The US government’s Global Health Security Agenda (GHSA), launched two years ago to contain the spread of new and emergent infections following the Ebola outbreak, has pumped in a whopping $ 8 million to map the rising anti-microbial resistance in India and build capacities to tackle it better. The grant was announced late last year and work is set to start soon, with clearances from the Union Health Ministry now in place.
The rising anti-microbial resistance is a serious health concern in India, and also figured in Prime Minister Narendra Modi’s meeting with US President Barack Obama in September last year.
While Indian hospitals acknowledge a rise in drug-resistant infections, there is no centralised documentation of the infection rates, with hospitals shying away from reporting this data fearing loss of business. This project is aiming, rather ambitiously, at the creation of a national network where hospitals will pool in their data on infection rates, which would then be in the public domain for patients to make an informed choice when they have to select a hospital to undergo treatment.
The project’s larger goal, however, is containing the spread of infections given the huge volume of traffic between India and US, said observers.
Titled ‘Capacity Building and strengthening of hospital infection control to detect and prevent anti-microbial resistance in India’, the project will be jointly executed by the Indian Council of Medical Research (ICMR), the All India Institute of Medical Sciences (AIIMS) and the India office of Centers for Disease Control and Prevention (CDC).
The project will start with surveillance, followed by data analysis. Systems will then be put in place to first check infections and eventually bring down resistance rates.
“The project will map surveillance of bloodstream infections, ventilator acquired pneumonia and other hospital-acquired infections,” Dr Kamini Walia, deputy director, ICMR and also the technical coordinator of the GHSA project, told The Hindu . The ICMR has been on the resistance trail since 2014 when it set up six nodal centres in four hospitals. Dr Walia said the GHSA grant came to India mainly because of ICMR's existing surveillance network. This project will build upon this network, before it is expanded to around 15 more hospitals in the country.
Work will start with six major hospitals — PGI in Chandigarh, JIPMER in Pondicherry, AIIMS in Delhi, CMC in Vellore, Hinduja in Mumbai and Assam Medical College in Dibrugarh — handpicked for their robust infection control mechanisms.
“The over-arching aim is to generate trained manpower that can carry out surveillance properly to get accurate infection rates. So these six hospitals will train the next set of hospitals. By 2020, there will be one centre per state that will act as a mentor or a nodal facility for the other hospitals,” said Dr Purva Mathur, member secretary of the infection control programme at the trauma centre of AIIMS, which will be heading the study. Dr Mathur, the principal investigator of the GHSA project, pointed out that the project has a wholesome approach — clubbing infection control with antimicrobial resistance. “The ultimate aim is to reduce the resistance,” she said.
Though funded by GHSA, the Union Health Ministry has apparently put its foot down on sharing data with the US. “The data on infection rates will be analysed by the ICMR, CDC and AIIMS. This is a multi-institutional project. We will constitute a committee of all the participatory hospitals,” Dr Walia said.
The GHSA, of which India is a signatory, has 11 action points, of which anti-microbial resistance figures on top.
“Anti-microbial resistance is creating huge problems in intensive care units. With no new antibiotics on the anvil, we are already late by 20 years,” said Dr Mathur.
