Akhilesh Kumar
Q 1: I think there is no programme at grass root level in veterinary sector in country where the state veterinarians are being trained and made aware of AMR. Further, there is no facility for ABST in filed setting. How a vet can take a decision and how we expect from him to do so when we did not for providing necessary infrastructure. In these situation is there any hope for curbing the menace of AMR?
Ans: We understand the issues of veterinary extension and the importance of laboratory infrastructure, resources and capacity support at ground level. We hope that any AMR surveillance initiative developed in the country will take this into consideration
Q 2: Are the steps taken to encounter this problem are practically reaching to human and veterinary practitioner prescribing the antibiotics without even having a thought about AMR in daily practice?
Ans: We understand your concern. There are issues with ground level implementation of measures taken to encounter the problem
Q 3: Why there is no regulation for powerful pharma companies who are delivering the 4 or 5th generation antibiotics for over counter sales?
Ans: The only regulation for pharma companies is so far is under development. The Ministry of Environment, Forest and Climate Change (MoEFCC) had in January 2020, put up draft standards for residual antibiotics in effluents from pharmaceutical manufacturing countries and common effluent treatment plants for public comments. The draft standards were developed after about two years of deliberation with different stakeholders including the pharmaceutical manufacturing companies. There has been opposition from the industry as the standards were being developed. Even now, the formal notification of the standards is being delayed due to industry push-back.
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Alfred Kompudu
Q 2: How about pandemic impact in the food animal farming industrial, how is the solution and what is the relation with AMR case.
Ans: The effect of industrial farming on pandemic has been discussed in the webinar which can be accessed at the following link https://www.cseindia.org/cse-webinar-10176
On the other hand, the effect of pandemic on industrial farming will be on the animal population and lead to a food security issue. Past pandemics have shown the culling of animals to prevent spread of diseases. Growing AMR in animals can also lead to animal deaths, as a result of antibiotics not being effective.
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Amarjeet Singh
Q 1: How much is plant based meat alternatives viable/can help meet the present and future demand of global meat? does this give opportunity for India for export plant based meat to western countries
• Does rural collective/co-operative livestock farming is way forward against industrial farming of livestock?
Ans: There are discussions and research around the present and future demands of global meat and how it could be met. In the Indian context, animal protein is important w.r.t. nutrition and livelihood. The issue is more about how we choose to grow our food. An approach which helps reduce use of chemical inputs, including antibiotic misuse in food animal production will be useful.
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Avinash Kumar
Q 1: Would ionophores be classified under antibiotics, specially the synthetic ones?
Ans: Ionophores are technically antibiotics. Though they are active against a variety of human pathogens such as Clostridium difficile, Methicillin-resistant Staphylococcus aureus, but they are not used in humans due to their toxicity. They are not medically important antibiotics as of now. However, studies from Norway have shown that use of ionophores in chicken has led to selection of resistance against medically important antibiotics.
Some relevant literature:
- https://vkm.no/download/18.2994e95b15cc5450716152d3/1498142579152/0025301628.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6763768/
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Harshita Singh
Q 1: What is the contribution of small farmers with 8-10 animals (cow/buffalo) or 500-1000 poultry birds to the problem of AMR?
Ans: The exact contribution of small farmers versus big farmers to AMR is not known. However, it is known that intensive farming is a driver of emergence and spread of resistant bacteria because of the high use of antibiotics involved. In the Indian context, small farmers may also be using antibiotics.
Our experience in the dairy sector has shown that even farmers with 8-10 animals (cow/buffalo) are using high end critically important antibiotics for treatment. Link to our assessment of antibiotic use in dairy sector is given below:
https://www.downtoearth.org.in/news/food/our-daily-dose-of-antibiotics-71804
In the poultry sector, a population of 500-1000 birds enclosed in a confined setting and small space, can reflect conditions similar to intensive farms characterized by high stocking density and high chances of infection/diseases. Antibiotics are therefore needed for keeping away such diseases. It is also used as a cheap alterative to unhygienic farm conditions, and for faster growth. Small farmers administer antibiotics through feed or openly using bulk antibiotics available. In 2014, CSE had reported the misuse of antibiotics in the poultry sector and had also found residues of antibiotics in chicken meat procured from local markets in Delhi NCR region. Link to CSE study:
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Harpreet Kaur Kohli
Q 1: Will adoption of vegetarian lifestyle be the new normal?
Ans: In the Indian context, animal protein is important w.r.t. nutrition and livelihood. The issue is more about how we grow our food. It is the intensive farming approach which involves antibiotic use because of the way animals are reared and poses a problem.
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Jayanta Topadar
Q 1: What are the elements of ONE HEALTH approach?
Ans: The key elements of One-Health comprises of all sectors that have connection to and can influence antimicrobial resistance (AMR). This includes human health, animal health, food-animal production, food, feed, plant health and environment. Also given below is the link to a report by the United Nations Inter-Agency Coordination Group (UN-IACG) on AMR which proposes practical solutions based on One-Health approach:
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Jolly Joseph
Q 1: What are measures taken in India on anti-microbial resistance public health problems?
Ans: India has a National Action Plan on Antimicrobial Resistance (2017-2021), which outlines plan for multiple stakeholders in India on containing AMR. The implementation of the National Action Plan is spearheaded by the National Centre for Disease Control (NCDC) with other stakeholders from animal, plant, food, drug, environment sectors. A Delhi Declaration on Antimicrobial Resistance reflects inter-ministerial consensus to adopt a holistic and collaborative approach to prevention and containment of AMR in India. It was endorsed by Ministers from 12 Ministries in India.
- Link to India’s National Action Plan on AMR:
- Link to Delhi Declaration
The National Action Plan also calls for states to develop their own state action plans on AMR to facilitate action for AMR containment on the ground. Kerala, Madhya Pradesh and Delhi have so far developed state action plans for respective states.
Link to state Action plans:
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Kamna Sagar
Q 1: World has experience devastating economic losses to farmers and Major outbreaks can you please explain that
Ans: The issue of concern is the non-therapeutic use of antibiotics in intensive food animal farming, and not the use of antibiotics during major outbreaks.
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Kiran M
Q 1: Antimicrobial resistance is global pandemic caused by many factors like antibiotic abuse at the medical and veterinary field reason for the same are plenty but repeatedly fingers are pointed at Industrial food animal farming, why no measures are recommended for avoiding drug abuse in medical field? is food animal rearing became a soft target? I need expert opinion on this line.
Ans: We do not think that food animal rearing is becoming a soft target. In fact AMR is a One-Health issue, which implies that it needs to be addressed multi-sectorally that includes human health, animal health as well as food-animal production among others. There are gaps which need to be addressed both in human-health and animal sectors. India’s National Action Plan on AMR outlines the country’s plan to address AMR in a multi-sectoral manner.
Link to India’s National Action Plan on AMR
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Mani Ramakrishnan
Q 1: Why can’t we slowly move towards herbivorous, which save us from animal based transmission, global warming, loss of water & land resources?. Provided we cultivate sufficient nutritious greens.
Ans: In the Indian context, animal protein is important w.r.t. nutrition and livelihood. The issue is more about how we grow our food. It is the intensive farming approach which involves antibiotic use because of the way animals are reared and poses a problem.
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Prasanna Patil
Q 1: • Explain how AMR, food animal production and emergence viral pandemics are related.
• What's the antibiotics use in India per kg biomass
Ans: This has been discussed in the webinar which can be accessed at the following link:
https://www.cseindia.org/cse-webinar-10176
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Priya Mani
Q 1: What are the factors responsible for AMR?
Ans: Please refer to the following links:
- https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
- https://www.cdc.gov/drugresistance/about/how-resistance-happens.html
What are the different mechanisms involved in the development of AMR?
Please refer to the following links:
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888801/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6604941/
- https://www.reactgroup.org/toolbox/understand/antibiotic-resistance/resistance-mechanisms-in-bacteria/
Practically possible remedies to reduce the development of AMR microorganism in India
Please refer to the following link:
India’s National Action Plan on AMR
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Ramesh Deshpande
Q 1: What is India's strategy to mitigate AMR pandemic? How state governments who are responsible to public health involved in this strategy?
Ans: India has a National Action Plan on Antimicrobial Resistance (2017-2021), which outlines plan for multiple stakeholders in India on containing AMR. The implementation of the National Action Plan is spearheaded by the National Centre for Disease Control (NCDC) with other stakeholders from animal, plant, food, drug, environment sectors. A Delhi Declaration on Antimicrobial Resistance reflects inter-ministerial consensus to adopt a holistic and collaborative approach to prevention and containment of AMR in India. It was endorsed by Ministers from 12 Ministries in India.
The National Action Plan also calls for states to develop their own state action plans on AMR to facilitate action for AMR containment on the ground. Kerala, Madhya Pradesh and Delhi have so far developed state action plans for respective states.
Link to state Action plans:
Kerala
Madhya Pradesh
Delhi
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