Lok Sabha Question No. 1487 (UNSTARRED), answered on 2016-03-04
Subject: Anti-Microbial Resistance
Ministry: HEALTH AND FAMILY WELFARE
Asked by: MEENAKASHI LEKHI, VINOD KUMAR BOIANAPALLI, POONAM  MAHAJAN, KINJARAPU RAM MOHAN NAIDU

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

## LOK SABHA UNSTARRED QUESTIO N NO. 1487 TO BE ANSWERED ON 4 TH MARCH, 2016

## ANTI - MICROBIAL RESISTANCE

## 1487. SHRIMATI MEENAKASHI LEKHI:

SHRI B. VINOD KUMAR: SHRIMATI POONAM MAHAJAN: SHRI RAM MOHAN NAIDU KINJARAPU:

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

- (a) whether the Government has taken note of reports of high rate of antibiotic resistance t of the standard antibiotic among Indian citizens;
- (b) if so, the reaction of the Government thereto including framing a National Policy the issuing advisory t o State Governments;
- (c)  whether  the  Government  has  carried  out  any  survey  to  collect  national  data  on  ba resistance to antibiotic; if so, the details thereof;
- (d)  whether  the  Government  has  entered  into  an  agreement  with  any  country/  multilat al organization to develop an action plan/strategy to tackle anti - microbial resistance; and
- (e) if so, the details thereof?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE

## (SHRI JAGAT PRAKASH NADDA)

(a) to (e): A National Policy for containment of Antimicrobial Resistance (AMR) in the country was formulated in the year 2011 and has been widely disseminated. The said policy envis enforcement and enhancement of regulatory provisions for use of antibiotics for humans a for veterinary use.

The Drugs  and  Cosmetic  Rule,  1945  were  amended  in  2013  to  incorporate  a  new Schedule H1 under the said rules containing 46 drugs which include IIIrd and IVth gener antibiotics, anti TB drugs and certain habit forming drugs for having strict control ove the sale of these drugs. The Drugs falling under Schedule H1 are required to be sold  in the count the following conditions:

Contd……

- (1)The supply of a drug specified in Schedule H1 shall be recorded in a separate registe time of the suppl y giving the name and address of the prescriber, the name of the patient name of the drug and the quantity supplied and such records shall be maintained for years and be open for inspection.
- (2)The drug specified in Schedule H1 shall be labeled with the symbol Rx which shall be in red and conspicuously displayed on the left top corner of the label, and shall also be lab the following words in a box with a red border:

'Schedule H1 Drug - Warning:

-It is dangerous to take this preparation except in accordance with the medical advice.

- Not  to  be  sold  by  retail  without the prescription of a Registered Medical Practitioner.'

An  insertion  has  been  made  in  the  Drugs  and  Cosmetics  Rules,  1945  to  specify  t withdrawal period of antibiotics in c ase of egg, milk, poultry and fish before these enter th human  food  chain.  The  Department  of  Animal  Husbandry,  Dairying  and  Fisheries  has  als issued Advisories in 2014 addressed to all States and Union Territories regarding judici of antibiotics t o prevent AMR.

A National Programme for Containment of AMR has also been initiated in 12th Five Year Plan with the following objectives.

-  To establish a laboratory based surveillance system by strengthening laboratories for A the country and to genera te quality data on antimicrobial resistance for pathogens of pub health importance.
-  To generate awareness among healthcare providers and in the community regarding ratio use of antibiotics.
-  To  strengthen  infection  control  guidelines  and  practices  and promote  rational  use  of antibiotics.

The antibiotic drug resistance is developed in the micro - organisms. ICMR is carrying out surveillance of drug resistance to antibiotics through its Antimicrobial Resistance Sur Research Network (AMRSN) in six pathogenic groups (i) Diarrhoeagenic bacterial organisms (ii)  Enteric  fever  pathogens  (iii)  Enterobacteriaceae  causing  sepsis  (iv)  Gram  negati -fermenters (v) Gram positives including MRSA (vi) Fungal infections. Four nodal centers for collection of d ata are CMC, Vellore, JIPMER, Puducherry, PGIMER Chandigarh and AIIMS, New Delhi. The significant findings from last 2 years indicate that Salmonella typhi multidrug resistance (MDR) toampicillin, chloramphenicol and trimethoprim -sulfamethoxazole is showing  a downward  trend.  However,  more  than  50%  of  bacterial  isolates  of  Klebsiella spp. and E. coli were found to be resistant to the currently used 3 rd generation cephalosporins, but they are sensitive to carbapenams and colistin.

Contd…….

The Government  of  India  has  signed  Memorandum  of  Understanding/Agreement  for cooperation  in  health  with  several  countries.  AMR  has  been  identified  as  one  of  the  a cooperation in agreements with some of these countries including Sweden, Netherland and U. .

During  the  World  Health  Assembly  in  May  2015,  the  Member  States  have  adopted  a Global plan for action on AMR.

Further,  Indian  Council  of  Medical  Research  (ICMR)  has  signed  a  Memorandum  of Understanding  (MoU)  with  the  Research  Council  of  Norway  (RCN),  a nd  also  initiated collaboration with National  Institute of Health,  USA (NIH) and Centers for Disease Con Atlanta, USA (CDC) regarding antimicrobial resistance.

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