The growing crisis in India surrounding antibiotic resistance is starkly evident, as a new study illustrates a dual tragedy: overuse of antibiotics is breeding dangerous superbugs, while millions of patients lack access to necessary medications. Conducted by the Global Antibiotic Research and Development Partnership (GARDP), the study focuses on carbapenem-resistant Gram-negative (CRGN) infections in low- and middle-income countries, revealing that India, Brazil, and South Africa are among the hardest hit.
Among the startling findings, only 6.9% of the patients afflicted with CRGN in these nations received suitable treatment. India accounts for roughly 80% of the prevalence of CRGN infections, yet it treats merely 7.8% of its estimated cases, indicating a significant gap in healthcare effectiveness. Commonly found in water, food, and the gastrointestinal systems, Gram-negative bacteria can lead to severe infections such as pneumonia and urinary tract infections, particularly threatening newborns and the elderly.
Dr. Abdul Gaffar, an infectious disease consultant at Apollo Hospital in Chennai, advocates for acknowledging the duality of antibiotic issues in India, stating, "We often see patients for whom no antibiotic works - and they die." The irony is stark: a world focused on combating antibiotic overuse often overlooks the plight of those in impoverished regions where access remains dangerously limited.
The study revealed that of eight intravenous drugs analyzed, notably older antibiotics like Colistin and newer ones such as Ceftazidime-avibactam, access was dismally low, with Tigecycline being the most utilized yet far from adequate. The GARDP study pointed toward inadequate infrastructure and financial barriers as key drivers behind this treatment gap. Many antibiotics remain out of financial reach for the poor, while wealthier individuals often misuse them without regard for risks.
Addressing the issue requires systemic change, including better regulation and affordable pricing models. Dr. Gaffar suggests that mandatory second approvals from specialists for antibiotic prescriptions could prevent misuse. Yet, access must not only be improved; it must also be paired with innovative healthcare models to mitigate risks of superbug proliferation.
India finds itself in a pivotal position—burdened by a high level of antimicrobial resistance but also potentially prominent in the development of solutions. Researchers believe that harnessing India's vast pharmaceutical industry could significantly drive advancements in antibiotic availability and new drug development.
By creating localized data systems to effectively assess needs, enabling better procurement strategies, and utilizing a hub-and-spoke model as seen in Kerala, India could emerge not only as a leader in tackling its own antibiotic crisis but also provide insight for global strategies against antimicrobial resistance.
If access to antibiotics remains obstructed, the foundation of modern medicine becomes vulnerable, risking the ability to perform routine surgeries and manage common infections. Dr. Gaffar emphasizes that ensuring successful access to antibiotics for those in need is just as critical as responsible usage itself, driving home the pressing necessity for systemic reform in antibiotic healthcare policies in India and beyond.
