Guest article by Professor Nusrat Shafiq, CAMO-Net India Co-Lead
As we mark World Antimicrobial Resistance Awareness Week (WAAW) 2025 – guided by the global theme “Act Now: Protect Our Present, Secure Our Future” – we reflect on the growing momentum behind efforts to address antimicrobial resistance across national, regional, and local levels in India.
Since India’s National Action Plan on AMR (NAP-AMR) was first introduced in 2017, there has been steady progress in updating and operationalising it. Following Kerala’s pioneering work on a State Action Plan for AMR, several other states have also designed and implemented their own strategies. Alongside government-led initiatives, scientific societies, healthcare organisations, and not-for-profit groups have created pragmatic frameworks, developed context-specific tools, and shared learning across sectors. National microbial surveillance efforts – including those driven by the Indian Council of Medical Research (ICMR) – have also expanded to include data on antibiotic use and antimicrobial stewardship research.
At PGIMER, our antimicrobial stewardship activities began formally in 2015. Since then, the institute has been actively contributing across multiple levels – raising awareness, strengthening knowledge, conducting audits and feedback, shaping policy, advocating for change, contributing to national and regional initiatives, generating research, and mentoring other groups starting their stewardship journeys. A few highlights since joining CAMO-Net are summarised below.
CAMO-Net India: From Awareness to Action
Hosted at PGIMER Chandigarh and supported by Wellcome, CAMO-Net India is part of a global alliance dedicated to addressing AMR through science, systems thinking, and stewardship. In line with this year’s theme – Act Now – the India Hub is delivering practical interventions across five key pillars:
1. Addressing access to antibiotics and mitigating shortages
After analysing antibiotic access challenges across varied geographical settings, we are now working collaboratively to explore how the “pharmacy of the world” can better respond to supply-related vulnerabilities. Multiple partners are contributing towards developing a framework to support more reliable access.
2. Better use of existing antimicrobials
Our population pharmacokinetic (Pop-PK) and pharmacodynamic (PD) studies are shaping more precise dosing strategies for groups often underrepresented in research – including the critically ill, neonates, and patients with renal dysfunction, particularly when infections involve resistant pathogens. Knowledge-sharing remains central to our approach: through webinars, off-site placements, collaborative work, and training activities. We now look forward to our upcoming workshop on 5 December during the next India meeting.
3. Building capacity and engagement
Through our institutional Antimicrobial Stewardship Programme (AMSP), we continue to empower clinicians, pharmacists, nurses, and researchers to become champions of responsible antibiotic use. Recent initiatives include a workshop for Medical Officers working across primary health centres in Punjab, supported by an ICMR-funded project, and a dedicated workshop for nurses which has inspired further similar programmes.
Recognising the need for flexible, contextually relevant training for LMICs, we launched Surgeons for Rational Use of Antimicrobials – a self-paced online module delivered by a multidisciplinary faculty with strong engagement from surgical specialties. Its case- and scenario-based approach helps translate scientific knowledge into practical decision-making.
It is also encouraging to note that the annual experience-sharing session on antimicrobial stewardship by healthcare institutes at the SASPI Conference continues to grow year on year.
4. Connecting science, policy, and systems
Our research-to-policy efforts include contributing to the strengthening of State Action Plans for AMR (SAP-AMR) in two North Indian states. The Principal Investigator and team serve as core members of State Committees, providing technical and scientific support to contextualise the NAP-AMR into implementable, state-specific frameworks.
5. Capacity strengthening across the CAMO-Net alliance
We continue to work closely with national and international partners to co-develop projects and expand capacity. Two of our researchers recently attended a one-week intensive AMS implementation course with the University of Cape Town team. Meanwhile, our Knowledge Manager is on a short-term fellowship at Imperial College London. We also look forward to hosting a training session on precision dosing this December at PGIMER.
Beyond these structured exchanges, everyday learning and collaboration continue informally across the network – a hallmark of CAMO-Net’s ethos.
As WAAW 2025 reminds us, acting now is essential to protect the effectiveness of antimicrobials for future generations. PGIMER and CAMO-Net India remain committed to advancing stewardship, strengthening evidence, and working collaboratively to support meaningful, sustainable change.
