In this World Antibiotic Awareness Week, CSE calls for regulating all
non-human use of antibiotics, to contain antimicrobial resistance (AMR)
- Streptomycin and tetracycline routinely used in high doses on crops, finds CSE. Streptomycin, a drug for treating TB in humans, being used indiscriminately to grow fruits, vegetables and rice
- “TB continues to be a public health crisis in our country. We must find a solution to avoid such widespread and negligent use of streptomycin in crops” — Sunita Narain, director general, CSE
- To preserve antibiotics for humans and contain AMR, CSE calls for curbing all unnecessary use of antibiotics in crops as well as in animals
- In addition, to minimise antibiotic pollution in environment, discharge limits of antibiotics in pharmaceutical industry waste must be notified urgently, says CSE
New Delhi, November 20, 2019: Centre for Science and Environment (CSE) released the findings of its new assessment here today to mark the World Antibiotic Awareness Week (November 18-24) – the findings suggest that antibiotics that are important for humans, are being rampantly used in crops.
Farmers along the banks of the Yamuna in Delhi, Hisar in Haryana and Fazilka in Punjab were found to be using streptocycline — a 90:10 combination of streptomycin and tetracycline — routinely and indiscriminately in high doses in crops, including on thosecrops which they not approved for. Says Amit Khurana, programme director, Food and Toxins programme, CSE: “We found that farmers are unaware about the recommended use and spray antibiotics frequently like pesticides as a regular practice.”
In humans, streptomycin is used for previously-treated tuberculosis (TB) patients, who make up over 10 per centof the total estimated TB incidence in India. It is also used in multidrug-resistant TB patients and in certain cases of TB meningitis (brain TB). Resistance to streptomycin is quite high and its large scale non-human use could add to the problem. The World Health Organization classifies it as a critically important antibiotic for humans.
AMR − antibiotic resistance − is a growing threat to global public health, and India is expected to be heavily impacted by it. Antibiotics are becoming ineffective as bacteria-causing infections are getting resistant to the antibiotics that are being used to kill them. Bacterial infections, which are quite common in India, are becoming difficult to treat or completely untreatable, leading to a huge health and economic burden.
Besides antibiotic over-use in humans, it is known that over-use and misuse of antibiotics for non-therapeutic purposes – growth promotion and mass disease prevention – in food animals such as chicken, fish and cattle as well as overuse in crops can contribute to AMR.
Says Khurana: “The health ministry’s ban on using colistin in food-producing animals is a welcome step. But to limit AMR from this sector, it is imperative that no medically important antibiotic is allowed to be used for promoting growth of food animals.”
Antibiotic pollution into the environment through waste from point sources such as pharmaceutical manufacturing units is another area of huge concern. It is known to escalate resistance in the environment, which can pass on to humans. Therefore, antibiotics in such waste should be considered and treated as hazardous chemicals.
“For over a year and half, a draft of standards for residual antibiotics in industrial effluents is under review of the Union ministry of environment, forests and climate change. It is time that these standards are notified and made enforceable,” says Khurana.
Unsafe disposal of unused and expired drugs also needs to be checked and controlled. CSE had recently published its findings on how unused or expired antibiotics are disposed of at the household level and by retailers and wholesalers of medicines across Delhi-NCR. CSE researchers point out that extended producer responsibility must be introduced to take back unused antibiotics. This best practice can minimise antibiotic pollution inthe environment, they add.
India’s five year action plan on AMR outlines a comprehensive multi-sectoral approach to combat AMR. Released along with the Delhi Declaration on AMR in April 2017, it called upon states and Union territories to develop their own plans. So far, Kerala and Madhya Pradesh have developed their State Action Plans,while Delhi is working on one of its own.
Says CSE director general Sunita Narain, who was a member of the United Nations Interagency Coordination Group on AMR: “Considering the progress made so far, we strongly feel that concrete and timely action is required by Central and state governments to contain AMR, particularly from animal and environmental routes.”
- CSE story on antibiotic misuse in crops: https://www.downtoearth.org.in/news/agriculture/too-much-too-often-antibiotics-in-indian-crops-can-make-them-ineffective-67838
- Down To Earth story on inappropriate disposal of unused and expired drugs: https://www.downtoearth.org.in/blog/health/antibiotic-awareness-states-need-to-do-more-to-dispose-unused-medicines-67570
- India’s National Action Plan on AMR is available at https://cdn.cseindia.org/userfiles/NAP-AMR.pdf