National Action Plan on AMR (NAP-AMR 2.0)

India launched the National Action Plan on AMR 2.0 (NAP-AMR 2.0). It is a five-year roadmap (2025-2029) aimed at containing one of the world’s most urgent public health threats. Read here to learn more.

On November 18, 2025, India took a decisive step in its long and complex battle against antimicrobial resistance (AMR).

The Union Health Minister formally launched the National Action Plan on Antimicrobial Resistance 2.0 (NAP-AMR 2.0), a strengthened, five-year roadmap (2025-2029) aimed at containing one of the world’s most urgent public health threats.

The timing of the launch, coinciding with the World Health Organisation’s World AMR Awareness Week (November 18-24), underscores India’s commitment to global collective action.

Anti-Microbial Resistance (AMR)

AMR happens when microorganisms, bacteria, fungi, viruses, or parasites evolve to withstand drugs designed to kill them.

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As a consequence, once-curable infections become difficult or impossible to treat. This silent pandemic threatens not only health systems but also economies, food security, and sustainable development.

The revised Action Plan builds on India’s earlier efforts, identifies gaps, and brings in a more forceful governance model, stronger sector coordination, and a practical One Health approach.

It represents a clear recognition: AMR is not just a medical issue- it is an ecological, agricultural, and developmental challenge.

National Action Plan on AMR 2.0 (NAP-AMR 2.0)

According to the latest WHO report, one in every six bacterial infections globally is now resistant to antibiotics, and India is among the major contributors to this trend.

High infectious disease burden, hospital overcrowding, antibiotic misuse in healthcare and livestock, and environmental contamination all combine to fuel AMR in the country.

India’s policy journey began with preliminary discussions in 2010, followed by the National Policy on AMR Containment (2011) and finally the first National Action Plan (2017–2021).

The earlier plan established a solid conceptual foundation, but real-world implementation remained hindered by:

• weak inter-ministerial coordination
• limited participation of the private healthcare and pharmaceutical sectors
• insufficient financing for surveillance and stewardship
• fragmented responsibilities across states

NAP-AMR 2.0 is India’s response to these lessons—designed not as a revision, but as a structural upgrade.

India as a Global Leader in AMR Governance

In the past decade, India has increasingly positioned itself as a global AMR champion. Several pioneering reforms illustrate this:

• Rational Antibiotic Use: Kerala and Gujarat became the first states to ban over-the-counter (OTC) antibiotic sales, a crucial measure in preventing misuse.
• Controls in Agriculture: Certain antimicrobials and pesticides have been banned in crop production to reduce environmental contamination and minimize pressure for resistance to evolve.
• India AMR Innovation Hub: This multi-stakeholder platform fosters research on novel diagnostics, therapeutics, and technologies. It has strengthened India’s innovation ecosystem by connecting ministries, academic institutions, biotech companies, and international partners.

NAP-AMR 2.0 builds upon these foundations, injecting renewed momentum and accountability.

What’s New in NAP-AMR 2.0?

The updated plan is anchored on six interconnected pillars, designed to collectively strengthen AMR governance, surveillance, stewardship, and public awareness.

1. Awareness, Education, and Training

AMR cannot be controlled without behavioral change. The new plan emphasizes:

• large-scale public awareness campaigns
• training programs for doctors, nurses, pharmacists, veterinarians, and farmers
• curriculum integration at medical, nursing, and agricultural institutes

Through targeted messaging, the plan aims to make rational antimicrobial use a societal norm, not a restricted policy directive.

2. Surveillance and Laboratory Capacity

Building a robust surveillance architecture is at the heart of NAP-AMR 2.0. The plan expands:

• AMR detection networks
• genomic surveillance
• sampling of antibiotic residues in the environment

A major new focus is systematic monitoring of wastewater from:

• hospitals
• livestock farms
• pharmaceutical facilities

This is a crucial recognition that environmental pathways accelerate the spread of resistance genes and require equal policy attention.

3. Infection Prevention and Control (IPC)

Better infection control reduces disease incidence—and therefore the need for antibiotics. The plan mandates:

• standardized IPC protocols in all healthcare facilities
• regular hospital audits
• improved sanitation, hygiene, and sterilization measures

This approach not only counters AMR but also improves patient safety overall.

4. Antimicrobial Stewardship (AMS)

Stewardship remains a core pillar but with expanded targets across human health, veterinary care, fisheries, and food production. Key measures include:

• guidelines for appropriate antimicrobial use
• prescription audits
• integration of veterinary stewardship in dairy and poultry sectors
• promoting alternatives to antibiotics in livestock rearing

By optimizing use while ensuring access, the plan strikes a balance essential for LMICs like India.

5. Research and Innovation

NAP-AMR 2.0 promotes innovation ranging from basic research to operational field studies. Priority areas include:

• rapid diagnostic tools
• novel antimicrobial compounds
• alternatives such as phage therapy and immunomodulators
• digital surveillance systems for real-time resistance tracking

India aims to position itself not just as an implementer but also as a global contributor of AMR solutions.

6. Governance and Coordination

Perhaps the most transformative change is the governance redesign. Unlike the earlier plan, where responsibilities were diffused, NAP-AMR 2.0 mandates:

• defined roles for each of the 20+ stakeholder ministries
• dedicated budgets
• timeline-linked action plans
• regular progress reviews

The shift from voluntary cooperation to enforceable accountability marks a major policy evolution.

One Health and NAP-AMR 2.0

A central philosophy underpinning NAP-AMR 2.0 is the One Health approach, recognizing that human health is inseparable from the health of animals and the environment.

Human Health

The Ministry of Health and Family Welfare, supported by NCDC and ICMR, leads AMR containment in clinical settings.

• ICMR’s AMR Surveillance Network, covering 30 laboratories and hospitals, continues to map resistance patterns in major pathogens.
• Efforts to incorporate genomic surveillance will help detect emergent resistance genes early.

Animal Health and Agriculture

Livestock and agricultural sectors are major contributors to antimicrobial use. The plan prioritizes:

• early diagnostic systems for livestock diseases
• reducing unnecessary antibiotic use in dairy and poultry
• biosecurity improvement in farms
• training farmers and para-veterinarians

The National Dairy Research Institute’s Point-of-Care diagnostic for mastitis in cattle is a model example of low-cost, high-impact innovation.

Environmental Surveillance

One of the strongest additions is the recognition of the environment as a reservoir of antimicrobial resistance. NAP-AMR 2.0 mandates comprehensive environmental monitoring and regulatory oversight, including:

• screening wastewater for antibiotic residues
• monitoring effluents from pharmaceutical manufacturing units
• Integration of environmental indicators into AMR risk assessments

This pushes AMR policy beyond hospitals and farms, into industrial compliance, wastewater management, and environmental protection.

Why NAP-AMR 2.0 Matters

AMR directly endangers medical advancements. Routine surgeries, childbirth, cancer chemotherapy, and organ transplants all depend on effective antibiotics. Without action, we risk a scenario where minor injuries can become fatal.

NAP-AMR 2.0 matters because:

• It corrects systemic weaknesses in the earlier plan.
• It establishes hard accountability mechanisms.
• It positions India at the forefront of global AMR governance.
• It operationalizes the One Health framework at the national level.

Most importantly, it acknowledges that AMR is not a future threat; it is already here.

Conclusion

With NAP-AMR 2.0, India signals its seriousness in preserving the efficacy of modern medicine. The plan is ambitious, evidence-based, and aligned with global AMR strategies developed by FAO, WHO, WOAH, and UNEP.

However, its success will depend on:

• sustained political will
• dedicated funding
• private sector engagement
• strong state-level implementation
• continuous monitoring and course correction

If executed well, NAP-AMR 2.0 has the potential to transform India’s health security landscape and contribute significantly to the global fight against drug-resistant infections.

In a world where superbugs respect no borders, India’s strengthened AMR strategy is not just a national responsibility; it is a global imperative.