People buying medicines from medical stores in Delhi.
Anup Kumar Singh, New Delhi. A man suffering from HIV-AIDS recently took a 28-day course of medicine on the advice of Artificial Intelligence (AI) and a medical store operator. Due to these antiviral medicines taken without medical advice, his life was in danger and he is currently admitted in a hospital in the capital in a very critical condition.
This is an example of the harm caused by going to a medical store and directly buying and consuming antibiotics, antivirals or other similar antimicrobial drugs. The tendency of people to consume antibiotics on their own will is giving rise to a deadly crisis like Antimicrobial Resistance (AMR), which is becoming a major challenge for public health. It is a matter of concern that half of the total antibiotics sold in the country are being sold without prescription.
AMR is a condition when medicines do not respond to bacteria and even a simple infection becomes fatal. Under the Drugs and Cosmetics Act 1940, there is a complete ban on over-the-counter (OTC) sale of all antimicrobial drugs, including antibiotics without prescription. The dangerous result of this uncontrolled sale and misuse of antibiotics is coming to the fore in the form of deaths of about three lakh people every year due to AMR in the country. The government is considering making it mandatory to have a blue stripe on the containers and strips of antimicrobial medicines, indicating that
Health experts warn that if this trend is not stopped immediately, treatment options will be limited, treatment of even common infections will become difficult and expensive and the number of deaths will increase. Antibiotics worth Rs 14 thousand crores are sold every year without prescription. According to the Central Drugs Standard Control Organization (CDSCO), the total annual sale of antibiotics in the country is estimated to be around Rs 28 thousand crores, of which 50 percent is from OTC sales.
This means that every year antibiotics worth about Rs 14 thousand crores are being sold directly over the counter without medical prescription. Antibiotics are categorized in schedule 'H' and 'H-1' of drugs which can be sold only on valid doctor's prescription, but OTC sale of antibiotics includes many drugs like amoxicillin, azithromycin, ciprofloxacin etc. In rural areas, quacks further increase this abuse.
Why is the surveillance system ineffective?
The number of licensed retail pharmacies and medical stores in the country is approximately 12 lakh. For their effective monitoring, experts say that about 3,500 drug inspectors are required. A total of 504 inspector posts are sanctioned in CDSCO, out of which about 249 posts are vacant. Similarly, at the state level also, only about 1,500 inspectors are considered to be working in the entire country, which is much less than the requirement.
Misuse of antibiotics continues to deepen the AMR crisis in India. Strict adherence to OTC sales and prescription written by a doctor is mandatory. Taking antibiotics in viral diseases is dangerous. - Dr. Narendra Saini, Chairman, ANR Committee, Indian Medical Association
Illegal e-pharmacy is increasing OTC sales of antibiotics. This is also giving a boost to PPM. To effectively stop this, it is necessary to strictly implement the prescription-only system. So that, people can be saved from the harm of antibiotics. - Rajeev Singhal, General Secretary, All India Organization of Chemists and Druggists
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