With the outbreak of Covid-19, the use of antibiotics has risen significantly across the globe including in India, Malin Grape, antimicrobial resistance (AMR) ambassador from Sweden, told News18.
In an exclusive conversation, the top Swedish official said, “India is an important country and the issue of fighting antimicrobial resistance should be made part of the political agenda by Prime Minister Narendra Modi’s government.”
She said that with the G20 presidency, India has an opportunity to lead a global call to action for AMR.
Antibiotic resistance is a serious global threat to human and animal health. According to the World Health Organization, antimicrobial resistance (AMR) occurs when bacteria, viruses, fungi, and parasites change over time and no longer respond to medicines, making infections harder to treat and increasing the risk of disease spread, severe illness, and death. WHO labels it as one of the top 10 global health threats facing humanity.
“We have seen the use and misuse of antibiotics has increased a lot during the Covid-19 outbreak period. In some parts, this has accelerated the development of antimicrobial resistance as well,” said Grape. “Now, we don’t know what will be the next pandemic but while we aim to increase preparedness and prevent the next outbreak, AMR should be the next big thing we should be ready to handle.”
According to a study published in The Lancet in 2021, the global use of antibiotics was estimated to be 40.2 billion DDD (defined daily doses) in 2018 and has increased by about 50 per cent in the last two decades.
At the same time, antibiotic consumption was 20.6 DDD in high-income countries (HIC) compared to 13.1 DDD per 1,000 population per day in low and middle-income countries (LMIC).
Use of antibiotics going down in Sweden
The official gave an instance of Sweden – where the use of antibiotics is extremely limited and prescription of antibiotics is done only for exclusive cases.
According to several studies, the overall use of antibiotics in Sweden in the past 20 years has decreased, without measurable negative consequences, and levels of antibiotic resistance are low compared to other countries.
“Even during the pandemic, the use of antibiotics went down in Sweden, whereas the majority of other countries reported a rise in the usage,” said the official.
With a continuous fall in the use of these medicines, not many pharmaceutical companies find Sweden a lucrative market. “Hence, we suffer from the problem of access. We don’t have enough options of antibiotics or advanced medicines which we require for severe cases or for people needing medicines,” she said.
Progress towards countering AMR ‘very slow’
Grape was in India to meet officials from the ministry of health and family welfare, Central Drugs Standard Control Organisation, and industry associations to discuss ways to prioritise AMR on the political agenda.
The progress of the work on antimicrobial resistance – which is referred to as a silent pandemic – she said, is in fact “very slow not only in India but in several other countries across the globe”.
“Unless we accelerate our response, we may be inviting the worst outcomes very soon,” she said while adding that “the world is not putting enough effort together”.
She emphasised that while India is a “pharmacy to the world” and is a leading manufacturer of medicines exported across the globe, it needs to put in efforts to safeguard the effectiveness of these medicines.
Highlighting the conflict of interest in advocating against the use of antibiotics, she said that the Indian government must devise incentives for keeping the industry profitable and encourage it to develop newer antibiotics.
India and Sweden have had a longstanding memorandum of understanding in the health sector since 2009, with AMR being a part of the collaboration.
The education of medical professionals is also very important as they can help in reducing the prescription of these medicines in cases where the problem is not severe and patients could be put on a wait-and-watch mode.
“For instance, a study showed that a dose of antibiotics cures a type of ear infection in half a day whereas, without antibiotics, it takes a day more to cure. Hence, the role of doctors is extremely important in judging where patients can be asked to avoid medicines,” she said.
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