Antimicrobial resistance (AMR) is an escalating public health crisis with the potential to undermine the effectiveness of current antibiotics, leading to longer hospital stays, more intensive care, and higher mortality rates. To address AMR, we must recognise that it is a multifaceted issue influenced by various sectors such as human health, animal husbandry, agriculture, and environmental factors. While the challenge is immense, innovation in both technology and strategy holds the key to mitigating this global health threat.
Understanding the complexity of AMR
AMR is not simply the result of overprescribing antibiotics in hospitals. It stems from numerous factors that include irrational antibiotic use in humans, animals and in agriculture. Inappropriate prescriptions, the use of antibiotics in animal feed for growth promotion and agricultural practices that encourage the use of antibiotics contribute significantly to the development of resistant pathogens. Once resistance develops, these microbes can spread rapidly, especially in healthcare settings where infection prevention measures may be inadequate.
Sanitation and infection control in hospitals are also critical to reducing the spread of resistant bacteria. Inadequate sanitation in communities, especially in low-income areas, further fuels the problem by allowing resistant pathogens to proliferate and spread. Socio-economic factors such as poverty, lack of clean water, and insufficient access to healthcare exacerbate the issue, making it a complex, multifactorial challenge.
The role of innovation in tackling AMR
Given the complexity of AMR, addressing it requires more than just conventional strategies. Innovation plays a central role in tackling this global challenge, not only through new devices but also by developing new approaches to influence behaviour and improve systems.
One of the most important areas where innovation can make a difference is in antibiotic stewardship. Ensuring rational antibiotic use in hospitals is critical to prevent the development of AMR. Technology can support healthcare providers with real-time data to guide antibiotic prescriptions and reduce unnecessary use. AI-powered decision support systems and digital health tools are increasingly being developed to assist clinicians in selecting the appropriate antibiotic, determining the correct dosage and setting the right treatment duration. These innovations enable healthcare providers to make informed decisions that minimise the risk of resistance and ensure that antibiotics are used only when absolutely necessary.
In addition to technological innovations, behavioural innovations are essential in the fight against AMR. Prescribers often face significant challenges in convincing patients to limit their demand for antibiotics, particularly when it comes to conditions like the common cold or flu, where antibiotics are ineffective. Public health campaigns and education programmes that raise awareness about the dangers of unnecessary antibiotic use can help shift public perception. By empowering patients to understand that antibiotics are not always the answer, and encouraging prescribers to resist pressure to overprescribe, we can foster a culture of responsibility in both the prescribing and consuming of antibiotics.
Innovations in diagnostics and vaccines
In addition to improving antibiotic stewardship, innovations in rapid diagnostics and vaccines are crucial in the battle against AMR. Rapid point-of-care diagnostic tools can help clinicians quickly identify the pathogen causing an infection and determine its antibiotic resistance profile. By providing immediate insights into the specific infection, these diagnostic tools allow for targeted treatments, reducing the use of broad-spectrum antibiotics and minimising the risk of resistance. These diagnostic innovations are particularly important in resource-limited settings where access to laboratories and timely test results may be restricted.
Along with diagnostics, the development of new vaccines can help prevent infections that often lead to the unnecessary use of antibiotics. Vaccines reduce the incidence of infections such as pneumonia, diarrhoea, and certain types of urinary tract infections, thereby reducing the need for antibiotics. Innovative vaccines can also target antibiotic-resistant pathogens, further contributing to the reduction of AMR.
Over the past two decades, my perspective on AMR has evolved significantly. Initially, I focused on policy changes, regulations, and stewardship programmes. However, through my work with the Longitude Prize, I came to realise that innovation is the true catalyst for change. While policies and regulations are important, they often face slow implementation and resistance. It is innovation that disrupts the status quo, providing practical, scalable solutions to complex challenges like AMR.
India’s potential leadership in AMR innovation
India, with its massive population, diverse healthcare infrastructure and socio-economic challenges, faces unique hurdles in combating AMR. However, the country’s sheer scale presents it with an opportunity to become a leader in AMR innovation. India has more than one million doctors, hundreds of thousands of pharmacies, and a large number of hospitals. The government’s commitment to addressing AMR through policy frameworks like the National Action Plan on AMR is commendable, but effective implementation requires innovation in healthcare practices, sanitation, and technology.
The Chennai Declaration on AMR has already made significant strides in raising awareness and engaging stakeholders from across sectors. However, to truly tackle AMR in India, we must integrate innovation at every level — be it in the development of new antibiotics, diagnostics, vaccines, or sanitation technologies. India has the potential to become a global leader in the fight against AMR by prioritising innovation in both policy and practice.
A multi-pronged approach
The path forward in combating AMR involves embracing a multi-pronged approach that integrates technological innovation, behavioural change, improved infection control practices, and better sanitation. By fostering a culture of innovation — at all levels of healthcare, governance, and society — India can make significant strides in mitigating the impact of AMR.
India’s leadership in the global fight against AMR will depend on how well we harness the power of innovation. With the right policies, infrastructure and support for entrepreneurs, India can set an example for the world in the fight against one of the most significant public health threats of our time.
(Dr. Abdul Ghafur is managing partner, QuorumVeda Consulting Services; consultant in infectious diseases, Apollo Hospitals, Chennai)
Published – February 19, 2025 04:00 pm IST