Kerala has successfully implemented Operation Amrith to ban the over-the-counter sale of antibiotics without prescriptions.
Operation Amrith (Antimicrobial Resistance Intervention for Total Health) is a program in Kerala, India that aims to curb the overuse of antibiotics and antimicrobial resistance (AMR).
The program was launched by the Kerala Drug Control Department in January 2024
The ban has led to a significant decrease in the sale of antibiotics in the state.
The sale of antibiotics through hospitals and medical stores in Kerala has decreased by Rs. 1,000 crore in the last year.
Kerala's Enforcement of the 2011 H1 Rule
Kerala was the first state in India to ban the over-the-counter sale of antibiotics without a prescription.
Kerala enforced the 2011 H1 rule, which prohibits the sale of all antibiotics without a prescription, even after the Indian government modified the rule in 2013.
Kerala's high doctor-patient ratio, availability of doctors, and different healthcare-seeking behavior of people contributed to its ability to enforce the stricter rule.
Challenges and Limitations of Kerala's Approach
Dr. Abdul Ghafur argues that Kerala's efforts will have limited impact in reducing antimicrobial resistance unless neighboring states adopt similar policies.
He suggests that Kerala consider adopting the modified H1 rule of 2013, which allows the sale of first-line antibiotics without a prescription while monitoring second and third-line antibiotics.
Kerala imports a significant portion of its food products, which may carry antibiotic residues and drug-resistant bacteria.
Recommendations for Kerala
Dr. Ghafur recommends that Kerala either become self-sufficient in food production or work with neighboring states to implement strict AMR action plans.
He suggests that Kerala adopt the modified H1 rule to encourage neighboring states to follow suit and gradually work towards a more comprehensive ban on OTC antibiotic sales.
Conclusion
Kerala's efforts to combat antimicrobial resistance are commendable but require a broader and coordinated approach involving neighboring states.
A balanced approach that considers both healthcare access and antibiotic stewardship is essential for long-term success.
Kerala can play a pivotal role in influencing regional AMR policies through its proactive measures and example.
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