AMR (anti-microbial resistance) is a problem that is getting worse. Anti-microbial drugs are becoming less effective and the world is not developing enough new ones to keep up.

The global costs, if we do not take action now, could be 10 million people dying every year by 2050, and a cumulative economic cost of around $100 trillion.

We estimated in our first report, published in December 2014, that in total about 700,000 people die every year from drug resistant strains of common bacterial infections, HIV, TB and malaria.

This number is likely to be an underestimate due to poor reporting and surveillance. Nearly 2,00,000 people die every year from multidrug-resistant and extremely drugresistant tuberculosis (TB) alone.

In India, antibiotic-resistant neonatal infections cause the deaths of nearly 60,000 new-borns each year. A current death toll on this scale means that more than one million people have lost their lives to drug-resistant infections in the 18 months since we published our first report.

Our ability to cure infections that were once considered benign is already damaged. For instance, the rapid development of drug-resistant strains of gonorrhoea combined with the fact that we do not have a rapid diagnostic test to guide doctors’ choice of prescription, means we are down to using our ‘last line’ antibiotic to treat gonorrhoea4.

After this antibiotic fails, there are no more treatment options on the shelf. For other infections, doctors running out of better options are using antibiotics that were once avoided due to their bad side effects. This is the case with colistin, for example, which can cause kidney failure and so was never given to patients for many years.

Over the past decade however, it has re-entered use as a last resort treatment for patients with particularly hard-to-treat Gram-negative bacterial infections5, and already colistin resistance is emerging.

The economic impact is also already material. In the US alone, more than two million infections a year are caused by bacteria that are resistant to at least first-line antibiotic treatments, costing the US health system $20 billion in excess costs each year.

Statement from Narendra Modi , Prime Minister of India:

The discovery of antibiotics had dramatically revolutionised the treatment of communicable diseases in the 20th century, but their indiscriminate use is now leading the world into a situation where life-saving formulations are progressively losing their efficacy.

India recognizes anti-microbial resistance as one of the major global threats to public health. We are committed to prevent, contain and combat anti-microbial resistance.

India has taken a number of steps to combat anti-microbial resistance. A national programme on containment of anti-microbial resistance is being implemented.

The National Centre of Disease Control and the Indian Council of Medical Research are engaged in anti-microbial resistance surveillance. We have placed restrictions on the sale of antibiotics by making necessary statutory changes. A campaign has been launched to increase awareness regarding anti-microbial resistance, along with national treatment guidelines for antibiotic use.

The prevention and containment of anti-microbial resistance requires multi-sectoral and multi-stakeholder action. India is committed to fully support global efforts to prevent and contain anti-microbial resistance.