Lok Sabha Question No. 821 (UNSTARRED), answered on 2021-07-23
Subject: Rising Anti-microbial Resistance
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Parvesh Sahib Singh

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

LOK SABHA U NSTARRED QUESTION NO. 821 TO BE ANSWERED ON 23 RD JULY, 2021

## RISING ANTI - MICROBIAL RESISTANCE

## 821. SHRI PARVESH SA HIB SINGH VERMA:

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

- (a) whether the Government is aware of rising anti microbial resistance in India and if so, the steps taken in this regard;
- (b)  whether  the  Government  is  working  on  One Health  concept  to synthesize  efforts  of healthcare in human, animals and environment; and
- (c) if so, the details thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR . BHARATI PRAVIN PAW AR )

- (a): Yes. Government is aware about the challenges posed by anti - microbial resistance (AMR) in India and has taken following measures to address the issue:
- National programme on AMR containment was launched during 12 th FYP in 2012 - 17. Under this programme, AMR Surveillance Network has been strengthened by establishing labs in State Medical College. 30 sites in 24 states have been included in this networ th March 2021.
- National Action Plan on Antimicrobial Resis tance (NAP-AMR ) focusing on One Health approach  was  launched  on 19 th April 2017 with the aim of involving various stakeholder ministries/departments. Delhi  Declaration  on  AMR -an  inter - ministerial  consensus  was signed  by  the  ministers  of  the  concerned  mini stries  pledging  their  support  in  AMR containment.  In the line with NAP - AMR three states have launched their state action plan
- a. Kerala has launched KARSAP
- b. Madhya Pradesh has launched MP - SAPCAR
- c. Delhi has launched SAPCARD
- AMR  Surveillance  Network: ICMR has established  AMR  surveillance  and  research network (AMRSN) in 2013, to generate evidence and capture trends and patterns of drug resistant infections in the country. This network comprises of 30 tertiary care hospit private and government.
- AMR Research & International Collaboration: ICMR has taken initiatives to develop new  drugs  /medicines  through  international  collaborations  in  order  to  strengthen  me research in AMR.
- o ICMR along with Research Council of Norway (RCN) initiated a join t call for research in antimicrobial resistance in 2017.
- o ICMR along with Federal Ministry of Education and Research (BMBF), Germany has a joint Indo - German collaboration for research on AMR.

- Initiatives to control overuse or misuse of antibiotics:

- [ ] ICM R has initiated antibiotic stewardship program (AMSP) on a pilot project basis tertiary care hospitals across India to control misuse and overuse of antibiotics in wards and ICUs.

- [ ] On the recommendations of ICMR, DCGI has banned 40 fixed d ose combinations (FDCs) which were found inappropriate.

- [ ] ICMR worked in collaboration with  Indian Council of Agriculture Research, Departme of Animal Husbandry, Dairy and Fisheries and the DCGI to ban use of Colistin as growth promoter in animal feed in poultry.

## Guidelines issued

- National Guidelines for Infection Prevention and Control in Healthcare Facilities have beenreleased by MoHFW in Jan 2020. ( https://ncdc.gov.in/showfile.php?lid=431 )
- ICMR has developed evidence based treatment guidelines for treatment of ten syndromes infections. It aims to rationalize the usage of antibiotics on Essential Medicines Formulary (EMF) and to establish consisten cy in the treatment of various infectious conditions.
- Further, ICMR has also issued the Treatment Guidelines for Antimicrobial Use in Commo
- Syndromes' in 2019. ( https://www.icmr.nic.in/sites/default/files/guidelines/Treatment\_Guidelines\_2019\_Final )

## IEC Activities

Media material has been developed to create awareness among various stakeholders regard AMR and appropriate use of antibiotics.

- (b) & (c): Yes. Government is working on One Health approach by interdisciplinary collaboration at the human - animal - environmental interface.

encouraging

The key priority areas include zoonotic diseases (emerging and re -emerging), food safety and antibiotic resistance.

Program  for  Strengthening  Inter - sectoral  Coordination  for  Prevention  and  Control  of ZoonoticD iseases' was launched in the 12th Five -year plan (2012 - 17) which is still continuing as  'National  One  Health  Program  for  Prevention  and  Control  of  Zoonoses'  in  15 th Finance Commission (2021 - 26) period.

This scheme aims to operationalize 'One Health' Mechanisms for prevention and control of Zoonoses by strengthening inter - sectoral coordination among all stakeholders. In this regard National  Institute  of  One  Health  is  being  established  at  Nagpur    which  will  house    B laboratory.

ICMR has undertaken a project on an 'Integrated One Health Surveillance Network for Antimicrobial Resistance' in collaboration with Indian Council of Agriculture research (ICAR to assess the preparedness of Indian Veterinary laboratories to participate in inte grated AMR surveillance  network.  ICMR  has  also  created veterinary  standard  operating  procedure  (Vet -SOPs) for enabling comparison of antimicrobial resistance patterns in animals humans.(https://main.icmr.nic.in/sites/default/files/guidelines/SOP\_Bacteriology\_Veterinar 19.pdf )