“The basic issue will be that they [livestock farmers] cannot afford it,” a veterinary surgeon in Chikamagalur district replied to the author’s question on the new proposed guidelines to control Antimicrobial Resistance(AMR).
This was the second time the same sentence featured in the same conversation. Earlier we were talking about the risks of Anti Microbial Resistance, when the doctor had mentioned that if second-line or third-line antibiotics become the norm for all treatments, the farmers will be unable to afford them, for their animals, as well as for themselves when they get sick.
I was in the first year of Master’s then, on the first of the three field components of my coursework.
One evening, some of us walked into the veterinary hospital there, largely because the bulk of the people we had spoken to kept an animal or two to add to their subsistence income. Many of the animals looked ill-nourished, and the occasional farmer mentioned they struggle to break even, despite the additional income they expected the animal to bring.
What started as a generic conversation on the roles and responsibilities of a veterinary doctor in rural Karnataka turned into the problems he saw but was unable to resolve, the chief among which was the misuse and resulting resistance with regards to antimicrobials.
Anti-Microbial Resistance (AMR) is a situation where microbes evolve over time to become resistant to various anti-microbials used on them. This is a natural process of evolution, but it has been accelerated by various factors, which include overprescription, unregulated sale and consumption, sub-par manufacturing and storage practice, poor adherence to treatment protocols among others.
AMR puts entire populations at a higher risk of infectious diseases, increasing risk of infection rates and mortality. Beyond primary treatment of infections, AMR also affects the treatment possibility of other non-communicable diseases like cancer, where antibiotics are necessary to prevent infections during the course of the treatment, or even surgical procedures ranging from a c-section to various other curative or palliative surgeries.
AMR additionally leads to rising costs of healthcare, as higher potency anti-microbials would be required to overcome resistance to first line drugs. Such second line drugs are more expensive, which effectively puts the healthcare out of reach of the many people who are already living on the economic margins of the society.
An example of how this plays out would be the crisis in treating Multi Drug Resistant Tuberculosis (MDR-TB). The emergence of MDR-TB in Peru, for instance, worsened the TB crisis, as the nation was already struggling with an inadequately financed TB treatment program, which made the prospects for second-line treatment worse.1 Apart from the economic demand on the state and the people, higher potency antibiotics also tend to pose higher short term and long-term risk to patients while driving worsened resistance.
