The Chennai Declaration: a solution to the antimicrobial resistance problem in the Indian subcontinent.

TO THE EDITOR—Hospitals in the Indian subcontinent have reported very high antimicrobial resistance rates. India, being the most populated country in the region, can play a significant role in tackling antimicrobial resistance initiatives. The Indian medical community has always been responsive to emergent public health problems. Unfortunately, antimicrobial resistance has not been considered a priority for discussion or action, for many reasons. These include a lack of awareness of the enormous adverse clinical and economic impacts of these infections; the relative lack of engagement by prescribing clinicians with Indian microbiologists, who mostly confine themselves to the laboratory; the absence of clinical pharmacists who support good-quality prescribing; and the desire for clinicians to only be concerned with good clinical outcomes for individual patients, regardless of their commitment to the broader public good. However, there may be some light at the end of this rather challenging tunnel. Recent extensive coverage of antibiotic resistance in the mass media and medical journals has made clinicians very concerned about the potential negative outcomes for their patients, leading to a significant positive change in their attitude towards infection control practices. Hospital managements also started recognizing the importance of having an infection control team and are more cooperative in listening to the recommendations of their infection control nurses and doctors. When it comes to prescribing antibiotics prudently, however, there appears to be much less progress. “A Roadmap to Tackle the Challenge of Antimicrobial Resistance: A Joint Meeting of Medical Societies in India” was organized as a preconference symposium of the Second Annual Conference of the Clinical Infectious Disease Society (CIDSCON 2012) in Chennai, India, on 24 August 2012. This was the first-ever meeting of medical societies in India on the issue of tackling resistance, with a plan to formulate a roadmap to tackle the global challenge of antimicrobial resistance from the Indian perspective. Representatives of most medical societies in India, the World Health Organization, the National Accreditation Board of Hospitals, the Medical Council of India, the Drug Controller General of India, and the Indian Council of Medical Research, along with wellknown dignitaries in the Indian medical field attended the meeting. The Chennai Declaration [1], a consensus document that evolved from the meeting, is designed to provide practical and implementable recommendations, suitable to tackle the Indian perspective of the resistance problem. The declaration is based on the theme of “an implementable antibiotic policy” and not “a perfect policy,” with recommendations on regulation of the sale of over-thecounter antibiotics without prescription, rationalizing higher-end antibiotic usage in hospitals, establishing hospital infection control committees, and upgradation of microbiology laboratory facilities in the country. The document has clearly laid out roles and responsibilities of all stakeholders, including the Ministry of Health, medical societies, media, journals, and the insurance industry. The Chennai Declaration can be a solution to India’s antimicrobial resistance problem and also can be an inspiration to policy makers in the neighboring countries of the subcontinent. Notes