(Excerpts from Interview of Dr. A. J. Tamhankar, national co-ordinator,
Indian initiative for management of antibiotic resistance (IIMAR) to Deccan Chronicle)
Indians popped in 13 billion pills, followed by 10 billion in China and seven billion in USA: suggests research by the Washington-based Centre for Disease Dynamics, Economics and Policy (CDDEP).
“Indians need to change their behavioral approach or else chances are
high that India might continue to remain as the highest pill consuming
country in the world”, said, A. J. Tamhankar, national co-ordinator,
Indian initiative for management of antibiotic resistance (IIMAR). “
In technical terms, it is behavior modification which can actually
help India reduce its dependency on pills and prevent deadly viruses and
bacteria becoming resistant to antibiotcs”, he said. After the State of
the World’s Antibiotics Report (2015) was released by CDDEP, it was
revealed that there was an increase in the presence of superbugs.
Particularly in India, 57 per cent of infections in 2014 was caused by
‘Klebsiella pneumoniae’, a dangerous superbug found in hospitals, which
was resistant to a type of antibiotics. This figure is against 29 per
cent in 2008.
“There is currently no proper policy at the national level to
regulate antimicrobial resistance in India. The policy introduced in
2011 has been put on hold. Antibiotics are sold OTC without the need of a prescription which is a serious
problem and needs to be addressed. “ said
N. Ramesh, scientist, Vellore Insitute of Technology.
" Treatment
options were slowly and steadily running out, he added. Explaining
that antibiotic resistance is a direct result of antibiotic use,
Dr. Tamhankar said, “More the patients use antibiotics, higher are the
chances of development of resistant in bacteria and viruses.”
Dr. Tamhankar said, “ In India when people fall sick due to fever or stomach
ache they randomly pop pills. When it doesn’t work, there is a common
perception that people are becoming resistant to certain antibiotics and
which is why there is no proper result. Later, they switch over to some
other pills. However, it is the bacteria which are becoming resistant
and not people and awareness on this needs to be raised.”, he added.
“ The maximum misuse happens in self-limiting diseases like cough and
cold, stomach aches and throat irritation among others. So improving
hygiene and staying clean are some ways these infectious diseases can be
kept away. This will reduce the dependency on pills” , Tamhankar said.
Further, he also stressed on upgrading and enforcing the existing laws
on sale of medicines to curb over-the-counter drug sale.
He also explained how lack of knowledge among medical representatives
is another hindrance. “Small pharmaceutical companies have a huge
spread across India and they hire medical representatives who are only
interested in achieving their target and are hardly concerned on the
social issues concerning anti-biotics and its misuse and side effects.
Their qualification and understanding of the issues are also low.”
“Lifestyle, work pressure of Indians is such that nobody has time to
get treated. People just want quick results as they hardly get
sufficient time to get treated. ”,
Tamhankar added.
Another interesting aspect was the curricula of MBBS courses across
the country. There was no adequate focus upon the aspect of drug
resistance, he explained.
Meanwhile, Ram Subramanian, Apollo Hospitals,
Chennai has a few solutions. “ Proper regulation of over the counter
sale of antibiotics, strict monitoring of antibiotic usage inside
hospitals and a proper scrutiny at the national level on antimicrobial
resistance can go a long way to help solve this issue”.
Arvind Singh , national coordinator, Emerging Anti-Microbial
Resistance Society (EARS) said a national policy for containment of
antimicrobial resistance is needed.