From 12-16 March, the Access to Medicine Foundation will be in New Delhi and Mumbai, India, to meet with Indian-based pharmaceutical companies and government representatives to share ideas and opportunities to limit drug resistance. The Foundation’s Executive Director, Jayasree K. Iyer, will also speak at the Delhi End TB Summit: “Innovations and Changed Mindsets to End TB.”
India is one of the largest producers of antibiotics globally by volume. By adopting and sharing good practices, Indian pharma companies can have a national and global impact on AMR. In a new briefing paper titled “How action in India can have global impact: The Indian pharmaceutical industry and antimicrobial resistance,” the Foundation describes how current company initiatives, alongside government actions, have significant potential to help halt the rise of AMR.
“There are no shortcuts in addressing AMR. Government and the pharmaceutical industry must see themselves as guardians of good healthcare systems and act in tandem to bring drug resistance under control. Now is the time for pharmaceutical companies to seize more opportunities to make change in India,” says Jayasree K. Iyer, Executive Director of the Access to Medicine Foundation.
Antimicrobial resistance in India
India has made significant gains in public health in the past two decades, yet it still faces some of the highest rates of infectious diseases and antibiotic resistance globally. The result is an increase in the need and demand for antibiotics, and in the risk that antibiotics will be overused or misused. This, in turn, drives drug resistance (also known as antimicrobial resistance or AMR).
A pharmacist in India stocks generic antibiotics. Good dispensing practices are a key part of slowing AMR. Photo: Manjunath Kiran/AFP
In 2016, 258 out of every 100,000 children aged under 5 in India died of pneumonia, diarrhoea or another common infectious disease. In 2017, resistance to key broad-spectrum antibiotics (the first-line of defence against an infectious disease) exceeded 70% for common bacteria that cause diarrhoea (E. coli) and pneumonia (A. baumannii, K. pneumonia). In 2010, Indians consumed 12.9 billion antibiotic pills, up from 8 billion in 2001.
Unsafe water sources, poor sanitation and a lack of access to handwashing facilities are the three largest factors for spreading infectious disease and accelerating resistance. The uneven and weak health system infrastructure also plays a significant role.
Who can halt AMR?
Bringing AMR under control requires consolidated, concerted action by multiple stakeholders. Infection prevention and control are key. Governments have the central enabling role in these areas. The government of India is already taking action, for example by tracking the rise and spread of resistance and launching an innovative “Red Line” campaign, which aims to ensure all antibiotic packaging features a distinctive red line to mark it as ‘prescription only’. Last year, the Indian government published its National Action Plan on Antimicrobial Resistance (NAP-AMR).
Pharmaceutical companies also have a major role to play. India has the world’s third largest pharmaceutical industry and one of the fastest growing pharmaceutical sectors globally (in 2017 revenue is estimated to have grown 7.4%). India is also one of the largest exporters of pharmaceuticals, with USD 16.8 billion in pharmaceutical exports in 2016-17. Given its share of the global market and position in global supply chains, and with many hundreds of antimicrobial products in their portfolios, the potential for Indian pharmaceutical companies to help control AMR is significant.
Opportunities for change
The Foundation will address these issues in a series of meetings with government officials and pharmaceutical companies in New Delhi and Mumbai this week. Discussions will cover the threat from AMR in India and internationally, the role for Indian pharmaceutical companies, and opportunities for collaboration between the industry and government, while exploring how best practices from the AMR Benchmark can drive progress to meet AMR objectives. The new briefing paper from the Foundation covers these issues and examples of what Indian companies are currently doing.
On Tuesday 13 March, the Foundation will be in New Delhi to participate in the Delhi End TB Summit. The event, organised by the Government of India, the Stop TB Partnership, and the World Health Organization (WHO), will bring together national governments, global health experts and multilateral institutions to commit to concerted and tangible actions on addressing TB and AMR.
“Information sharing is a critical enabler for good practice to spread across the Indian pharmaceutical sector, and to help coordinate efforts for curbing AMR. We know from our Antimicrobial Resistance Benchmark that there is willingness and a capacity to control AMR – we want to catalyse this by working with companies and the Indian government to translate findings into action,” says Jayasree K. Iyer, Executive Director Access to Medicine Foundation