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By Hrishabh S Iyer
I. Introduction
Antimicrobial resistance is a global crisis with significant global health implications including the loss of millions of lives. A statement that shook the United Nations Office on Drugs and Crime (UNODC) came straight from the AMR technical Officer of WHO for the Regional Office for Africa. Responsible for close to 5 million deaths, the abuse of antimicrobials poses a grave and significant threat to humans and is the lead driver in microbial entities exhibiting resistance to pharmacological agents.
The Kerala government has thus sworn in an inaugural pursuit to act as a corkscrew to stop the pipeline of antibiotics and restrict access. The health department, along with public participation would facilitate as the grooves of the screw to lock in drug abuse. Operation Amrith is a first-of-its-kind project that was born out of the need to combat anti-microbial resistance. It strives to eradicate illegally sold over-the-counter (OTC) medication in its massive battle against AMR-related deaths.
This article aims to bring to notice the potential the operation carries and acts as a medium of inspiration for other states to follow suit. The bigger picture of this article is to proliferate the message on AMR to other states and Union Territories to the country to cumulatively fight and tackle the potential issue. Moreover, a pre-emptive effort into the research and development of the matter would prove to be transcendental in the global arena. There lies hope in the cause of the blog to pollinate the larger public as there lies the important value and critical information that could prove to be quintessentially vital to the medico-pharmacological field.
II. Operation Amrith
A. The birth of a revolution
The Antimicrobial Resistance Intervention for Total Health (AMRITH) is a project undertaken by the Kerala State Drug Control Department primarily focusing on surprise inspection at medico-pharma stores to prevent the overuse of antibiotics. Its goal is to phase out prescription-less OTC drugs and take strict actions against contravening pharmacists. The excessive use of antibiotics creates a shield within the consumer’s body rendering its consumption eventually redundant, making the human body susceptible to be a spawn point for new pathogens modern sciences would struggle to fight off. This ‘silent pandemic’ is a global health and economic threat, exacerbated by poverty and poor living conditions.
AMR is not just a breeding ground for new bacteria, but also a catalyst for growing complexities in procedures such as C-sections and chemotherapy. The operation aligns itself with the Kerala Antimicrobial Resistance Strategic Action Plan (KARSAP). Together, they insist that pharmacies maintain records of antibiotic sales and increase antibiotic literacy. These proactive measures could potentially save up to 3% of the world’s GDP.
B. Role in the war against drugs
The increased efforts of the Kerala state government are exemplary in the sense that the government has taken quintessential steps since the soft launching of the Kerala Antimicrobial Resistance Surveillance Network (KARS-NET) in 2018. Although its final goal is to counter AMR, it specifically targets environmental surveillance and adopts comprehensive approaches to tactically beat AMR.
III. Parties to the operation
A. State Drug Control Department
Acting as the chief of the operation, it creates a bridge between medicine norms and legality, allowing a passageway for overall health, security, and awareness by monitoring OTC sales. By taking strict actions and ensuring pharmacies poster an “antibiotics not sold without doctor’s prescription” display, the state-assigned body, Kerala State Pollution Control Board (KSPCB) is the pioneer in the fight against AMR. Another important role undertaken by the state would be the harsh penalization of offenders who sell over-the-counter drugs without a valid prescription. There have already been instances where even licensed doctors were denied the sale of legal drugs without a prescription thereby promising grand success to the operation.
B. The Common Public
In the hind leg and suspension of the operation, the people play a pivotal role in dispensing information and ensuring that they are constantly learning the effects and side-effects of several commonplace medicines they take and the counter-effective consequences of the same. From contacting toll-free numbers to lodge complaints to educating others on the relevance of the mission, the public is the cavalry and the forefront of the entire program. The successful functioning of this operation is incumbent on the willingness, understanding, and execution of instructions issued by the State government. By keenly paying attention to the harmful side effects of excessive drug intake, both buyers and sellers can actively take part in the fight against potential immunosuppressants.
To further the success of the operation, citizens and residents can be urged to call out pharmacies selling OTC drugs without asking for a valid prescription. The job of the public could even be as simple as following the latest news to be updated on the developments and reach of the operation, which would provide the know-how of the mission. Accordingly, the most pivotal change that people can undertake is understanding the harm behind consuming OTC medication of free will. The mentality that a drug such as paracetamol can cure something as minuscule as a headache is a callous approach toward an immunosuppressive world. The most important thing to knowledge is the willingness to learn. Cerebrally packed with clarity and knowledge will ensure the pragmatic success of the operation.
C. Recommendations
The scope of Operation AMRITH is as wide as the cogs and gears of the mission. The entire operation is dependent on how receptive the public is to understanding the severity of AMR. The response of the public is subject to the government promoting educational campaigns to sensitize the public about the same. Most governmental schemes face failure or stagnation because of a lack of public response. The only shortcoming to this operation is the people not responding. Heavy penalisation on pharmaceutical employees selling prescription-less OTC drugs would further result in the smooth sailing of the operation as it would act as a precedent among other sellers.
The cost-to-benefit ratio of the operation is fairly small, especially when looking at the potential loss if not done properly. The World Bank estimates healthcare expenses to boom by $1.2 trillion by 2050. If pushed by the Central Government as well, costs incurred for waste disposal, as seen in the Programme on Removal of Unused Drugs, Operation AMRITH’s limits would know no bounds. A massive influx of help in the form of coordination is mandatory from pharmacists and the public to curb this issue. Given the appraisal the mission has seen in the past couple of months, it wouldn’t go so far as to say the operation’s scope is narrow.
IV. Conclusion
The growth of AMR across the world has increased multi-fold in recent years, putting the boon of modern medicine at risk. With massive economic costs with experts estimating a global deficit of US $1 trillion by 2050, AMR is a silent and deadly killer. The Kerala government being the first state in India to take upon the challenge to fight this global disease is commendable beyond recognition and must be taken inspirationally by the other states as well. India as a global leader in the medicine front can play a massive global role in helping to detoxicate AMR by pledging international help and allegiance. The operation’s surveillance, research, and attempts to put a stop to this growing disease are the pinnacle of research and development and medicine. Getting coveted recognition from the United Nations themselves, other Indian states must get inspired and implement similar programs to mitigate any risk of the birth of a silent epidemic.
Hrishabh S Iyer is a third-year law student at Jindal Global Law School. His zeal lies in international military law, transnational terrorism and foreign diplomacy.
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