Policies and Interventions to Improve Access to Next-Generation Antimicrobials in Low- and Middle-Income Countries
Center for Global Development Europe
Background
India bears a huge burden of drug-resistant pathogens, posing a threat to health security The widespread unregulated use of antimicrobials in homes and hospitals is a major contributory factor to the rise and spread of drug-resistant pathogens. To combat this menace, gaps in knowledge on AMR in India must be filled, antimicrobial innovation enhanced, accessibility increased, and stewardship strengthened.
About the Study
This study aimed to assess the current situation of AMR in India, evaluate the scope of the National Action Plan on AMR (NAP-AMR), and suggest policy recommendations to improve innovation and reduce the overuse and misuse of “high-end” antimicrobials (also referred to here as Watch and Reserve Antimicrobials according to the WHO AWaRE categorization).
Methodology
We compiled an antimicrobial surveillance database, created a drug pipeline and approval database, reviewed the NAP-AMR and state action plans, conducted stakeholder interviews, and performed systematic literature reviews.
Key Recommendations
To overcome these challenges of drug accessibility, affordability and procurement in a complicated regulatory set up like India, we recommend:
Enhancing Access to High-End Antimicrobials while ensuring appropriate stewardship practices:
- Modify action plans for Watch and Reserve antimicrobial procurement and include them in state drug procurement lists. Improve inter-state coordination for transparency and efficiency.
- Use alternate channels for procurement of low volume drugs (state-owned pharmacies, private aggregators, or incentivizing Jan Aushadhi Kendras) and enhanced diagnostics facilities.
- Ensure hospitals follow stewardship practices beyond accreditation programs. Enhanced surveillance to minimise future AMR.
- Use AB-PMJAY to introduce essential Watch and Reserve antimicrobials.
Creating an Innovation Ecosystem for Antimicrobial R&D:
- Develop targeted antimicrobial profiles specific to Indian context.
- Procedural changes to boost high-end antimicrobial innovation.