Understanding of environmental dimensions of antimicrobial resistance in India

The UN Environment Programme (UNEP) and Indian Council of Medical Research (ICMR) have launched a new collaborative project – ‘Priorities for the Environmental Dimension of Antimicrobial Resistance (AMR) in India’, marking an important step towards recognizing and addressing the environmental dimension of AMR.

Antimicrobial resistance is a multi-faceted, complex global public health issue and has been recognized as a ‘One Health’ issue owing to its significant linkages with the human health, animals, and environment. While aspects addressing AMR from the human health perspective have received much attention, focus on the environmental dimensions of AMR has been limited. This includes the effects of discharging antibiotics and other antimicrobial compounds, such as disinfectants and heavy metals, into natural environments which has the potential to drive the evolution of resistant bacteria.

The project aims to strengthen environmental aspects of national- and state-level AMR strategies and action plans. It will undertake secondary research and stakeholder consultations to enhance understanding of the environmental dimension of AMR in India. Outreach activities targeting environmental authorities and ministries at the regional and state level in India are also planned. The work will also contribute to a regional brief on the environmental dimensions of AMR being prepared by UNEP Regional Office for Asia and the Pacific.

UNEP is supporting this project in India under the larger framework of Environment and Health, which is being led by the Inter-Ministerial Steering Group on Environment and Health (EH), co-chaired by the Ministry of Health and Family Welfare and Ministry of Environment, Forest and Climate Change. ICMR-National Institute of Cholera and Enteric Diseases (NICED), which is the Anti-Microbial Resistance Hub of ICMR since 2019, will implement this project.

“ICMR-NICED is the implementing organization for UNEP-funded project, Environmental Dimensions of AMR in India. NICED will generate information on environmental risk factors for developing AMR, environmental spread of AMR and strategies for its containment. This will provide guidance on collective action and integration of this issue in policy and decision-making,” said Dr. Shanta Dutta, Director, ICMR-NICED.  

This launch is significant and historic because the environmental dimension of the AMR is going to be taken up at the country level in India. The work done will feed into the Ministry of Health’s National Action Plan on AMR.,” said Mr. Atul Bagai, Country Head, UNEP India.

The term ‘One Health’ is very vast with many interfaces. The demand on NICED which is a national institute and on India is huge – as it is also for other countries – to find ways to address issues around ‘One Health’, which is intricately linked with antimicrobial resistance,” added Dr Samiran Panda, Head, ECD, ICMR.

“AMR in the environment is an issue inadequately recognized by the stakeholders. It is critical to understand that we have to engage with the environment as a critical part of our AMR response. I am happy to highlight that this initiative taken by UNEP has substantiated convergence of both these sectors,” said Mr. Lav Aggarwal, JS, Ministry of Health and Family Welfare.  

In December 2017, the UN Environment Assembly (UNEA) recognized that AMR is an increasing threat to global health, food, security and sustainable development, and underlined the need to further understand the role of environment in the development and spread of AMR. UNEP is working to provide evidence that can inform national and global strategies. At governance level, Inger Anderson, Executive Director of UNEP, is an ex-officio member of the One Health Global Leaders Group on antimicrobial resistance (Global Leaders Group), a key global governance structure which includes members from Member States, civil society and the private sector.