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India must overhaul medical training to act on antimicrobial resistance

BMJ 2013; 347 doi: (Published 03 July 2013) Cite this as: BMJ 2013;347:f4230
  1. Abdul Ghafur, consultant in infectious diseases, Apollo Hospital, Chennai, India
  1. drghafur{at}

Abdul Ghafur, an author of the Chennai Declaration for controlling antibiotic resistance, says that India needs to rationalise its use of the drugs and train more infectious disease specialists

High rates of antimicrobial resistance; a lack of functioning policy for antibiotic use; inadequate infrastructure for infection control in many hospitals; and a scarcity of infectious disease specialists: what else do you need for bugs to flourish?

These conditions apply in most countries of the Indian subcontinent. The region has never considered antibiotic resistance a menace serious enough to warrant investment. The burden of malaria, tuberculosis, typhoid, and others was enough to preoccupy Indian healthcare professionals. Hospital acquired infections have been considered primarily to be a problem for, and a preoccupation of, well resourced countries, perhaps leading to neglect of the impact of these infections.

What we forget is that India has an unusual blend …

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