Irresponsible use of antimicrobials, including antibiotics, is accelerating the rise of ‘superbugs’. These superbugs are causing infections that were once easily treatable by antimicrobials but are now becoming increasingly difficult to treat and, in some cases, turning life-threatening. Unnecessary use of antimicrobials coupled with poor infection prevention measures and lack of new antimicrobials has resulted in a full-blown global health crisis of Antimicrobial Resistance (AMR). The climate crisis is also affecting patterns of infectious diseases which may lead to an increase in the use of antimicrobial drugs and a rise in AMR. 

While the problem of AMR has reached a tipping point in India, there are countless and yet, often unheard of superheroes – in research labs, hospitals, and on the ground, among communities – who are working very hard to stop the rise of these deadly superbugs. In our SaS-AMR Champions Series, commemorating the World Antimicrobial Awareness Week (WAAW2021), we bring to you conversations with some of these ‘Superheroes Against Superbugs’ that we hope would inform, inspire, and encourage us all to act against AMR to ensure a healthy future for all.

Agriculture, on which 70% of the rural households are dependent, accounts for around 22% of the Gross Domestic Product (GDP) of our country. Even though agriculture forms the backbone of our economy, Indian farmers are under a lot of distress due to multiple social, economic and environmental factors which are threatening their livelihood. One of the ways in which farmers protect their crops from diseases is by using antibiotics. This rampant and excessive use of antibiotics in agriculture today is a major driver of AMR. But do farmers have a choice? As a veteran agricultural researcher and an experienced executive director of a non-profit organization, Centre for Sustainable Agriculture (CSA), G.V. Ramanjaneyulu (Ramoo), shares his thoughts on controlling the spread of AMR in agriculture.

How does AMR spread through plant or animal farming and what are some ways in which this can be prevented?

Ramoo: The use of pesticides, particularly antibiotics like oxytetracycline and streptomycin, for managing diseases make plant pathogens resistant to them. Some of the streptomycin-resistant genes in plant-associated bacteria are similar to those found in bacteria isolated from humans, animals and soil. These are also associated with gene transfer proficient elements – these elements enable the genes to spread from one bacteria to another, and thus, spreading streptomycin resistance among those.

Antimicrobial genes used as markers in Genetically Modified crops, like Kanamycin resistance markers, increase the chance of developing AMR in plant-associated pathogens through reproduction as well as through horizontal gene transfer which involves direct movement of genetic material from one pathogen to another. 

Only way we can avoid these problems is by promoting natural pest and disease management practices which are quite successful in reducing the disease incidence and use of resistant varieties among other ways. Rampant use of antibiotics in dairy, poultry, aquaculture and small ruminants production can be avoided or minimised by promoting low density production systems and by having good agricultural practices in place.

Are there any awareness programmes and incentives for farmers to help them adopt practices for sustainable agriculture? Do you think that the majority of farmers are able to understand and relate to the problem of AMR?

Ramoo: There are no major programs in agriculture or livestock production. Forget about farmers, even the consumers do not understand the problem of AMR through agriculture. At best, they engage themselves in animal growing practices from an ethical perspective. There is a need for a special campaign around this and more communication material may have to be produced for both groups of people. Farmers and consumers both want to understand the impact agricultural practices will have on their lives before they think of the environment or other people. Farmers use antibiotics hoping for higher productivity and profits. But in the process, they end up having high-density farms which harbour more pathogens and give rise to more diseases. Communications aimed towards farmers should inform them that sustainable small farms are the way to go in the longer run. Communications for the consumers, on the other hand, should focus on the impact of food production practices on their own lives. Impact on the environment is secondary to them.

60% of those who drop out of school get into agriculture in India. We run programs with schools to train children about sustainable farming techniques along with training programs with farmers to encourage them to adopt sustainable agriculture. We also routinely conduct nutritional counselling sessions in cities to inform the consumers.

Considering the resource-intensive nature of these practices, how do sustainable farming enterprises sustain amidst strong competition in India?

Ramoo: The growing demand for safe and healthy food and the impending threat from Climate Change will ultimately tilt the preference for shifting towards sustainable production. India’s demand for organic food is increasing at a 28% compound annual growth rate (CAGR) whereas it is 16% internationally. The production is also increasing at 23% CAGR. There are examples from coastal Andhra Pradesh on growing fish sustainably. We have been involved in encouraging backyard poultry with 50-100 free-ranging birds and small poultry farms with 500-1000 birds but in low density in various districts of Telangana and Andhra Pradesh.

We need to create models for scaling up these and other successful examples already available.

Sahaja Aharam run by CSA is one such example where the food is sourced from 100% certified organic farms and processed at exclusive certified organic processing facilities by farmers themselves. In addition, the ecological footprint of the produce is actively shared with the consumers, thus, actively engaging them in the process and encouraging them to make better choices. There are other similar models like 24 Mantra Organic that sells 100% organic food and Safe Harvest specialising in pesticide-free food. Sahaja Samrudha is an NGO that works with farmers to conserve the biodiversity of the indigenous crop varieties. 

There is also the concept of agricultural carbon credits being implemented in other countries. The farmers generate carbon credits by reducing their carbon footprint, which they can sell to companies interested in offsetting their carbon emissions. This is, however, an idea that has not caught on in India yet.

Are consumers in India sensitised on the issue of AMR? Will they pay a premium for products made ‘without the routine use of antibiotics?’ How can this message be driven into the communities?

Ramoo: The demand for pesticide-free products is certainly growing. The upper-middle-class and people transitioning into this class are the biggest consumers. They are involved in their food and are becoming health conscious. We can add AMR also into the campaign and build awareness.

We should ask for access to food with labels like ‘pesticide free’ or ‘without the routine use of antibiotics’. Currently, in India food companies except the organic food companies are not required to mention their production process. They only mention the ingredients, allergen content and expiry dates. If consumers see clearly where and how their food has been prepared, there are people willing to pay extra.

Messages should be sharp and solutions in terms of access to food with labels like ‘pesticide free’ or ‘without routine use of antibiotics’ should be increased.

As a consumer, how can we contribute to stopping the spread of AMR through farming practices?

Ramoo: The consumer has to become an active consumer. They have to talk to others, write about it on social media. They can push for labeling food and ensure the food packet labels describe the production process. This will help consumers make informed food choices.

In the market, it is the customer’s rejection that makes all the difference!

Interview by Team SaS and G Bhargavi Krishna Sree; Bhargavi is a research scholar, with an inclination to study and understand the coordination between the synthesis of various cell wall components in bacteria. She uses E. coli, an established model organism to study these natural processes.

Cover Art by Mahek Kothari