UPSC Mains 2014 GS Paper 3 Q11: model answer

In 2010 a gene that made bacteria resistant to almost all antibiotics was named NDM-1, after New Delhi. India objected to the name, but the message stuck: the country had become a hotspot of antimicrobial resistance (AMR).

Yes, overuse and free availability contribute

• Every dose puts selective pressure on bacteria; the resistant ones survive and spread.
• Antibiotics are sold over the counter without prescription.
• Incomplete courses and self-medication.
• Use for viral fevers and colds, where they do nothing.
• Irrational FDCs containing antibiotics.
• Animal and poultry use as growth promoters, and pharma effluents near factories.
• Hospital infections with poor infection control.
• Lancet estimates link AMR to hundreds of thousands of deaths in India each year.

Mechanisms for monitoring and control

• Schedule H1 (2014): listed antibiotics need prescriptions and sale registers.
• Red Line campaign: packs marked with a red line.
• National Action Plan on AMR (2017), with a second plan in 2025.
• ICMR's AMR Surveillance Network and NCDC surveillance.
• Colistin banned in animal feed (2019).
• Kerala's KARSAP and drive to make the state antibiotic-literate.

Issues

• Weak enforcement across lakhs of pharmacies.
• Informal providers prescribe freely.
• Poor diagnostics: doctors treat blindly.
• Few new antibiotics in the pipeline.
• Access gap: some poor patients still lack antibiotics they need, so control must not become denial.

Way forward

• Diagnostic-led prescribing, hospital stewardship, One Health surveillance and public awareness.

A missed antibiotic course is not a private matter; resistance spreads to everyone.