The New Action Plan on AMR Needs a Shot in the Arm

Dec. 2, 2025

Context

India’s National Action Plan on Antimicrobial Resistance (NAP-AMR 2.0) for 2025–29 arrives at a moment when AMR affects human health, veterinary practices, aquaculture, agriculture, waste systems and food chains.
NAP-AMR 2.0 offers a strong scientific and strategic foundation, but its success hinges on robust Centre–State coordination.
Antibiotic residues, resistant organisms and environmental discharge circulate across soil, water, livestock and markets, making AMR a quintessential One Health challenge that demands coordinated governance across sectors.

Evolution and Achievements of the First Plan

The 2017 National Action Plan marked a major step in recognising AMR as a national priority.
It advanced multi-sectoral engagement, expanded surveillance networks, improved laboratories and promoted stewardship.
Importantly, it embedded AMR within a One Health framework that linked human, animal and environmental health.
However, implementation remained uneven. Only a few States, Kerala, Madhya Pradesh, Delhi, Andhra Pradesh, Gujarat, Sikkim and Punjab, developed formal State Action Plans, and even fewer advanced towards full implementation.
Most States continued to rely on fragmented, sector-specific actions.
The limited progress stemmed from the fact that health services, pharmacy regulation, veterinary oversight, agricultural practices, food-chain safety and waste governance fall largely under State jurisdiction.

NAP-AMR 2.0: Advances and Strengthened Vision

NAP-AMR 2.0 provides a more implementation-oriented and operationally specific framework. It outlines clearer timelines, resource planning and responsibilities.
A critical improvement is the explicit recognition that the private sector delivers a major share of human and veterinary health services, and its involvement is essential for national AMR control.
The plan deepens its One Health approach by strengthening attention to food systems, environmental contamination and waste management, which are major pathways for resistant organisms.
It proposes integrated surveillance systems across human, animal, agricultural and environmental sectors, promoting more harmonised monitoring.
In governance, NAP-AMR 2.0 elevates national oversight by placing intersectoral coordination under NITI Aayog through a dedicated Coordination and Monitoring Committee.
It emphasises that every State and Union Territory should establish State AMR Cells and prepare State Action Plans aligned with the national framework, supported by a national dashboard for tracking progress.
These shifts indicate a growing understanding of AMR as a multi-departmental development challenge, not just a technical health issue.

Persistent Gaps: The Missing Centre–State Mechanism

Despite major improvements, a core structural limitation remains.
The plan urges States to create AMR Cells and Action Plans but does not establish a mechanism to ensure compliance.
There is no formal Centre–State review platform, no statutory requirement for States to notify plans, no joint monitoring process, and no financial incentives linked to implementation, such as under the National Health Mission.
Because most AMR determinants lie under State authority, this absence of accountability structures is a critical weakness.
Without mechanisms for political engagement and administrative follow-through, even a well-designed plan risks achieving limited impact.

The Path Forward: The Need for a Unified and Accountable Structure

Effective implementation requires a clear Centre–State architecture.
A national–State AMR council, chaired by the union Health minister and guided by NITI Aayog, could serve as the apex decision-making and review body connecting human health, veterinary systems, agriculture, aquaculture, food safety and environmental governance.
State participation would strengthen if the Union Government formally requested all States to prepare and notify State AMR Action Plans with defined timelines and annual reviews.
High-level communication through Chief Secretaries can elevate AMR on administrative agendas.
Additionally, conditional financial support under the NHM, even modest, can enhance surveillance, stewardship, infection control and laboratory strengthening.

Conclusion

AMR spreads through hospitals, farms, markets, food systems and waste streams; therefore, national plans cannot succeed without strong State participation.
India now has an opportunity to build a coordinated, accountable model for AMR control that could serve as an international example.
With political commitment, integrated governance and sustained support, NAP-AMR 2.0 can become a transformative milestone rather than a statement of intent.