India poised to lead global fight against AMR: Dr Abdul Ghafur

Dear Hon’ble Prime Minister,

I write with the utmost respect to convey my sincere appreciation for your recent Mann Ki Baat message highlighting the growing challenge of antimicrobial resistance (AMR) and the importance of rational antibiotic use by doctors and the public. Your intervention has significantly elevated national awareness on an issue that poses a serious threat to public health, healthcare delivery, and the economy—both in India and globally.

Your message also underscored an equally important truth: AMR is not a single-dimensional medical problem, but a complex socio-economic challenge that demands a holistic response. While irrational antibiotic use in human medicine is a key driver of resistance, it is only one part of a much larger ecosystem. Antibiotic use in veterinary practice and agriculture, gaps in infection prevention, and weaknesses in sanitation and hygiene all play a critical role.

In this context, Swachh Bharat Abhiyan, followed by Swasth Bharat, may represent the world’s largest and most impactful AMR intervention—though not labelled as such. While antibiotic misuse contributes to the creation of resistance, it is sanitation and cleanliness that largely determine the spread of resistant organisms. By transforming public attitudes towards hygiene, sanitation, and cleanliness in hospitals and communities, your leadership has directly strengthened India’s ability to contain the transmission of drug-resistant infections. Given India’s population density, it is reasonable to state that without Swachh Bharat, the AMR burden in our country would have been far higher.

National institutions such as the Indian Council of Medical Research (ICMR) and the National Centre for Disease Control (NCDC) have made significant contributions in helping us understand the depth of antimicrobial resistance in the country. At the same time, the Department of Biotechnology, through its supported organisations such as C-CAMP and multiple academic–industry collaborations, has helped build one of the world’s largest innovation ecosystems focused on AMR. In parallel, the Indian pharmaceutical industry is increasingly leading innovation in antimicrobial drug discovery, with globally significant contributions such as cefepime–enmetazobactam and cefepime–zidebactam, alongside several Indian startups actively working on the development of new antibiotics.

Importantly, under your leadership, India also took a decisive and globally admired policy step by banning the growth-promotional use of colistin in poultry and animal farming. Colistin is one of the most critical last-resort antibiotics in human medicine. By prohibiting its non-therapeutic use in agriculture, India effectively protected this life-saving molecule, prevented a rapid rise in colistin resistance, and preserved its utility for critically ill patients. This action demonstrated how strong political leadership can translate scientific evidence into courageous policy, with long-term benefits for public health.

Despite having a high resistance burden, India is therefore also emerging as a global leader in tackling AMR—through sanitation, innovation, and responsible regulation. Under your guidance, India is uniquely positioned to show the world how antimicrobial resistance can be addressed through three key pillars: first, innovation-led solutions; second, sanitation and infection prevention as core AMR strategies; and third, effective implementation at the state level, recognising that health is primarily a state subject.

Making State Action Plans on AMR mandatory would be a decisive step in translating national vision into on-ground impact. Establishing a clear national mechanism to ensure and monitor their implementation by states would further strengthen this effort.

History reminds us that transformational public health change is driven by strong leadership and clear national direction. India, under your leadership, has already demonstrated this through Swachh Bharat, through decisive regulation of colistin for growth promotion, and through fostering innovation. Our country is well placed to show the world that antimicrobial resistance can be tackled not through fear alone, but through cleanliness, innovation, coordinated governance, and public participation.

As has often been said, “Leadership is the capacity to translate vision into reality.” India has the vision, the capability, and the experience to lead the global AMR response—and your voice has already set that process in motion.