Lok Sabha Question No. 2272 (UNSTARRED), answered on 2015-12-11
Subject: Antibiotic Resistance
Ministry: HEALTH AND FAMILY WELFARE
Asked by: VINAYAK BHAURAO RAUT, DINESH TRIVEDI, DHARMENDRA YADAV, SHRIKANT EKNATH SHINDE, PREM DAS RAI, SRIRAM MALYADRI, BOORA NARSAIAH GOUD, SANJAY JAISWAL, RAHUL RAMESH SHEWALE, SHIVAJI ADHALRAO PATIL, Shrirang Appa Barne, ANANDRAO  ADSUL, E. T. MOHAMMED BASHEER, E. T. MOHAMMED BASHEER

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

## LOK SABHA UNSTARRED QUESTION NO. 2272 TO BE ANSWERED ON 11 TH DECEMBER, 2015

## ANTIBIOTIC RESISTANC E

## 2272. SHRI VINAYAK BHAURAO RAUT:

SHRI DINESH TRIVEDI:

SHRI DHARMENDRA YADAV:

DR. SHRIKANT EKNATH SHINDE:

SHRI PREM DAS RAI:

SHRI MALYADRI SRIRAM:

DR. BOORA NARSAIAH GOUD:

DR. SANJAY JAISWAL:

SHRI RAHUL SHEWALE:

SHRI ADHALRAO PATIL SHIVAJIRAO:

SHRI SHRIRANG APPA BARNE:

SHRI ANANDRAO ADSUL:

SHRI E.T. MOHAMMED BASHEER:

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

- (a) the volume of antibiotic drug market and their consumption during each of the last three years and the current year;
- (b) whether as per the results of a study of the Indian Council of Medical Research (ICMR), indiscriminate  use  of  antibiotics has  made  close  to  50  per  cent  people develop  resistance  to strong antibiotic drugs, if so, the details thereof along with the number of fatalities reported due toantibiotic resistance during the said period;
- (c)  whether  according  to  a  World  Health Organisation  (WHO)  survey,  most  people don't understand  how  to  keep  antibiotic res stance  from  growing,  if  so,  the  details thereof  and  the reaction of the Government the reto;
- (d) whether the Government has entered into any agreement with certain countries/ multilateral organizations to develop an action plan to tackle antibiotic resistance, if o, the details thereof; and
- (e)  the  action  plan  drawn  by  the Government  to  c heck  indiscriminate  use  of antibiotics, strengthen the surveillance of antimicrobial resistance and spread awareness in this regard?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (SHRI JAGAT PRAKASH NADDA)

- (a) : Information regarding consumption of antibiotics in India is not being centrally collecte

(b) : No. The antibiotic drug resistance is developed in the micro - organisms. ICMR is carrying out  surveillance  of  drug  resistance  to  antibiotics  through  its  Antimicrobial  Res Surveillance Rese arch Network (AMRSN) in six pathogenic groups (i) Diar rhoeagenic bacterial organisms(ii) Enteric fever pathogens (iii) Enterobacteriaceae causing sepsis (iv) Gram n Non - fermenters (v) Gram positives including MRSA (vi) Fungal infections. The data i s being collected  from  CMC,  Vellore,  JIPMER,  Puducherry,  PGIMER  Chandigarh  and  AIIMS,  New Delhi.  The  signific ant  findings  from  last  2  years  indicate that S lmonella  typhi multidrug resistance (MDR) toampicillin, chloramphenicol and trimethoprim -sulfameth oxazole is showing  a downward  trend. However,  more  than  50%  of  bacterial  isolates  of Kl bsiella 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. There is no data  available  regarding  fatalities reported due to antibiotic resistance.

(c): As informed by ICMR, a ccording to a WHO survey, the public health awareness about antimi crobial resistance is very low.

The  Government's  Programme  on  containment  of Antimicro bial  Resistance  (AMR) includes the component of increasing awareness on rational use of antibiotics.

(d): 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 areas of cooperation in Agreements/ MOUS with some of these countries including Sweden, Netherland and U.K.

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

Further,  Indian Council  of  Medica l  Research  (ICMR)  has  signed  a  Memorandum  of U nderstanding  (MoU)  with  the  Research  Council  of  Norway  (RCN),  and also initiated collaboration with National  Institute of Health,  USA (NIH) and Centers for Disease Con Atlanta, USA (CDC) r egarding antimicrobial resistance.

(e): In  order  to  strengthen  the  surveillance  of  antimicrobial  resistance  (AMR)  in country, Indian  Council  of  Medical  Research  ( ICMR)  has  set  up  a  National  Anti - Microbial Resistance Research and Surveillance Network ( AMRRSN) to enable compilation of National Data of AMR at different levels of Health Care.

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 generation antibiotics, anti TB drugs and certain habit forming drugs for having strict control over the sale drugs. The Drugs falling under Schedule H1 are required to be sold  in the country wi following conditions:

- (1)The supply of a drug s pecified in Schedule H1 shall be recorded in a separate register at time of the supply giving the name and address of the prescriber, the name of the patie

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 i and conspicuously displayed on the left top corner of the label, and shall also be labeled with the following words in a box with a red border:

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Further,  Government  of  India  has  formulated  a  National  policy  for  containment antimicrobial resistance in 2011. A National Programme for Containment of AMR has also be 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 generate quality data on antimicrobial resistance for pathogens of health importance.
-  To generate awareness among healthcare providers and in the community regarding rationa use of antibiotics.
-  To  strengthen  infection  control  guidelines  and  practices  and  promote  rational  u antibiotics.