The Indian medical establishment has been well and truly pricked. The Lancet, a medical journal, reported last week that antibiotic-resistant bacteria had been found in samples of drinking and seepage water in New Delhi. Since then, the study has been described as unscientific, a waste of time, and driven by questionable motives. The more innocuous Delhi Jal Board has quaintly proclaimed its water safe.
The link between drug-resistant bacteria and India’s capital dates back a few years. In 2008, a Swedish patient who had been convalescing at a Delhi hospital was found to carry a peculiarly resistant and transmittable strain of Klebsiella pneumoniae. The gene that gave the bacterium its dangerous characteristics was named New Delhi metallo-beta-lactamase (NDM-1), because it was thought to originate in the city’s hospitals. This was unfortunate nomenclature, needlessly sullying a city and country for a bug that doesn’t adhere to borders (The Lancet, which used the name in an article last year, later apologized).
Nevertheless, that the bug has now surfaced in New Delhi’s general water supply should have worried the government instead of pitching it into a blame game. The resistance and ease of transmission inherent in NDM-1 are both causes for concern, and not just for India. The Lancet study notes that resistance has now spread to 14 species of bacteria and 16 countries. And many if not all of the strongest antibiotics available globally are impotent against strains containing it. Consider that new antibiotics take years, at times decades, to develop, and the bug starts assuming monster proportions. The World Health Organization already believes NDM-1 represents a “doomsday scenario of a world without antibiotics”.
At its roots lies a different malaise. Overuse and misuse of antibiotics are anywhere a danger. But in populated countries such as India, where antibiotics can be bought over the counter, the risk is particularly acute. This has worried health professionals for decades, but no palpable solution has been found. And despite India’s growing popularity as a medical tourism hotspot, the quality and reach of its healthcare services are patchy at best. This has scuttled any possibility of banning over the counter sales of drugs: In places where doctors themselves are a rarity, prescriptions would be well nigh unheard of.
That leaves the myth of the bacteria-resistant Indian. Not only is popular belief in this extra-medical ability a total anomaly in an increasingly literate India, it is also rather callous. Yet if the country continues to put less store in saving its people than in protecting its reputation, then this famed resistance to the bug could well turn out to be our best hope.
Is India underplaying the problem of drug-resistant bacterial strains? Tell us at firstname.lastname@example.org