini ngs  for  Doctors/Nurses  on  AMR, Spreading awareness among Hospital Staff.

(d) : The  State  wise  data  on  deaths  due  to  influenza  A  (H1N1),  Malaria,  Chikungunya Japanese Encephalitis, Acute Encephalitis Syndrome and Kala azar is placed at annexure.

(e) : Yes.  Indian Medical Association (IMA) has disseminated information about judicio usage of antibiotics by meetings, emails, webcast and newsletters to its members.

…………………

## Annexure

| State - wise Deaths Due to infectious diseases   | State - wise Deaths Due to infectious diseases   | State - wise Deaths Due to infectious diseases   | State - wise Deaths Due to infectious diseases   | State - wise Deaths Due to infectious diseases   | State - wise Deaths Due to infectious diseases   | State - wise Deaths Due to infectious diseases   | State - wise Deaths Due to infectious diseases   |
|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|--------------------------------------------------|
| Sl No                                            | State / U.T.                                     | Diseases                                         | Diseases                                         | Diseases                                         | Diseases                                         | Diseases                                         | Diseases                                         |
|                                                  |                                                  | Influenza H1N1 (2017) as on 17.12.2017           | Malaria (2016)                                   | Chikungunya (2016)                               | Japanese Encephalitis (2016)                     | Acute Encephalitis Syndrome(2016)                | Kala-Azar (2016)                                 |
| 1                                                | Andhra Pradesh                                   | 14                                               | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 2                                                | Arunachal Pradesh                                | 1                                                | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 3                                                | Assam                                            | 5                                                | 5                                                | 0                                                | 92                                               | 187                                              | 0                                                |
| 4                                                | Bihar                                            | 0                                                | 0                                                | 0                                                | 25                                               | 102                                              | 0                                                |
| 5                                                | Chhattisgarh                                     | 64                                               | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 6                                                | Goa                                              | 12                                               | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 7                                                | Gujarat                                          | 431                                              | 2                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 8                                                | Haryana                                          | 9                                                | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 9                                                | Himachal Pradesh                                 | 15                                               | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 10                                               | J & K                                            | 19                                               | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 11                                               | Jharkhand                                        | 2                                                | 10                                               | 0                                                | 5                                                | 5                                                | 0                                                |
| 12                                               | Karnataka                                        | 15                                               | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 13                                               | Kerala                                           | 76                                               | 1                                                | 0                                                | 0                                                | 5                                                | 0                                                |
| 14                                               | Madhya Pradesh                                   | 146                                              | 1                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 15                                               | Maharashtra                                      | 775                                              | 25                                               | 0                                                | 1                                                | 1                                                | 0                                                |
| 16                                               | Manipur                                          | 1                                                | 0                                                | 0                                                | 1                                                | 1                                                | 0                                                |
| 17                                               | Meghalaya                                        | 0                                                | 44                                               | 0                                                | 4                                                | 4                                                | 0                                                |
| 18                                               | Mizoram                                          | 0                                                | 1                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 19                                               | Nagaland                                         | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 20                                               | Odisha                                           | 54                                               | 77                                               | 0                                                | 42                                               | 115                                              | 0                                                |
| 21                                               | Punjab                                           | 86                                               | 1                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 22                                               | Rajasthan                                        | 255                                              | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 23                                               | Sikkim                                           | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 24                                               | Tamil Nadu                                       | 17                                               |                                                  | 0                                                | 0                                                | 3                                                | 0                                                |
| 25                                               |                                                  |                                                  | 0                                                |                                                  |                                                  |                                                  | 0                                                |
|                                                  | Telangana                                        | 21                                               | 1                                                | 0                                                | 0                                                | 0                                                |                                                  |
| 26 27                                            | Tripura                                          | 0 22                                             | 15 0                                             | 0 0                                              | 1 0                                              | 1 0                                              | 0 0                                              |
| 28                                               | Uttarakhand Uttar Pradesh                        | 132                                              | 0                                                | 0                                                | 73                                               | 621                                              | 0                                                |
| 29                                               | West Bengal                                      | 26                                               | 59                                               | 0                                                | 39                                               | 256                                              | 0                                                |
| 30                                               | A & N Islands                                    | 1                                                | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 31                                               | Chandigarh                                       | 6                                                | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 32                                               |                                                  | 4                                                |                                                  |                                                  |                                                  | 0                                                |                                                  |
|                                                  | D & N Haveli                                     |                                                  | 0                                                | 0                                                | 0                                                |                                                  | 0                                                |
| 33                                               | Daman & Diu                                      | 2                                                | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 34                                               | Delhi                                            | 12                                               | 0                                                | 0                                                | 0                                                | 0                                                | 0                                                |
| 35                                               | Lakshadweep                                      | 0                                                | 0 0                                              | 0                                                | 0                                                | 0                                                | 0                                                |
| 36                                               | Puducherry Total                                 | 9 2232                                           | 242                                              | 0 0                                              | 0 283                                            | 0 1301                                           | 0 0                                              |

Source:  National Health Profile brought out by CBHI, Dte.GHS and NCDC