FOOD/INVESTIGATION
ency of inspection is quarterly, too low to check malpractices.
HOW THIS AFFECTS US
The biggest problem in the Indian dairy sector is that there are no standard treatment guidelines for livestock diseases. Veterinarians, therefore, cannot refer to a standard document and prescribe antibiotics.
Farmers indiscriminately use on animals antibiotics that are crucial for humans. According to the World Health Organization, critically important antimicrobials (CIAs) are the limited therapies to treat human infections caused by bacteria from non-human sources (see ‘Rampant misuse’, of which some are categorised as highest priority critically important antimicrobials (HPCIAs). In India, bacterial resistance to thirdgeneration cephalosporins is already high with and showing more than 75 per cent resistance. Both these bacteria cause several common infections.
A 2018 data with National Centre for Disease Control’s National AMR Surveillance Network shows 86 to 93 per cent resistance of to ampicillin and 82 to 87 per cent to cefotaxime. Similarly, resistance of to cefotaxime was 81 to 89 per cent. A study published in
in 2019 reported high levels of resistance in commensal in a cohort of 125 children between one and three years in a rural area of Madhya Pradesh. Highest resistance was observed for ampicillin while for each child, more than 90 per cent resistance to cephalosporins was observed.
It is disturbing how antibiotics are being passed on to environment. About 70 per cent of the antibiotics given to animals are excreted unmetabolised. As cow and buffalo dung are used as manure in agricultural farms, it can make soil bacteria resistant and environment a reservoir of antimicrobial resistance (AMR)-causing determinants. Other than food, human exposure to resistant bacteria through direct handling of dairy animal waste or through environmental route can lead to drug-resistant infections.
THE WAY OUT
India’s bovine population is almost 300 million. Obviously, the scale of CIA use is gigantic. A well-defined roadmap to limit misuse of CIA, and no use of HPCIA, is critical to reduce the huge burden of antibiotic resistance. DAHD should develop standard treatment guidelines to reduce the misuse of antibiotics. The outreach of veterinary extension system should be strengthened.
DAHD must also expand the vaccine coverage for diseases through its programmes. It should run awareness campaigns for farmers so that they follow withdrawal period before selling milk. Good farm management and hygiene should be promoted to prevent mastitis.
It is time FSSAI set tolerance limits for antibiotics such as amoxicillin, ceftriaxone and gentamicin, which are used in dairy animals, and not listed by FSSAI. Antibiotics with no tolerance limits should not be allowed for use in them. The regulator should help state food and drug administrations to strengthen routine antibiotic monitoring in milk and make the data public.
FSSAI must also increase the frequency of testing milk as per STI and support states on its implementation.
The Central Drugs Standard Control Organisation must regulate over-the-counter sale of antibiotics. It should work with state drug officials to ensure that no antibiotic is sold without prescription.
The Indian Council of Agricultural Research should also develop low-cost diagnostics for early disease diagnosis and antibiotic residue monitoring at all levels be it farm, veterinary healthcare setting or milk collection centre. Considering the linkages of environmental spread of AMR with dairy farm waste, the Central Pollution Control Board along with state pollution control boards should ensure that its guidelines for Environmental Management of Dairy Farms and Gaushalas are followed.