Opinion Time to revisit lessons from drive against TB, polio, HIV
Citizen ownership represents deep public engagement where AMR is viewed not as a distant scientific issue but as a shared social challenge.
India’s own public-health successes underscore the power of citizen participation. The polio eradication campaign, community-led HIV advocacy, tuberculosis survivor networks, and women’s collectives like Kudumbashree demonstrate that widespread behaviour change and treatment adherence improve when communities lead. 
Antibiotics are life-saving medicines, but their power is diminishing due to widespread overuse and misuse. When antibiotics are taken unnecessarily or stopped prematurely, bacteria develop resistance, making common infections harder and more expensive to treat. This threatens routine medical procedures and imposes a substantial socio-economic burden, especially on low- and middle-income countries like India.
The recent World Antimicrobial Awareness Week marked the launch of India’s National Action Plan (NAP) 2.0, reaffirming the government’s commitment to tackling antimicrobial resistance (AMR), one of the most serious public health threats of the 21st century. Since the first NAP in 2017, India has strengthened AMR surveillance networks, introduced regulations to discourage misuse of antibiotics, banned certain antimicrobials as growth promoters in poultry, improved access to diagnostics through the National Essential Diagnostics List, and enhanced infection control through initiatives like Kayakalp. Standards for antimicrobial use in the food sector have also been introduced. However, significant gaps remain, and successful implementation of NAP 2.0 over the next five years will be critical. Notably, in countries where NAPs succeeded, progress was closely monitored, and a key factor was strong community participation and ownership.
Citizen ownership represents deep public engagement where AMR is viewed not as a distant scientific issue but as a shared social challenge. When people perceive AMR containment as a personal responsibility, they are more likely to adopt prudent behaviour: Seeking medical advice before taking antibiotics, completing prescribed courses, and avoiding leftover non-prescribed drugs. Reducing infection is a crucial, often under-emphasised, pillar of AMR containment. Fewer infections mean lower antibiotic consumption and reduced selection pressure for resistance. Citizen-led initiatives can significantly influence hygiene, sanitation, vaccination, and waste management. Community actions — such as promoting handwashing in schools, safe food handling, and maintaining clean water sources — have reduced infectious diseases.
Citizen ownership can also complement weak enforcement systems, particularly in India, where over-the-counter access to antibiotics remains common. Informed citizens are more likely to question inappropriate prescriptions and resist easy access to antibiotics from unlicensed sellers. Global evidence points to this: Thailand’s community-driven antibiotic awareness initiatives have reduced unnecessary antibiotic purchases; in the UK, social-marketing campaigns have lowered demand for antibiotics for viral illnesses. For India, similar strategies involving local influencers, self-help groups, and youth networks must be tailored.
India’s own public-health successes underscore the power of citizen participation. The polio eradication campaign, community-led HIV advocacy, tuberculosis survivor networks, and women’s collectives like Kudumbashree demonstrate that widespread behaviour change and treatment adherence improve when communities lead. Embedding citizen ownership within AMR strategies is therefore not only justified but essential for bridging the gap between policy intent and real-world behaviour — and for securing a healthier future.
The writer is senior scientist and programme officer, AMR, Indian Council of Medical Research
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