The growing global threat of antimicrobial resistance (AMR) took center stage at a high-profile consultation hosted by the Max Institute of Healthcare Management (MIHM) at the Indian School of Business (ISB) and the International Centre for Antimicrobial Resistance Solutions (ICARS). The event, held at ISB's Hyderabad campus, gathered experts and stakeholders to explore sustainable ways of using last-resort antibiotics through strengthened antimicrobial stewardship practices.

The consultation was part of the TANDEM-ABX initiative, a project jointly implemented by ICARS in India and Kenya with support from the Novo Nordisk Foundation. In India, the initiative is being executed with ISB MIHM and Christian Medical College (CMC) Vellore as key partners. The project focuses on fostering responsible use of antibiotics by interlinking stewardship systems from policy frameworks to hospital-level practices.

A Diverse and Unified Front

The event brought together a wide array of stakeholders, including clinicians, microbiologists, pharmacists, hospital administrators, civil society groups, biotech innovators, and policymakers from Telangana. Discussions emphasized the critical need to address the misuse of antibiotics in low- and middle-income countries (LMICs) like India, where overuse and inappropriate prescribing undermine efforts to control AMR.

In his opening address, R.V. Karnan, Commissioner of Health and Family Welfare for the Telangana Government, underlined the state’s commitment to AMR mitigation. "Telangana's AMR action plan will strengthen our healthcare system’s approach to antimicrobial stewardship. ISB's research initiative will provide valuable insights for evidence-based policymaking, particularly in understanding how we can better coordinate stewardship efforts across different healthcare settings," he said.

Tackling AMR: Challenges and Innovations

The challenge of antimicrobial resistance in LMICs lies in striking a balance between access and stewardship. While India’s pharmaceutical industry ensures affordable antibiotic availability, the ease of access often leads to misuse, threatening the effectiveness of "Reserve" class antibiotics. These critical antibiotics, with their narrow spectrum of action, risk losing efficacy if not used judiciously.

Professor Sarang Deo, Deputy Dean – Faculty and Research and Executive Director at ISB MIHM, emphasized the importance of evidence-based stewardship efforts. "While antimicrobial stewardship programs are growing across hospitals, there is a dire need to generate strong evidence about the feasibility of coordinated stewardship efforts across multiple healthcare stakeholders. This consultation has generated several ideas on how to structure such a pilot and use it to shape policy."

Global Insights for Local Solutions

The consultation also offered a platform for exchanging international and local perspectives. Dr. Jyoti Joshi, Senior Science Advisor at ICARS and project lead for TANDEM-ABX, highlighted the broader implications of India’s experiences for other LMICs. “Learnings from India can be useful globally to tackle AMR. Proactive planning to establish antimicrobial stewardship systems will promote health preparedness and responsive policy to ensure the right patient gets the right antibiotic, while preserving reserve antibiotics as a precious global good,” she said.

Adding a local perspective, Dr. Ranga Reddy Burri, President of the Infection Control Academy of India, echoed concerns about balancing antibiotic access and misuse. "While India's robust pharmaceutical industry ensures affordable antibiotics, this accessibility presents the challenge of misuse, which risks losing our most valuable antibiotics," he noted.

A Call to Action

As AMR continues to pose a significant threat to global health, the collaboration between ISB MIHM, ICARS, and other stakeholders offers a promising pathway for change. Through initiatives like TANDEM-ABX and proactive antimicrobial stewardship, India is not only tackling its local AMR challenges but also setting an example for LMICs worldwide.

The Hyderabad consultation marks a pivotal step in bridging gaps between policy, practice, and innovation, reinforcing the urgent need to safeguard antibiotics as a global resource.