Kerala comes up with Operation AMRITH to tackle AMR

Operation Amrith is aimed at conducting surprise raids in retail medical shops for detecting OTC sale of antibiotics
Photo: iStock
Photo: iStock
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The Kerala Drug Control Department launched tests in the first week of January 2024 called Operation Amrith (AMRITH - Antimicrobial Resistance Intervention For Total Health) to prevent the overuse of antibiotics in the state.

“The Drugs Control Department has a very significant role to play by way of regulatory action for optimising the use of antibiotics by preventing over-the-counter (OTC) sale of antibiotics,” Dr Sujith Kumar K, Drugs Controller (in charge), Drugs Control Department, Government of Kerala, said in an email to Down To Earth.

Pharmacies must keep accurate records of antibiotic sales as per this initiative. Additionally, a poster mentioning ‘antibiotics not sold without doctor’s prescription’ should be displayed in the establishment. If not complied, strict action would be taken against pharmacies and medical stores that supply antibiotics without doctor’s prescription.

The public can also participate in this initiative by reporting any pharmacies selling antibiotics without a prescription to the Drug Control Department.

Operation Amrith is aimed at conducting surprise raids in retail medical shops for detecting OTC sale of antibiotics and also a Toll Free Number is provided (Toll Free No 18004253182) for lodging complaints against medical shops, according to the department. Once a complaint is received, it will be transferred to the corresponding zonal office for verification and immediate departmental actions will be taken, if violation is detected.

“Through this initiative, we are seeking the help of everyone in Kerala to join in the fight against antimicrobial resistance (AMR). Through this participatory antimicrobial stewardship initiative whereby public and law enforcers join hands, we hope to end OTC sales of antibiotics in Kerala,” said Dr Aravind Reghukumar, HOD (infectious diseases), Government Medical College Thiruvananthapuram as well as convener of Kerala Anti-Microbial Resistance Strategic Action Plan (KARSAP).

The Kerala government was the first state in India that came up with the state action plan on AMR, KARSAP, in 2018. Aligned with India’s National Action Plan on AMR, Kerala’s plan reflected a multi-sectoral approach. Besides human health aspects, it aimed to address animal and environmental dimensions of the AMR problem, which is crucial for effective containment of AMR. Delhi-based think tank, Centre for Science and Environment, had actively contributed to the Kerala action plan and has been an implementation partner in the state’s AMR containment efforts.

After the release of the state action plan on AMR, the Kerala government came up with many initiatives to deal with the issue of AMR in the state. This includes the Antibiotic Literate Kerala Campaign, under which the state is taking several initiatives to raise awareness about AMR. In August 2023, Kerala became the first state in India to establish block-level AMR Committees in all 191 blocks.

“Activities regarding operation Amrith are being carried out in a time-sensitive manner under the ‘antibiotic-literate Kerala’ initiative of KARSAP,” added Dr Reghukumar.

With regard to surveillance, the government launched Kerala Antimicrobial Resistance Surveillance Network (KARS-NET) for human use surveillance and developed an integrated AMR surveillance plan in 2018-19 for non-human sector surveillance.

The Kerala State Pollution Control Board (KSPCB) also inaugurated an AMR laboratory for environmental surveillance of AMR in August 2023.

Moreover, according to The Hindu, the health department in Kerala has made commitments to completely phase out over the counter sale of antibiotics without prescription and take action against pharmacists selling antibiotics OTC without prescription.

Additionally, for proper disposal of unused antibiotics, the Kerala government has come up with the Programme on Removal of Unused Drugs (PROUD), which is a drug take-back programme piloted in 2019 in the district of Thiruvananthapuram.

The ability of bacteria and other microbes to resist the drugs used to inhibit or kill them is known as AMR. Considered as a ‘silent pandemic’, this phenomenon was associated with being responsible for about five million deaths worldwide in 2019, with 1.3 million deaths being directly attributed to it.

In 2017, the World Bank estimated that the global increase in healthcare costs are expected to reach up to $1.2 trillion per year by 2050 in a high AMR impact scenario. In a similar situation, the world will lose 3.8 per cent of its annual gross domestic product by 2050 and there could be up to 10 million deaths annually, with the most deaths happening in Asia and Africa.

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