Antimicrobial resistance: the next BIG pandemic

Divya Chaudhry, Priyanka Tomar


Pandemics have indefinitely threatened the resilience of health systems worldwide. Based on the costs inflicted by some of the deadliest pandemics in human history, economists have projected that global pandemics could cost over USD 6 trillion and generate an annual estimated loss of over USD 60 billion. While the global health community is tirelessly trying to curb the burden of premature mortality from several old and new forms of pathogens, it is now faced with the silently emerging antimicrobial resistance (AMR) pandemic that could endanger some of the most significant advances in modern medicine. Owing to rampant antibiotic consumption in India, the article shows why the country may become the ‘AMR capital of the world’. It shows how health systems may be strengthened both at the national and international levels to reduce premature mortality and morbidity attributable to AMR and pandemics. 


Antimicrobial resistance, Pandemics, Health systems, Premature mortality, Public health, Surveillance

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Jackson M. The Routledge history of disease. New York: Routledge; 2016.

Drlica K, David P. Antibiotic resistance: Understanding and responding to an emerging crisis, New Jersey: Pearson Education; 2011.

Roos R. CDC estimate of global H1N1 pandemic deaths: 284000. Centre for Infectious Disease Research and Policy (CIDRAP), 2012. Available at: Accessed on 22 June 2017.

Global HIV statistics. UNAIDS, 2016. Available at: Accessed on 22 June 2017.

Factsheet on HIV/AIDS. World Health Organisation (WHO), 2016 Available at: mediacentre/factsheets/fs360/en/. Accessed on 22 June 2017.

Factsheet on Tuberculosis. World Health Organisation (WHO), 2016 Available at: Accessed on 22 June 2017.

Institute for Health Metrics and Evaluation (IHME) Available at: Accessed on 20 June 2017.

CIDRAP. World Bank says flu pandemic could cost $3 trillion. Centre for infectious disease research and policy, 2008. Available at: Accessed on 22 June 2017.

Taylor T. The economics of pandemic preparedness. Conversable Economist, 2016. Available at Accessed on 22 June 2017.

Commission on a Global Health Risk Framework for the Future. The neglected dimension of global security: A framework to counter infectious disease crises. Washington DC: The National Academies Press; 2016.

Jasovský D, Jasper L, Anna Z and Otto C. Antimicrobial resistancea threat to the world’s sustainable development. Upsala J Med Sci. 2016;121(3):159-64.

World Health Organisation. National action for global change on antimicrobial resistance, 2016. Available at handle/10665.1/13066/WPR_2016_DHS_008_eng.pdf?ua=1. Accessed on 22 June 2017.

O’Neill J. Antimicrobial resistance - Tackling a crisis for the health and wealth of nations, 2014. Available at: files/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf. Accessed on 22 June, 2017.

Directorate General of Health Services, Ministry of Health and Family Welfare. National Policy for Containment of Antimicrobial Resistance in India. New Delhi: Government of India, 2016.

Laxminarayan R, Matsoso P, Pant S, Brower C, Røttingen JA, Klugman K, et al. Access to effective antimicrobials - a worldwide challenge. Lancet. 2015;387:168-75.

Van Boeckel TP, Gandra S, Ashok A, Caudron Q, Grenfell BT, Levin SA, Laxminarayan R. Global antibiotic consumption 2000 to 2010: An analysis of national pharmaceutical sales data. Lancet Infect Dis. 2014;14:742-50.

Laxminarayan R, Chaudhury R. Antibiotic resistance in India: Drivers and opportunities for action. PLOS Medicine. 2016;13(3).

Kumar A, Biswalb M, Dhaliwala N, Mahesha R, Appannanavarb SB, Gautamb V, et al. Point prevalence surveys of healthcare-associated infections and use of indwelling devices and antimicrobials over three years in a tertiary care hospital in India. J Hospital Infect. 2014;86(4):272-74.

Malhotra S, Sharma S, Hans C. Prevalence of Hospital Acquired Infections in a tertiary care hospital in India. Int Invent J Med Medical Sci. 2014;1(7):91-4.

CDSCO, New Delhi. Minutes of the special meeting (62nd) of the Drugs Technical Advisory Board, 2013. Available at

addata/MinutesDTAB%2062nd.pdf. Accessed on 22 June 2017.

Gautam CS, Saha L. Fixed dose drug combinations (FDCs): Rational or irrational: A view point. Br J Clin Pharmacol. 2008;65(5):795-6.

Indian Council for Agricultural Research (ICAR) - Central Institute of Brackishwater Aquaculture (CIBA). Responsible use of antimicrobials in Indian aquaculture – Opportunities and challenges, 2016. Available at: cibaspl83.pdf. Accessed on 22 June, 2017.

Sahu R, Saxena P. Antibiotics in chicken meat. New Delhi: Centre for Science and Environment; 2014.

Kakkar M, Rogawski L. Antibiotic use and residues in chicken meat and milk samples from Karnataka and Punjab. New Delhi: Public Health Foundation of India; 2013.

Dutt A. Four ministries to come together to combat antimicrobial resistance. Hindustan Times, 2017. Available at

mNo2rV7LK.html. Accessed on 22 June 2017.