Lok Sabha Question No. 2015 (UNSTARRED), answered on 2024-12-06
Subject: Cases of Antimicrobial Resistance
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Shri Vamsi Krishna Gaddam

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 2015 TO BE ANSWERED ON 06.12.2024

## CASES OFANTIMICROBIALRESISTANCE

## 2015. SHRI VAMSI KRISHNA GADDAM:

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

- (a) whether it is a fact that India accounts for nearly 40 per cent of the world's cases of Anti Microbial Resistance (AMR), contributing to around 60,000 deaths annually across the country, if so, the details thereof;
- (b) whether it is a fact that resistance of key pathogens like E. coli and Klebsiella pneumoniae to critical antibiotics has risen sharply, with susceptibility rates dropping below 20 per cent in 2023 and if so, the details thereof;
- (c) whether the current regulatory framework for antibiotic prescriptions has been found inadequate in the country and if so, the details thereof and if not, the reasons therefor;
- (d) the steps taken/proposed to be taken by the Government to address this gap;
- (e) whether the National Programme on AMR Containment and the National Antimicrobial Surveillance Network (NARS-Net) have been effective in combating AMR and if so, the details thereof along with the measures taken by the Government in this regard; and (f) whether the Government plans to invest more in research and public awareness to combat
- AMR and if so, the details thereof along with the specific action plan in this regard

## ANSWER

## THE MINISTER OFSTATE IN THE MINISTRY OF HEALTH & FAMILY WELFARE

(SHRI PRATAPRAO JADHAV)

- (a) Government does not possess the information on total number of cases of Antimicrobial Resistance (AMR) and deaths related to AMR.
- (b) The susceptibility to many antibiotics have declined in both E. coli and Klebsiella pneumoniae. The susceptibility has not dropped below 20 percent to any of the antibiotics for any pathogen. The data and report can be seen at the following link; https://www.icmr.gov.in/icmrobject/uploads/Documents/1725536060\_annual\_report\_2023.pd
- f
- (c) & (d) Government has taken various steps to regulate antibiotic prescriptions. The details are annexed at Annexure 1.
- (e) National Programme on AMR Containment and the National AMR Surveillance Network (NARS-Net) have been effective in combating AMR. The details are annexed at Annexure 2.

(f) Government has emphasized research on AMR and has allocated funds towards development of typhoid diagnostics, expanding AMR surveillance to secondary level hospitals, antimicrobial stewardship implementation in tertiary care hospitals, study impact of vaccination on prevention of AMR and Centre of Advanced Research (CAR) for treatment of drug resistant infections. Public awareness material for promoting judicious use of antibiotics and on infection prevention practices including importance of hand hygiene have been developed and being used to increase public awareness.

## ANNEXURE REFERRED TO IN REPLY TO PART (c & d) OF THE LOK SABHA UNSTARRED QUESTION NO. 2015 FOR 06.12.2024 REGARDING CASES OF ANTIMICROBIALRESISTANCE

1. Standard Treatment Guidelines (STGs) have been issued by Ministry of Health and Family Welfare, Government of India and the same are available in public domain. and can be accessed at https://ncdc.mohfw.gov.in/guidelines-resources/
2. Government has issued Guidelines on Infection Prevention and Control which aim at prevention and control of healthcare associated infections to reduce the use of antibiotics in healthcare settings.
3. Standard Treatment Guidelines have also been prescribed under various National Health Programs.
4. The Government of India through Central Drugs Standard Control Organization (CDSCO) regulates safety, efficacy and quality of the drugs under the provisions of Drugs & Cosmetics Act, 1940 & its rules. Antibiotics have been included in Schedule H and H1 of the Drugs and Cosmetic Rules and are required to be sold by retail only under the prescription of a Registered Medical Practitioner.
5. States have also been advised to ensure prescription of generic drugs and conduct regular prescription audits in public health facilities.
6. Practice of prescription audit is one of the prerequisites for getting certified under the National Quality Assurance Standards (NQAS).

## ANNEXURE 2

## ANNEXURE REFERRED TO IN REPLY TO PART (e) OF THE LOK SABHA UNSTARRED QUESTION NO. 2015 FOR 06.12.2024 REGARDING DEATHS DUE TO AIR POLLUTION RELATED ILLNESS

1. Laboratories of NARS-Net sites are being strengthened so as to ensure generation of quality AMR Surveillance data to generate National AMR surveillance reports. For improving the AMR data Quality, data monitoring and feedback is done on monthly basis with all the NARS-Net sites.
2. Technical trainings are imparted to the sites for specialised lab tests (broth microdilution test) and for critical antibiotics such as colistin and vancomycin
3. NARS-Net sites are being trained to use AMR data locally to guide evidence based use of antimicrobials. They are trained to develop antibiograms and share with the clinicians to promote judicious use of antimicrobials.
4. National Infection Prevention and Control (IPC) guidelines have been released and translated into training modules. The training modules have been used to conduct trainings of trainers for all States and UTs and have been made available on NCDC website for use by states to further cascade trainings within the states.
5. Healthcare associated infection Surveillance has been initiated in 40 sites and training to evaluate Healthcare Associated Infection (HAI) rates in their Intensive Care Units (ICUs) has been imparted to monitor and strengthen the Infection prevention practices
6. Information Education and Communication (IEC) material has been developed for creating awareness among general public and healthcare workers. The IEC material is available on NCDC website https://ncdc.mohfw.gov.in/iec-on-amr/