The Drug Controller General of India (DCGI) has asked authorities of all states and Union territories (UTs) to stop pharmacies from selling antibiotic drugs without a doctor’s prescription in a step aimed at tackling drug resistant bacteria.
“All state and UT drug controllers should sensitize their enforcement officials to keep strong vigil to ensure that such drugs are not sold by retail without prescription of registered medical practitioners…,” DCGI V.G. Somani said in an advisory dated 23 December.
A copy of the advisory has been seen by Mint.
The regulator also asked All India Organization of Chemists & Druggists (AIOCD) to “educate their members” on licencing conditions regarding antibiotic sales, and told drug makers to discourage pharmacists from selling drugs without prescriptions.
Antibiotics fall under schedules H and H1 of the Drugs and Cosmetics Rules, which means they can be sold only under prescription.
However, regulations for pharmacies are lax and violations are rampant. A number of such medicines are sold widely over the counter without prescriptions.
The move by the regulator indicates increased awareness about anti-microbial resistance, where bacteria and other microbials become immune to medicines on overuse, thereby making them ineffective against the infection.
The ministry of health and family welfare had issued a National Action Plan on anti-microbial resistance (AMR) in 2017, seeking a coordinated move with the help of various other ministries such as animal husbandry and environment.
Anti-microbial resistance is globally seen as a major problem in the pharmaceutical sector with the United Nations’ Interagency Coordination Group on Antimicrobial Resistance estimating drug-resistant infections to cause at least 700,000 deaths every year, including 230,000 from multidrug-resistant tuberculosis alone.
“A worst-case scenario developed by the World Bank has suggested that this figure could rise to 10 million deaths every year by 2050 if no action is taken,” the agency said.
Around 10 million lives a year and a cumulative $100 trillion of economic output will be at risk because of the rise of drug-resistant infections by 2050, according to estimates from another study supported by the UK government and Wellcome Trust in 2016.
India, home to an estimated 130,000 multidrug resistant TB patients in 2019 according to the World Health Organization, is crucial to the success of this global fight.
However, the sale of medicines without prescriptions is not the only reason for the rise in anti-microbial resistance, according to experts. Effluents discharged by drug manufacturing units also add to the problem.
The advisory by the DCGI comes two months after the department of pharmaceuticals wrote to drug manufacturers, warning against antibiotic residues in the effluents of their plants.
The Central Pollution Control Board (CPCB) is also working on effluent treatment norms for pharmaceutical companies. CPCB had set up an expert committee to draft standards for antibiotic residue in industrial effluents. The draft is now close to finalization.
GlaxoSmithKline Pharmaceuticals’ Augmentin, Alkem Laboratories’ Clavam, and Aristo Pharmaceuticals’ Monocef are some of the most popular antibiotics in India.
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