Human beings have suffered from diseases from the beginning of history, while their causes remained unknown. The establishment of the germ theory brought a great revolution in the prevention of infectious diseases. After germs were identified as the cause, attempts to isolate them became successful; and different preparations were applied to kill these microorganisms. So far, many germs have been identified, and mankind has also been building armamentaria—medicines, equipment, and techniques—to fight these illnesses and germs. The preparations used against microbes and biological organisms are commonly called antibiotics or antimicrobials.

Their discovery was one of the great milestones in the fight against outbreaks and epidemics of infectious diseases. But we are not the only living organisms fighting for survival. These microorganisms are also going through numerous processes of genetic mutation and evolution to survive, which can be perfectly related to the re-emergence of diseases like malaria and tuberculosis that were thought to be have been on the path to being eliminated.

A study conducted at Harvard Medical School showed that it takes only 11 days for microorganisms to develop resistance to a drug a thousand times stronger when it evolves through exposure to similar medicines at lower doses. Antimicrobial resistance can be understood as the ability of a microorganism to stop an antibiotic from working against it.

Although Nepal has been one of the forerunners on the Indian subcontinent in recognising the dangers of antimicrobial resistance, it has had a bumpy journey in putting together a comprehensive response to address it. Growing interest in earning money and opportunities to make immense profits in health and education in a country like ours with poor political commitment towards health may have given rise to an increasing number of polyclinics and education centres. Unethical and irrational use of drugs, with commercial interests in mind, has become a common practice in developing countries like Nepal.

To avoid long waiting lists, overcrowding and unsatisfactory care in large hospitals, patients are flocking to small clinics and pharmacies. The little knowledge of health and disease control and preventive measures the business operator obtains through a short course needed to validate their pharmaceutical business is posing a danger towards increasing antimicrobial resistance.

In today’s scenario, the pharmaceutical sector is currently one of the most profitable. Any individual may fall sick at any time, and there is always a demand for healthcare. Pharmaceutical companies are always looking to increase sales, hence selling antibiotics in an irrational and unethical way for the sake of money has become common. Antibiotics have become so readily available that they can be bought everywhere without any prescription. It is not only the producer and seller whom we should blame, but also the consumers who come up with self-medication techniques by looking up dubious sources on the internet or through previous experiences of antibiotic use.

Developed countries have already acknowledged the issue of antibiotic resistance, and are working to combat it in various ways. Raising a problem without a solution is only criticism. Potential solutions could be: Providing health education about rational and proper use of antibiotics and the hazards of unnecessary use; providing motivation to go for checkups and consultation before using antibiotics; passing legislation against sales of drugs without a prescription, along with providing limited, broad-spectrum antibiotics in unreachable cases; stratifying the use of potent drugs as per the level of health workers; and minimising the irrational prescription of antibiotics for veterinary purposes.

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