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Role of NCDC in containment of Antimicrobial resistance (AMR)

Antimicrobial resistance in pathogens causing important communicable diseases has become a matter of great public health concern globally including our country. Resistance has emerged even to newer, more potent antimicrobial agents like carbapenems. The factors responsible for this are widespread use and availability of practically all the antimicrobials across the counter meant for human, animal and industrial consumption. There are definite policies /guidelines for appropriate  use of  antimicrobials at national level in specific national health programmes being run in the country eg RNTCP, National AIDS control programme etc. For other pathogens of public health importance like Enteric fever, diarrhoeal disease, Respiratory infections etc the individual hospitals are following their own antimicrobial policies and hospital infection control guidelines. To monitor antimicrobial resistance it is necessary to have regulations for use and misuse of antibiotics in the country, creation of national surveillance system for antibiotic resistance, mechanism of monitoring prescription audits, regulatory provision for monitoring use of antibiotics in human, veterinary & industrial sectors and identification of specific intervention measures for rationale use of antibiotics. M.O.H.F.W  during August 2010  constituted a national task force  under the Chairmanship of DGHS, with Director NCDC being the member Secretary for containment of Antimicrobial resistance in the country  with the following  terms of reference/agenda:

  1. To review the current situation regarding manufacture, use and misuse of antibiotics in the country
  2. To recommend the design for creation of a national surveillance system for antibiotic resistance
  3. To initiate studies documenting prescription patterns and establish a monitoring system for the same
  4. To  enforce and enhance regulatory provisions for use of antibiotics in human ,veterinary and industrial use
  5. To recommend specific intervention measures such as rationale use of antibiotics and antibiotic policies in hospitals
  6. Strengthening of  diagnostic Methods pertaining to antimicrobial Resistance Monitoring
Antimicrobial Resistance

Thereafter, a series of meetings of the task force were held under the chairmanship of DGHS coordinated by NCDC, ,following which National antibiotic policy was framed and has been submitted to M.O.H.F.W for their approval before it is rolled out for implementation in the country. NCDC has again been asked to be the coordinating institution for implementation of the policy.

In the mean time another initiative was also taken by M.O.H.F.W for containment of AMR in the country.

A memorandum of understanding (MOU) was signed in Feb 2009 for cooperation in the field of Health care and public health between the  Govt of India and Sweden.The MOU  included collaboration  among other health issues, communicable diseases and antimicrobial resistance(AMR) as areas of collaboration, Following this, a thematic workshop on Antimicrobial Resistance Under the aegis of the Indo-Swedish Health Week celebration  was held at National Institute of Health and Family Welfare (NIHFW) on 2 February 2010. The workshop was coordinated by NCDC, Delhi as directed by M.O.H.F.W. During the workshop, NCDC was also designated as the nodal agency for co-ordinating all activities pertaining to antimicrobial resistance (AMR) under the aegis of Indo Swedish collaboration. During the workshop, the areas for joint Indo-swedish collaboration for containment of AMR in the country were  discussed  at length. The key recommendations of the workshop on AMR were

  1. the need for doing a gap analysis in the country  between existing knowledge and additional information needed for containment of AMR
  2. Formation of an Indian task force with various working groups in several fields eg Antibiotic usage, antibiotic resistance healthcare associated infections etc
Recently, a letter and memorandum of intent has also been received from Govt of Sweden for taking the collaboration  on antimicrobial resistance forward and work together for containment of AMR.
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