india

Updated: Sep 20, 2019 04:26 IST

India and China are among the major hotspots for antimicrobial resistance (AMR) in livestock, which has massive implications for animal and human health as well as the supply of meat to feed the world’s rapidly-expanding population, said a study published in the journal, Science on Thursday.

The World Health Organization (WHO) defines AMR is the ability of a microorganism such as bacteria, viruses, and some parasites to stop an antimicrobial [like antibiotic, antiviral etc] from working against it. As a result, standard treatments become ineffective, infections persist and may spread to others.

More than half the of the world’s chicken (54%) and pigs (56%) are raised in Asia. AMR is driven by misuse and over-use of antimicrobials for intensive animal farming, and almost three-fourth of all antibiotics used are in animals raised for food, according to the study.

Globally, the proportion of drugs with a failure rate of 50% increased annually 173% in chickens and 161% in pigs between 2000 and 2018, according to data from 901 point-prevalence surveys.

Point prevalence is the proportion of a population that has the condition at a specific point in time.

The study identified north-eastern India, north-eastern China, northern Pakistan, Iran, eastern Turkey, south coast of Brazil, Nile delta, Red river delta in Vietnam and the areas surrounding Mexico City and Johannesburg as AMR hotspots. The trend is also visible in Kenya, Morocco, Uruguay, Brazil, Iran, Chile, besides central India and southern China.

The study stresses the need for controlling AMR in animals as the emerging infectious diseases are associated with drug-resistant pathogens that are transferring from animals to humans.

“Whenever we talk about antibiotic resistance, we talk about people but it is necessary to understand that it is a huge problem among animals as well. This is the first global study that looks at the trends of antimicrobial resistance among animals,” said Ramanan Laxminarayan, study co-author and director of Center for Disease Dynamics, Economics & Policy, Washington DC, United States.

“In Asia, targeted interventions such as legislative action and subsidies to improve farm hygiene could reduce the need for antimicrobials in animal production,” the study said.

While Africa has no hotspot except Johannesburg, scientists warn that missing AMR data in Uruguay, Paraguay, Argentina and Brazil is a global concern as these are big meat exporters.

High temperature also raises AMR. “High temperature causes stress and conflicts in animals, thus increasing the risk of wounds that require preventive antimicrobial treatment,” the study said. “We also found that most of the resistance was reported from peri-urban areas, where these animals are mainly found,” said Laxminarayanan.

Of greater concern is the presence of resistance to third and fourth generation antibiotics, used when no other antibiotics work, and which are critical for treatment of human beings.

“The use of antibiotics in animals is very high in India and China, and the worry is that the antibiotic resistance in animals and resistant pathogens in the environment will find its way to humans. In India, there is very high resistance to antimicrobials among humans too,” said Dr Pallab Ray, professor of microbiology at Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, who has worked extensively on AMR.

In 2017, India put together a National Action Plan to combat antibiotic resistance bringing several sectors like healthcare and animal husbandry together. The programme aims to establish a surveillance network, generate quality data on AMR, strengthen infection control guidelines and practices, promote rational use of antibiotics, and to generate awareness.

According to the policy document, the emergence of resistance is not limited to the older and more frequently used classes of drugs but also to newer and more expensive drugs, like carbapenems, which are used to treat diseases resistant to normal antibiotics.

The Indian government also banned the use of one such last line antimicrobial drug Colistin for use in animals. “Colistin ban is a good step; there is absolutely no reason it should be used in animals, and usually for growth promotion,” Laxminarayan said.

The researchers suggest that the maps be used to find regions that are poorly surveyed and that sampling be intensified in those areas. They have also urged high-income countries, where antimicrobials have been used in farms since the 1950s, to support the transition to sustainable animal production in low and middle income nations.

“Policymakers should use this study to ask veterinarians to reduce prescriptions for antimicrobial drugs. Such interventions are necessary even in countries where AMR is emerging as they will go through the same problems that the current hotspots are going through,” said Laxminarayan.