National Action Plan on Antimicrobial Resistance (NAP-AMR) 2017 – 2021
PROBLEM STATEMENT
AMR is a major public health concern in India. The emergence of resistance is not only limited to the older and more frequently used classes of drugs but there has also been a rapid increase in resistance to the newer and more expensive drugs, like carbapenems. Available data indicates to rising rates of AMR, across multiple pathogens of clinical importance, at the national scale.
In 2008, about 29% of isolates of Staphylococcus aureus were methicillin resistant, and by 2014, this had risen to 47%.
Extended-spectrum betalactamase (ESBL) producing strains of Enterobacteriaceae have emerged as a challenge in hospitalized patients as well as in the community.
The Indian Network for Surveillance of Antimicrobial Resistance (INSAR) reported MRSA prevalence rate of 41% based on data from 15 tertiary care centres, and also showed a high rate of resistance to ciprofloxacin, gentamicin, cotrimoxazole, erythromycin, and clindamycin.
The burden of AMR in livestock and food animals has been poorly documented in India
The “National Programme on the Containment of Antimicrobial Resistance” was launched under the aegis of the National Centre for Disease Control (NCDC) under the 12th Five Year Plan (2012 – 2017).
National Action Plan on Antimicrobial Resistance (NAP-AMR) 2017 – 2021
The threat posed by antimicrobial resistance (AMR) to public health as well as global health security has been reiterated in numerous World Health Assembly (WHA) resolutions. AMR is also prioritized under the Global Health Security Agenda (GHSA), and India is one of the contributing countries.
The Ministry of Health & Family Welfare (MoHFW) identified AMR as one of the top 10 priorities for the ministry’s collaborative work with WHO.
The Ministry of Health & Family Welfare notified three governance mechanisms in September 2016 to address this challenge. These include the Intersectoral Coordination Committee, Technical Advisory Group and Core Working Group on AMR for technical coordination and oversight.
The Core Working Group has been activated and has drafted the National Action Plan on Antimicrobial Resistance (NAP-AMR), which was further reviewed at the National Workshop on Development of National Action Plan on AMR that included members from Core Working Group and the Technical Advisory Group.
GOAL
The goal of GAP-AMR is to ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them.
To achieve its goal, the global action plan sets out five strategic objectives, to:
1. Improve awareness and understanding of antimicrobial resistance;
2. Strengthen knowledge through surveillance and research;
3. Reduce the incidence of infection;
4. Optimize the use of antimicrobial agents in health, animal and food sectors; and
5. Develop the economic case for sustainable investment that takes account of the needs of all countries, and increase investment in new medicines, diagnostic tools, vaccines and other interventions.
SIX STRATEGIC PRIORITIES HAVE BEEN IDENTIFIED UNDER NAP-AMR
- Improving awareness and understanding of AMR through effective communication, education and training
- Strengthening knowledge and evidence through surveillance
- Reducing the incidence of infection through effective infection prevention and
control - Optimizing the use of antimicrobial agents in health, animals and food
- Promoting investments for AMR activities, research and innovations
- Strengthening India’s leadership on AMR
Within each strategic priority and focus area, strategic interventions, key activities and outputs have been defined with tentative responsibility and timelines –
- Short (within 1 year)
- Medium (between 1 and 3 years)
- Long-term (between 3 and 5 years)
