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

Dr Abdul Ghafur, coordinator of the Chennai Declaration and Consultant in Infectious Diseases, Apollo Hospitals, Chennai, has welcomed the Prime Minister’s recent Mann Ki Baat address highlighting the dangers of Antimicrobial Resistance (AMR) and the need for responsible antibiotic use by doctors and the public.

He said the message had significantly raised national awareness about the dangers of irrational antibiotic use by both doctors and the public. He described AMR as a serious and growing threat to public health, healthcare delivery, and economic stability—not just in India, but worldwide.

Dr Ghafur noted that the Prime Minister’s remarks correctly framed AMR as more than a purely medical problem. “Antimicrobial resistance is a complex socio-economic challenge,” he said, adding that while misuse of antibiotics in human medicine is a major driver, it is only one part of a larger ecosystem.

According to him, antibiotic use in veterinary practice and agriculture, inadequate infection prevention measures, and gaps in sanitation and hygiene all play a crucial role in the emergence and spread of drug-resistant organisms. Addressing AMR, he said, therefore requires a holistic and coordinated response across sectors.

In this context, Dr Ghafur highlighted the Swachh Bharat Abhiyan as one of India’s most powerful yet under-recognised interventions against antimicrobial resistance. Though not labelled as an AMR programme, he said the nationwide cleanliness and sanitation drive has had a direct impact on limiting the spread of resistant infections.

“While misuse of antibiotics contributes to the creation of resistance, sanitation and cleanliness largely determine how widely resistant organisms spread,” he explained. By changing public behaviour around hygiene and cleanliness—both in hospitals and communities—the Swachh Bharat mission has strengthened India’s ability to contain infections. Given the country’s population density, Dr Ghafur said it is reasonable to conclude that India’s AMR burden would have been far higher without this initiative.

He also acknowledged the contribution of national institutions such as the Indian Council of Medical Research (ICMR) and the National Centre for Disease Control (NCDC) in generating data and improving understanding of antimicrobial resistance patterns across the country. These efforts, he said, have helped place AMR firmly on the national health agenda.

At the same time, Dr Ghafur pointed to India’s rapidly expanding innovation ecosystem in antimicrobial research. Supported by the Department of Biotechnology, organisations such as C-CAMP and several academic–industry partnerships have helped build one of the world’s largest innovation platforms focused on AMR. He noted that the Indian pharmaceutical industry is increasingly contributing to global antimicrobial drug discovery, with important developments such as cefepime–enmetazobactam and cefepime–zidebactam, alongside several startups working on next-generation antibiotics.

One of the most significant policy interventions, according to Dr Ghafur, has been the government’s decision to ban the use of colistin for growth promotion in poultry and animal farming. Colistin is considered a last-resort antibiotic in human medicine, used to treat critically ill patients with life-threatening infections.

By prohibiting its non-therapeutic use in agriculture, India protected the effectiveness of this life-saving drug and prevented a rapid rise in colistin resistance, he said. The move has been widely praised internationally as an example of evidence-based policymaking backed by strong political will. “It showed how scientific evidence can be translated into courageous policy decisions with long-term public health benefits,” Dr Ghafur added.

Despite carrying a high burden of antimicrobial resistance, India is now emerging as part of the global solution, he said. The country’s approach—combining sanitation, innovation, and responsible regulation—offers important lessons for other nations facing similar challenges.

Dr Ghafur said India’s AMR strategy rests on three key pillars: innovation-led solutions, sanitation and infection prevention as core resistance-control measures, and effective implementation at the state level, given that health is primarily a state subject. In this regard, he suggested that making State Action Plans on AMR mandatory could help translate national vision into tangible outcomes on the ground.

He also called for a clear national mechanism to monitor and support state-level implementation of AMR plans, ensuring consistency and accountability across the country.

“History shows that transformational public health change is driven by strong leadership and clear national direction,” Dr Ghafur said. He pointed to Swachh Bharat, the regulation of colistin use, and the promotion of biomedical innovation as examples of how India has already demonstrated this capacity.

India, he concluded, has the vision, capability, and experience to lead the global response to antimicrobial resistance—not through fear alone, but through cleanliness, innovation, coordinated governance, and active public participation.