12 February 2026 Punjab Khabarnama Bureau : Antimicrobial resistance (AMR) is one of the gravest public health challenges of the 21st century, and its rapid rise offers a stark reminder of a principle articulated more than 160 years ago by Charles Darwin: organisms evolve to survive. Bacteria, exposed repeatedly and often unnecessarily to antibiotics, adapt quickly, becoming resistant and harder to kill. While Darwin’s theory of natural selection has proven timeless, India’s drug policy response to antimicrobial resistance has not kept pace with the scale or urgency of the problem.
India bears one of the highest burdens of infectious diseases globally and is also among the largest consumers of antibiotics. This combination makes the country particularly vulnerable to AMR. Yet, despite repeated warnings from scientists, doctors, and global health agencies, antibiotic misuse remains widespread, driven by weak regulation, easy over-the-counter availability, and gaps in public awareness.
At the heart of the AMR crisis is the misuse and overuse of antibiotics. In many parts of India, antibiotics are routinely prescribed for viral infections, against which they are entirely ineffective. Self-medication is common, with patients often buying powerful drugs without prescriptions. Incomplete treatment courses, incorrect dosages, and the use of last-resort antibiotics for minor ailments further accelerate resistance.
Darwin’s theory explains exactly what happens next. Bacteria exposed to antibiotics do not all die; those with natural resistance survive and multiply. Over time, these resistant strains become dominant, rendering standard treatments ineffective. This process is not theoretical — it is unfolding daily in hospitals and communities across India.
India’s drug policy has attempted to respond, but implementation has been inconsistent. Regulations exist on paper to restrict the sale of certain antibiotics without prescriptions, yet enforcement remains weak. Pharmacies often dispense antibiotics freely, particularly in rural and semi-urban areas where access to qualified doctors is limited. Economic incentives, lack of oversight, and consumer demand all contribute to regulatory failure.
Another major contributor to AMR is the use of antibiotics in agriculture and animal husbandry. Antibiotics are widely used to promote growth and prevent disease in livestock, often without veterinary supervision. These drugs enter the food chain and environment, exposing bacteria to low doses that encourage resistance. India’s policy framework has struggled to regulate this sector effectively, despite clear evidence linking agricultural antibiotic use to resistant infections in humans.
Hospitals, too, play a role. Overcrowding, poor infection control practices, and the lack of robust antimicrobial stewardship programmes mean that resistant bacteria spread rapidly in healthcare settings. While some large hospitals have adopted stewardship protocols, many smaller facilities lack the resources or training to implement them.
India has released national action plans to combat antimicrobial resistance, aligning with global strategies. These plans emphasize surveillance, rational drug use, public awareness, and research. However, critics argue that progress has been slow and uneven. Surveillance systems remain fragmented, data collection is limited, and coordination between states is inconsistent.
Public awareness is another weak link. Many people still view antibiotics as a cure-all solution, unaware of the long-term consequences of misuse. Without sustained education campaigns, behavioural change remains difficult. Doctors, under pressure from patients and time constraints, may also overprescribe antibiotics as a precautionary measure.
The consequences of inaction are severe. Antimicrobial resistance threatens to push modern medicine backwards, making routine surgeries, childbirth, and cancer treatments far riskier. Infections that were once easily treatable could become deadly again. Economically, AMR increases healthcare costs through longer hospital stays, more expensive drugs, and lost productivity.
Experts argue that India needs a stronger, more enforceable drug policy rooted in science and accountability. This includes strict regulation of antibiotic sales, better monitoring of prescriptions, and penalties for violations. Investment in diagnostic tools is also crucial, allowing doctors to distinguish between bacterial and viral infections before prescribing antibiotics.
Equally important is strengthening the healthcare system itself. Improving sanitation, vaccination coverage, and infection prevention can reduce the need for antibiotics in the first place. Research and development of new antibiotics and alternative therapies must also be encouraged, though innovation alone cannot solve a problem driven by misuse.
Darwin’s theory teaches that adaptation is inevitable. Bacteria will continue to evolve as long as selective pressure exists. The real question is whether human policy can adapt just as effectively. India’s current drug policy, while well-intentioned, has not yet matched the speed or scale of bacterial evolution.
Antimicrobial resistance is not just a medical issue; it is a governance challenge. Without decisive action, India risks becoming a hotspot for untreatable infections, with global consequences. Darwin may have been right about survival of the fittest, but public policy must ensure that human health does not become the casualty of our own inaction.
Summary
Antimicrobial resistance reflects Darwin’s theory of evolution in action, but weak enforcement and misuse of antibiotics expose serious flaws in India’s drug policy, threatening public health and future medical treatments.