Antimicrobial resistance: drivers, One Health and India's NAP-AMR
Why in news: The Lancet Commission on 21st Century Global Threats to Health, launched in Berlin on 11 October 2026, lists AMR among 17 catastrophic threats.
Antimicrobial resistance (AMR) arises when bacteria, viruses, fungi and parasites stop responding to medicines meant to kill them, driven mainly by misuse and overuse of antimicrobials. WHO's GLASS report of October 2025 found one in six lab-confirmed bacterial infections resistant in 2023. A Lancet Commission launched in October 2026 lists AMR among 17 catastrophic health threats.
Syllabus: Prelims · Science & Technology; GS3 · Science & Technology; GS2 · Health, Education & Human Resources
Why this matters for UPSC
AMR sits in GS2 health and GS3 science and technology. Prelims asks about WHO's AWaRe groups, the Quadripartite, GLASS, Schedule H1 and the Red Line campaign; Mains, how NAP-AMR and One Health can curb antibiotic misuse.
In short
Antimicrobial resistance (AMR) is the ability of bacteria, viruses, fungi and parasites to survive the medicines meant to kill them, making infections hard or impossible to treat.
AMR will be contained only if NAP-AMR 2.0 turns ministry plans into enforced prescription control, farm stewardship and surveillance reaching beyond tertiary hospitals.
Why it matters
A child with a urinary infection, a patient after surgery or a person on cancer treatment depends on antibiotics working. When they fail, the illness lasts longer, the hospital stay grows, costlier second-line drugs and more tests are needed, and some infections cannot be treated at all. Families pay more, and a sick worker earns less. A dairy farmer whose cattle get mastitis faces the same problem with the drugs that once cured it. Resistant bacteria travel with people, food and water, so careless use in one district harms patients far away. The larger question is whether modern medicine, from organ transplants to intensive care, stays safe.
Prelims pointers
- AWaRe: developed in 2017 by the WHO Expert Committee on Selection and Use of Essential Medicines; groups Access, Watch and Reserve; revised every two years.
- Reserve group antibiotics: last-resort drugs for confirmed or suspected multidrug-resistant infections, to be protected by national and international stewardship.
- Quadripartite on AMR: FAO, UNEP, WHO and the World Organisation for Animal Health (WOAH, formerly OIE); its Joint Secretariat coordinates the global response.
- TrACSS (Tracking AMR Country Self-assessment Survey): the annual survey through which countries report progress on their AMR national action plans.
- NAP-AMR 2017 priorities: awareness, surveillance, infection prevention, optimal antimicrobial use, research investment, and India's leadership on AMR, the India-specific sixth.
- Schedule H1, Drugs Rules, 1945: sale only on a registered medical practitioner's prescription; supply entered in a separate register kept three years for inspection.
- MDR-TB: tuberculosis that does not respond to isoniazid and rifampicin, the two most effective first-line TB drugs.
- ICMR's AMRSN: set up in 2013; draws on tertiary-care hospitals, so its data are not extrapolated to the community.
Practise a UPSC-style question
With reference to WHO's AWaRe classification of antibiotics, consider the following statements:
1. Access group antibiotics are first-choice treatments for common infections and carry a lower potential to cause resistance.
2. Reserve group antibiotics are meant as last-resort options for confirmed or suspected multidrug-resistant infections.
3. The classification was developed by the World Organisation for Animal Health to monitor antibiotic use in livestock.
Which of the statements given above is/are correct?
- (a) 1 and 2 only
- (b) 2 and 3 only
- (c) 1 and 3 only
- (d) 1, 2 and 3
Show the answer
Answer: (a) 1 and 2 only
Answer: (a) 1 and 2 only. AWaRe is WHO's stewardship tool for human antibiotic use, not a WOAH livestock tool.
Statement 1: correct. WHO describes Access antibiotics as first-choice treatments for most common infections, with lower resistance potential than the other two groups.
Statement 2: correct. Reserve antibiotics are last-resort drugs for confirmed or suspected multidrug-resistant infections, to be protected by stewardship programmes.
Statement 3: incorrect. The WHO Expert Committee on Selection and Use of Essential Medicines developed AWaRe in 2017; WOAH keeps ANIMUSE, its database on antimicrobial use in animals.
Eliminate: Statement 3 is the surest to judge: AWaRe belongs to WHO's essential-medicines work. Out: (b), (c), (d).
Trap: Swapped attribution. WOAH is a real Quadripartite partner on AMR, so crediting it with WHO's antibiotic classification sounds plausible.
Remember: AWaRe = Access, Watch, Reserve; WHO Expert Committee, 2017; UN target of 70% Access use by 2030.
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