Its recommendations could become the backbone of a national policy, says international expert Professor Goossens

Indian medical experts and politicians reacted emotionally to the international uproar caused over two years ago by a study of the extent of antimicrobial resistance.

This response even stalled the discussion on antibiotic resistance in India; the scientific repercussions were equally damaging as Indian researchers could neither collaborate nor share samples, bacterial isolates or data with international groups, the latest edition of The Lancet Infectious Diseases says.

Felt ‘exposed’

According to an article in the British medical journal, politicians and physicians felt “very exposed” after the publication of the study by Karthikeyan Kumarasamy and his colleagues in the Lancet in 2010 on the possible implications of multidrug-resistant organisms such as Escherichia coli harbouring NDM-1.

Though the data from this study should have stimulated widespread discussion on resistance in India and the rest of the world, the debate that followed was skewed towards the effects on health tourism.

India had reacted strongly to the study linking a multiple drug-resistant superbug detected in Britain to the country and said the bacteria or ‘Superbug’ was not a public health threat.

Appreciating the complexity of the problem faced by the Indian authorities, eminent researcher Herman Goossens said in an article, ‘The Chennai Declaration on antimicrobial resistance in India,’ that India should make sincere efforts to formulate an antibiotic policy, and the medical community should give wholehearted support to the authorities.

“However, to apply these policies, India would need to class clinical microbiology and infectious diseases as independent specialities.

“Currently, only a few hospitals are offering postdoctoral fellowship programmes in infectious diseases, and microbiologists will have to be more proactive and become clinical microbiologists,” he said.

Pointing out that the recommendations of the Chennai Declaration, if implemented, could become the backbone of a national policy, Prof. Goossens said the recent advertisement by the Ministry of Health for rational antibiotic prescription — a result of the Chennai meeting — would hopefully mark the beginning of a shift in the attitude of the medical community and authorities to tackle antimicrobial resistance.

For the first time, medical societies in India came together and organised a symposium — A Roadmap to Tackle the Challenges of Antimicrobial Resistance — in Chennai on August 24 last to discuss the problem of antimicrobial resistance and possible solutions.

The Chennai Declaration calls for urgent initiatives to formulate an effective national policy to control the rising antimicrobial resistance, including a ban on over-the-counter sale of antibiotics, and to bring about changes in the medical education curriculum to include training in antibiotic usage and infection control.

International experts, including Prof. Goossens, were invited to explain how high-income countries were trying to tackle antimicrobial resistance.

The meeting occasioned an intense debate between international experts and representatives of the Indian medical societies, yielding the so-called Chennai Declaration.

Hoping that the outcome of the meeting would make a difference, Prof. Goossens said the situation in India was indeed worrying — though antimicrobial resistance, particularly in Gram-negative bacteria, was a worldwide problem.