Context

• Prime Minister Narendra Modi’s remarks on antimicrobial resistance (AMR) during the 129th edition of Mann Ki Baat on December 28, 2025 may represent a pivotal moment for national awareness and policy focus.
• His statements have been viewed as an opportunity for collective recognition in addressing what many medical experts regard as India’s next major public health crisis.

From Specialist Concern to Mass Awareness

• For years, AMR has occupied a largely technical space dominated by infectious disease experts, health institutions, and government bodies.
• Strategic interventions such as the National Action Plan on AMR and targeted regulatory actions against antibiotic misuse have been initiated, yet these measures have not significantly altered public behaviour.
• PM Modi’s address directly confronted the behavioural roots of AMR, emphasizing thoughtless and indiscriminate use of antibiotics and cautioning against self-medication.
• By referencing Indian Council of Medical Research data illustrating decreased antibiotic efficacy against common infections such as pneumonia and urinary tract infections, the speech connected scientific evidence with everyday risks.
• His closing advisory, “Avoid taking medicines by yourself, particularly antibiotics,” transformed AMR from an abstract clinical problem into a matter of individual and collective responsibility.
• This mainstreaming of AMR may enable broader societal engagement, particularly because public behaviour is a major determinant of resistance patterns.
• Expanding awareness at the population level targets the widest base of influence, potentially achieving more than specialized policy instruments alone.

The Limits of Awareness and the Need for Structured Surveillance

• The Limits of Awareness
  • Awareness, however, addresses only one dimension of a problem that has grown into a multi-sectoral crisis.
  • AMR in India draws from intersecting drivers involving human health, animal health, agriculture, and environmental contamination.
  • A One Health approach has emerged as the most coherent framework for coordinating interventions across these domains.
  • Drug use in livestock production, untreated discharge of pharmaceutical waste, and hospital-based infections contribute cumulatively to resistance patterns, demanding a shift from siloed action to integrated governance.
• Need for Structured Surveillance
  • At the current juncture, surveillance capacity is a critical bottleneck.
  • Comprehensive AMR surveillance remains limited in scale, geographical coverage, and institutional diversity.
  • Although the National AMR Surveillance Network (NARS-Net), established in 2013, now includes 60 sentinel laboratories, national reporting to the World Health Organization’s GLASS system in 2023 contained data from only 41 sites across 31 States and Union Territories.
  • Urban tertiary hospitals dominate these datasets, whereas secondary and primary care centres, where a large portion of antibiotic prescriptions occur, remain sparsely represented.
  • This skews the national picture and impedes the ability to detect emerging resistance patterns outside major metropolitan centres.
  • Inclusion of private healthcare providers is also essential; India’s healthcare landscape involves substantial private sector participation, particularly for outpatient consultations and inpatient care in non-urban areas.

Political Will, Public Infrastructure, and the Challenge Ahead

• The 2015 WHO Global Action Plan on AMR outlines five central pillars: raising awareness, strengthening surveillance and research, reducing infections, optimising antimicrobial use, and incentivising innovation.
• PM Modi’s remarks advance the awareness pillar, but durable progress across the remaining pillars requires sustained political will and resource allocation.
• Surveillance expansion demands substantial investments in laboratory infrastructure, trained personnel, diagnostic systems, and data integration, areas that typically receive limited health budgeting.
• Reducing infection rates depends on improved sanitation, vaccination coverage, and hospital infection control practices, while optimization of antibiotic use requires both prescriber discipline and retail regulation.
• India’s large informal pharmaceutical market and the ease of antibiotic procurement without prescription remain significant obstacles.
• Long-term sustainability also hinges on support for new drug discovery, diagnostics, and vaccines, fields that carry high development costs and uncertain commercial returns.
• Global experience demonstrates that without structured incentive mechanisms, pharmaceutical innovation in antibiotics stagnates even as resistance accelerates.

Conclusion

• PM Modi’s speech represents a potentially transformative moment for AMR governance by shifting it from a specialized policy discourse to a matter of public concern.
• Yet AMR remains a systemic crisis requiring coordinated interventions rooted in surveillance, regulation, infrastructure, and multi-sectoral cooperation.
• Awareness may catalyse change, but only sustained action can ensure that resistance patterns stabilize rather than escalate.