By Dr. Juri B Kalita
Some health crises arrive with unmistakable drama—sudden outbreaks, overwhelmed hospitals, frightening mortality rates. They dominate news cycles and prompt immediate action. Antimicrobial resistance operates differently. It advances gradually, almost imperceptibly, until suddenly it’s too late.
This lack of dramatic narrative makes AMR particularly dangerous. We’re experiencing what amounts to a slow-motion pandemic, one that claims over 1.2 million lives annually yet rarely makes headlines. By 2050, if current trends continue, resistant infections could cause 10 million deaths per year while imposing $100 trillion in economic costs on the global economy.
To grasp the magnitude, consider what a post-antibiotic world might resemble. Hip replacements and other joint surgeries become too risky because post-operative infections can’t be reliably treated. Cancer chemotherapy, which weakens the immune system, turns life-threatening as patients can’t fight off resistant bacteria. Childbirth regains its historical dangers. A simple scraped knee could, in the worst cases, prove fatal.
This isn’t speculation or fear-mongering. It’s the reality we’re moving towards unless something changes. We’re essentially facing the prospect of returning to a pre-antibiotic era, with all the medical limitations that entailed.
The World Health Organization lists AMR among the top ten global public health threats. Specific bacteria have developed concerning levels of resistance: Methicillin-resistant Staphylococcus aureus (MRSA), Carbapenem-resistant Enterobacteriaceae (CRE), and multidrug-resistant tuberculosis represent just a few examples. These organisms are present in India, including in the Northeast, though precise local data often proves difficult to obtain.
Why does this crisis receive so little attention compared to other health threats? Perhaps because it lacks a clear narrative structure. There’s no patient zero, no identifiable moment when things went wrong, no obvious villain. Resistance develops gradually across millions of individual instances of antibiotic use and misuse. It’s death by a thousand cuts, each too small to notice but collectively catastrophic.
The distributed nature of the problem also complicates response. Unlike an epidemic that can be contained through quarantine or vaccination, AMR requires coordinated changes in behaviour across entire societies—from prescribing practices to agricultural policies to individual patient compliance. It demands sustained effort over years and decades, which proves politically and socially challenging.
Yet there’s a crucial difference between AMR and many other global challenges: this one is almost entirely human-caused, which means it’s human-solvable. We created this crisis through how we use antimicrobials. We can mitigate it through more responsible practices.
The solutions aren’t mysterious. Improve infection prevention through better hygiene and sanitation. Ensure accurate diagnosis before prescribing antimicrobials. Use narrow-spectrum antibiotics when possible rather than broad-spectrum drugs. Regulate agricultural antimicrobial use. Invest in new drug development. Educate healthcare providers and the public. None of this requires revolutionary technology—just commitment and coordination.
For individuals across India, awareness represents the first step. You cannot address a problem you don’t know exists. The bacteria developing resistance in your community, in your household, potentially in your own body, won’t announce themselves. They work silently, gaining strength each time antimicrobials are misused.
The crisis may not make headlines, but it deserves our urgent attention nonetheless. Because the time to act isn’t when antibiotics have completely stopped working—it’s now, while they still mostly do.
(The writers is a Consultant Microbiologist & Infection Control Officer, Bethany Hospital, Shillong)
