Incredibly Unwell India
must follow up quick delivery of tourist visas with efforts to tackle the
emergent threat of super bugs by nayan Chanda
India has
recently launched an online visa program- me in the hope of doubling the inflow
of tourist dollars, which has been well below the country’s
potential. Quick delivery of visas is, however, only the first and easiest
step. It is much harder to provide the facilities for a safe and enjoyable
visit for millions wishing to taste what the country’s tourist
promotion has billed as ‘Incredible India.’ It is high time the country redoubled its efforts to tackle the
emergent threat of superbugs that has increasingly come to be associated with
India. In recent years, the so-called superbugs — the catch-all for
pathogens resistant to known antibiotics — have caused thousands of deaths around the world. Even developed
countries like the US and those in Western Europe see nearly 50,000 deaths each
year from infections caused by antibiotic-resistant bacteria. In 2010, a
British scientist named a superbug NDM-1 — after New Delhi where it was found, — and it
caused an uproar. Some even spoke of a plot to harm India’s rising
medical tourism. Now, a research paper published by the US National Institute
of Health has named India as the likely home of superbugs. The paper warned
that health care providers should be aware of the increased risk of superbug infection
“among returned travelers, especially those from India”. Shortly
thereafter, in September, President Obama concluded that superbugs pose a
serious public health risk and appointed a commission to prepare a five-year
plan to confront the potential spread of the disease. The seriousness and
international nature of the problem was highlighted by the fact that in
addition to the relevant health authorities the commission included the state
and defence departments. In a way, those afflicted with the superbug are
victims of India’s success. The rise of the country’s $12.4 billion
pharmaceutical industry, producer of nearly one-third of the world’s
antibiotics, has seen the proliferation of powerful generic drugs to every
corner of India. Until recently, local chemists in any small town would hand
strips of antibiotics, without a prescription, to customers complaining of
common ailments like diarrhoea, fever or cough. The indiscriminate use of such
magic drugs has provoked an inevitable response: these ‘bugs’ have
gradually developed a resistance to antibiotics. According to Yale University’s Manisha
Juthani-Mehta, a specialist in infectious diseases, between 70 to 90 per cent
of Indians have drug resistant variety residing harmlessly in their intestines.
The problem is that open-air defecation and poor public hygiene have allowed
the superbug to contaminate the river, waterways and even drinking water. If
such bacteria infects other organs or enters the blood stream it can be
lethal. There have been incidences in
India’s private hospitals where international patients after undergoing
routine bypass surgery have died of an infection from superbug. Global concern
led India to set up a taskforce in 2011 to address the issue of the superbug.
After initially blaming unnamed foreigners for plotting to damage India’s medical
tourism industry (which brought in $872 million in revenues in 2010) the
government has taken some long overdue measures. A decision earlier this year
requiring chemists to insist on a doctor’s prescription before selling common antibiotics should help in
reducing the overuse of antibiotics. However, the efficacy of the rule will
depend on its enforcement. The Modi government’s cleanliness campaign and
the drive to build toilets in the countryside, where millions relieve
themselves in the open, is a good start. Along with measures to provide
toilets, clean drinking water and build sanitation infrastructure, India needs
to launch mass education campaigns about public hygiene and preventive
healthcare. The country certainly needs more international visitors, but the
easy availability of tourist visas should not merely open the door to an
incredibly unwell India.
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