The situation regarding antibiotic resistance is truly alarming. Health ministry as well as food safety and drug regulators can no longer afford to sleep over the problem, says the writer Dinesh C Sharma
It was exactly four years ago that India first heard of a new superbug named after its national capital – New Delhi. The emergence of New Delhi Metallo-beta-lactamase (NDM-1) as a new health threat globally was announced in medical journal The Lancet in August 2010. Prior to this, Indian scientists too had reported the emergence of this superbug but their warnings went virtually unnoticed. Unlike their science fiction counterparts, superbugs are not monstrous organisms but tiny free-floating genetic material which can render disease-causing bugs untreatable to most drugs. These superbugs can’t be treated with any available antibiotics, making even treatable ailments hard-to-treat.
"In dairy and poultry sectors, antibiotics are being used in the same way as pesticides and fertilisers are used in agriculture farms"
The NDM-1 episode clearly showed that threat of antibiotic resistance was growing. This means that several disease causing agents are acquiring immunity to antibiotics, making them useless. NDM-1 is no more India’s problem. The World Health Organisation has recognized antibiotic resistance as a global health threat. One of the chief causes of antibiotic resistance is misuse, overuse and abuse of antibiotics. What has India – as the epicenter of NDM-1 – has done since 2010 to prevent misuse of antibiotics? The answer is simple: nothing. Not only can one still buy powerful antibiotics without any prescription, you can buy antibiotics by weight just like you buy atta or maida. Yes, that’s what you can do in the wholesale drug market, Bhagirath Palace, in Delhi and in agricultural belts of Punjab and Haryana. Perhaps the situation is similar in other parts of the country as well.
Antibiotics bought in kilos are not meant for human use but are being used indiscriminately in the veterinary sector. In dairy and poultry sectors, antibiotics are being used in the same way as pesticides and fertilisers are used in agriculture farms. Farmers believe the more antibiotics you use, the more would be the productivity of animals (more milk from cattle and fatter chickens in poultry farms). Tonnes of antibiotics being used this way are not only finding their way into the environment but into the guts of consumers who eat antibiotic-laced chicken, mutton or consume dairy products. The recent expose by the Centre for Science and Environment (CSE) about high amounts of antibiotics found in muscles, kidney and liver of chickens has given us the proof of this.
Interestingly, the CSE study was initiated at the behest of cardiac surgeon Dr Devy Shetty from Bangalore. He noticed that many of his patients from rural areas coming for heart surgery were resistant to frontline antibiotics. This was surprising because such people had no history of high antibiotic administration (which could have introduced resistance in them), yet they were resistant to antibiotics. Shetty then thought the resistance could be due to antibiotics they were consuming as part of their diet and zeroed in on chicken. He requested CSE to take up the study, which has only confirmed his worst fear that it was chicken that was making his patients drug-resistant. Small amounts of antibiotics ingested as part of food over a period of time can make gut bacteria resistant to antibiotics. In addition, chicken itself may carry resistant genes or infection agents which are drug-resistant, although the CSE study has not found any proof if it.
The situation is getting truly alarming, while the health ministry as well as food safety and drug regulators sleep over it. The health ministry needs to act immediately to curb misuse of antibiotics among humans. For regulating antibiotic use in veterinary sector, other ministries like animal husbandry will have to take action. The World Health Organization (WHO) recommends that antibiotics that are critical for human use should not be used in animals. European countries have standards for antibiotics in food commodities. At present, India has no such standards. The Food Safety and Standards Authority of India, the food safety regulator, will have to wake up and take note of the antibiotic use. The government needs to set up systems for monitoring and surveillance of antibiotic use and antibiotic resistance in humans and animals on a regular basis.
The expose about antibiotics in chicken should not be seen as an attack on poultry issue, but a public health issue. This is an issue clearly linked to profits of the industry because antibiotics are pumped into chicken as growth promoters so that chicken grow fat and resulting products yield higher prices. The industry will have to look for alternatives in terms of feed and agents to prevent infections, instead of indulging in unrestricted use of antibiotics, steroids and other drugs. Many of these drugs are being imported from China and are of questionable quality. It is not health of just chicken eaters which is at stake but also of vegetarian consumers as resistance can spread to them through environmental routes.
-The writer is a journalist and author. His latest book is “Know Your Heart: The Hidden Links Between Your Body and the Politics of the State”.
Govt. wakes up only when a CSE survey highlights the shortfalls. Coordinated effort of all stakeholders is needed which is lagging at present.
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