Superbugs in India

Last week, I had the exciting opportunity to travel to Delhi for a meeting on Antimicrobial Resistance. This was thanks to the Longitude Prize, a prize fund seeking emerging diagnostic technology that will help solve the antimicrobial resistance (AMR) crisis. The meeting was planned to coincide with the opening of an exhibition on Superbugs and involved individuals from the UK and India who are active in either developing diagnostics for AMR or who have first-hand experience of the problems caused by AMR in healthcare.

The setting was appropriate, as AMR poses a serious problem in India. Antibiotics are easily available without a prescription, with strong, 3rd generation antibiotics often being used to treat conditions they will have no effect on. Within healthcare, cultures are rarely undertaken and we heard that healthcare practitioners can feel under pressure to prescribe antibiotics, else the patient will simply obtain one from a different healthcare practitioner who can then claim to have “cured” the illness. This misuse of antibiotics, coupled with ideal conditions for spreading resistance such as poor sanitation and overuse in non-healthcare settings, has made India a hotbed for antimicrobial resistance.

However, India’s government seems aware of the scale of the problem and is making efforts to tackle the issue. The importance given to the opening of the Superbugs exhibition is evidence of this, with attendance by government ministers, and its engaging exhibits will hopefully increase public understanding of the issues as it tours the country. At the meeting, we heard about innovative efforts of Indian start-ups and Universities to tackle AMR, activities which the government is supporting through grant funding and support. In fact, India has the second largest number of companies entered into the Longitude Prize, after the UK. There was talk at the meeting of how to further these efforts, such as the setting up of a sample repository to aid research into antimicrobial resistance.

Superbugs exhibition, Delhi

Superbugs exhibition, Delhi

A rapid antimicrobial susceptibility test is clearly needed both in the India and around the world. However, in order to bring such technology to market, changes and pressures are needed at a governmental level. Such changes are underway thanks to the efforts of active governments and healthcare organisations such as the World Health Organisation advising and implementing policies to ensure that in future, antibiotics will be prescribed based on a test result. We discussed the fact that the true value of diagnostics must be recognised, work that is being carried out by the recently formed consortium ValueDx. A rapid AST will not only provide optimal treatment for the patient concerned, but has far more wide reaching benefits in tackling antimicrobial resistance and safeguarding important antibiotics for where they are most needed.

There is growing momentum towards the implementation of a rapid AST in healthcare and it is clearly needed sooner rather than later. It has been encouraging to see the attitude of governments such as India’s towards tackling AMR. Efforts must be continued as there is a critical need for a test such as our rapid AST to become adopted into the clinical pathway in order to tackle the urgent problem of antimicrobial resistance.