We Have a Policy, But No Progress: Dr. Raman on India's AMR Surveillance Gaps

Time of India

3 days ago

New Delhi: As India's National Action Plan (NAP) on
Antimicrobial Resistance
(AMR) approaches a decade since its launch, top public health voices are sounding an alarm: the country remains dangerously underprepared to tackle the growing threat of
superbugs
.
Speaking at an ETHealthworld webinar titled 'Running Out of Cures: A Deep Dive into India's Antimicrobial Resistance Crisis,' Dr. Raman Gangakhedkar, former Head of Epidemiology and Communicable Diseases at the Indian Council of Medical Research (ICMR), offered a blunt assessment.
'The moment you say it's almost 10 years old, have we made a major difference? Perhaps not,' said Dr. Gangakhedkar. 'We have a national AMR policy in place—and that's probably the only thing we've managed well. Implementation is still weak, surveillance is fragmented, and both clinician education and community awareness remain at a primitive stage.'
One of the fundamental pillars of combating AMR is surveillance, which, Dr. Gangakhedkar noted, remains in disarray. He pointed out that the first AMR surveillance system was initiated by ICMR, involving around 20 tertiary-care hospitals—primarily private and urban-based.
'Did it provide a generalizable framework? No,' he said. 'These hospitals had infrastructure and willing clinicians, but this cannot represent the national picture. Surveillance needs to span all levels—from primary health centers to tertiary hospitals and even into communities.'
He emphasized that relying solely on tertiary-care data limits prevention efforts.
'Unless surveillance is done across the board, action will always remain delayed and narrow in scope.'
One of the most dire consequences of unchecked AMR is
drug-resistant sepsis
, now among India's leading infectious killers. Yet, there has been no public health emergency response. Why?
'We lack generalizable data on AMR's real-world impact,' explained Dr. Gangakhedkar. 'We only see occasional headlines. Communities don't demand action. Hospitals don't elevate it as a crisis. Every death due to AMR remains an anecdote, not a call for change.'
He noted that the COVID-19 pandemic was a missed opportunity.
'We created infectious disease (ID) blocks, procured ventilators, and set up RT-PCR labs across districts. But we didn't use that momentum to build an AMR-focused health infrastructure. We let it pass.'
One of the most striking challenges, according to Dr. Gangakhedkar, is the lack of community-driven advocacy.
'With TB or HIV, patients can unite, demand services, lobby for policy. But who speaks for sepsis deaths? Who demands accountability for AMR-linked fatalities? Families are often too overwhelmed, and there is no platform for collective action.'
He stressed that every citizen, every caregiver, has a role to play.
'Each person leaving a clinic should ask: Was I prescribed an antibiotic? Was it necessary? That level of awareness can trigger systemic shifts.'
Dr. Gangakhedkar also underscored the urgent need for a
One Health approach
.
'You cannot tackle AMR in isolation—veterinary practices, poultry farms, environmental factors, and human health are all interconnected,' he said. 'You can't say the veterinary sector should be left alone. Coordinated efforts across all sectors are non-negotiable.'
'To me, more than successes, we have a long to-do list ahead. The time to act is now—before we truly run out of cures," he concluded.