It will be too late to tackle the problem of antimicrobial resistance if we fail to act now, given data that show that things are going out of hand, alerted experts gathered at the 9th Annual Conference of Clinical Infectious Diseases Society, CIDSCON 2019, conducted at Kochi from 23 to 25 August 2019.
Antimicrobial resistance has emerged as a major threat to public health, as it is expected to cause 10 million deaths annually by 2050, according to a UK Government Review on AMR. However, there is not enough information to show the global impact and cost of the phenomenon.
“We may not have very good systematic data. But we need to be very careful, because by the time we get that kind of systematic data, it will be too late. So, I think we have enough data to show that we are going in the wrong direction and that things are slipping.,” says Dr. Subramanian Swaminathan, Senior Consultant for Infectious Diseases, BGS Gleneagles Global Hospitals, Kengeri, Bengaluru.
Antimicrobial resistance (AMR) has already emerged as a public health threat in India, alongside major infectious diseases that continue to pose a tough challenge.
“If you look at it, TB, HIV and AMR are the three major problems in the country. So, the discussion in the conference is centered on these important themes,” said Dr. George M Varghese, Associate Professor,Department of Medicine & Infectious Diseases at the Christian Medical College, Vellore.
Of course, there are new infectious outbreaks like NiV, he said. They occur every now and then, but the key objective of CSID doctors is to spread the scientific knowledge and update doctors about infectious diseases, he added.
India carries one of the largest burdens of drug-resistant pathogens worldwide. “Nearly 400, 000 people in India may be dying due to AMR every year,”noted Dr. Nicholas Day, Professor and Director of the Mahidol Oxford Tropical Medicine Research Unit, Thailand.
Highlighting the need for judicious antibiotic use, experts urged the clinical community to explore newer modalities to counter the problem of drug resistance.
“Drug development is not keeping up with the pace of the increasing resistance. So, at some point, we have to come up with new strategies that do not depend upon antimicrobials to deal with infections,” commented Dr. P H Chandrashekhar, Professor, Clinical Educator Chief, Division of Infectious Diseases, Wayne State University, USA.
The quality of drugs is another critical issue, when it comes to drug resistance. A large number of generic substitutes are available in India. It is difficult to believe that all of them are equally potent, some of the participants noted.
“The problem is that, it is not about one or two drugs. There are about 30 generic substitutes for a single product. Nowhere else in the world will you find 30 or 40 generic meropenems as we see in India,” pointed out Dr. George K Varghese, Senior Consultant in Internal Medicine and Infectious Disease, Mazumdar Shaw Medical Centre, Bangalore, and the President of CIDS.
According to Dr Varghese, all these generics are required to be tested systematically and only a national body can do it. There are some attempts by the government to address the issues, he added.
Speakers also emphasized the need for monitoring worldwide antifungal resistance.
Studies show that Candida auris strain of fungus becomes a massive problem in India. It is often difficult to identify and is often misidentified, says Dr. Chandrasekhar. It can be hard to treat successfully when the fungus invades the blood stream. Its frequently resistant to one or more antifungals. Thus, a good infection control is paramount to eradicate this fungus.
The Padma Shri award winner Dr. Umesh Bharti, was presented with M.G. Alexander award by the society at the event for his commendable work on rabies. The award recognizes individuals who have made outstanding contributions to tropical infections in India.
The conference deliberated on a range of topics from common infections in clinical practice to transplant-related infections and highlighted the rising global issue of AMR.
The event was convened by over 700 participants involving physicians and academicians in the field of medicine including internal medicine, infectious diseases, critical care, pulmonology, microbiology, transplant medicine, and clinical research. The 3-day meet conducted lectures, interactive case discussions, meet the professor sessions, workshop and quiz competitions.