India is the Pill-Popping Capital of the World

2 million Indians are at the risk of dying every year by 2050 because of overuse of antibiotics

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From burning throats to tummy aches, we are just conditioned to reach for antibiotics. This culture of popping antibiotics unwisely needs an overhaul. (Photo: iStock)

India is an “antibiotic addict”; there has been a six-fold increase in the number of antibiotics being popped by Indians in the last five years. This includes the Carbapenems, the strongest and the highest class of antibiotics, typically used as a “last resort” by doctors to treat serious infections.

Snapshot
  • Last year Indians popped in 13 billion pills, followed by 10 billion in China and 7 billion in USA: The State of the World’s Antibiotics Report, 2015
  • 2 million Indians are at a risk of dying every year by 2050 because serious diseases will become resistant to antibiotics.
  • 58,000 newborns died in India in 2014 with diseases caused by drug resistant bacteria: Union Health Ministry
  • If your doctor is handing out antibiotics like candies, it’s time to double check.

And it’s not just India, the report found that globally people are recklessly popping more pills than ever before. From the year 2000 to 2010, there has been a massive 36% spike in antibiotic consumption world over.

Also because of this unchecked phenomenon, we are now in a situation that is unique in human history: once curable diseases have gone highly resistant to common drugs. Whether it’s resistant Klebsiella, KPC, spreading east across the planet from the United States; or NDM-1 superbug moving West from India; or popping up unpredictably in the Near East; or “pig MRSA”; the bugs are on the ascent, and we have a limited window of time in which to block their advance.

These alarming findings are from a global antibiotic misuse map, prepared by Washington based think-tank, Centre for Disease Dynamics, Economics and Policy (CDDEP).

From 2000 to 2010, global antibiotic consumption grew by 30%. But in India, it was a dramatic 57% increase (Photo: iStock)
From 2000 to 2010, global antibiotic consumption grew by 30%. But in India, it was a dramatic 57% increase (Photo: iStock)

Where Is the National Antibiotic Policy?

Antibiotic misuse will cost the lives of over two million Indians annually from 2050. That should be reason enough to restrict the sale and use of antibiotics in India. But just where did the national antibiotic policy, which had to restrict the sale of antibiotics, go?

The Union Health Ministry took two years (2009 to 2011) to come up with an ambitious antibiotic policy which had measures like banning over-the-counter sale of 90 antibiotics and colour-coding drugs according to categories, but it was shelved indefinitely in October 2011. This even though the health ministry itself admits that 20-50% of all antibiotics use in India is inappropriate.

The argument has been that with an acute lack of doctors in rural areas, people will be left without any access to drugs. So if over-the-counter sale of antibiotics is clamped down, it may become life threatening for people in far flung areas. The health ministry in India, therefore, decided to do away with the entire policy. But is that really the solution? Or rather, are there no other solutions?

 Earlier this year, 40% of poultry samples tested for six antibiotics by the Centre for Science and Environment (CSE), tested positive for antibiotic residue; 23% of the samples contained residues of one antibiotic and 17% had residues of more than one (Photo: iStock)
Earlier this year, 40% of poultry samples tested for six antibiotics by the Centre for Science and Environment (CSE), tested positive for antibiotic residue; 23% of the samples contained residues of one antibiotic and 17% had residues of more than one (Photo: iStock)

Some experts say we are moving back to the pre-antibiotic era. No, this will be a post-antibiotic era. In terms of new replacement antibiotics, the pipeline is virtually dry, the cupboard is nearly bare.
– Margaret Chan, Director General, World Health Organization

India’s cupboard is in danger of getting bare quicker than anywhere else in the world.

What Will We Do When Antibiotics Won’t Work?

 The era of antibiotics is coming to a close. In just a couple of generations, what once appeared to be miracle medicines have been beaten into ineffectiveness by the bacteria they were designed to knock out (Photo: iStock)
The era of antibiotics is coming to a close. In just a couple of generations, what once appeared to be miracle medicines have been beaten into ineffectiveness by the bacteria they were designed to knock out (Photo: iStock)

The post-antibiotic apocalypse is within sight.

Hyperbole? Unfortunately not.

Already 7 lakh people are dying per year around the world from infections which can resist all antibiotics. Surgeons might start losing patients because opening the body will let in resistant bacteria. Giving birth will become much more risky. Injuries will become a lot more dangerous. Strep throat will cause heart damage.

It’s the stuff nightmares are made of, but that’s an ugly reality. On much of the planet, most meat animals are injected antibiotics every day, not to cure illnesses, but to fatten them up and to protect them against the factory farm conditions they are raised in.

We ought to ban antibiotic use in livestock. Antibiotic usage in medicine ought to be cut by half.

What else should we do?

My guess: Develop ways to make our immune systems much stronger. For starters, get cracking on lots of vaccines against bacterial diseases. When drugs can’t help you are on your own. Your own immune system needs to become much stronger.

Antibiotic policies around the world with regard to usage have been retarded for decades. Time to stop being so stupid.

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