Spotlight 19/03/18 | AMR multi-disciplinary course, in Kolkata, India

Welcome back after our short break due to the UK University lecturer union (UCU) strike action.

Last month I ran a six-day multi-disciplinary course on Antimicrobial Resistance at The Institute of Post-Graduate Medical Education and Research in Kolkata, India. This course was jointly organised by Prof Abhijit Chowdhury from the Institute of Public Health, Kalyani and Prof Simon Croft (LSHTM). We recruited both Indian and LSHTM scientists and discussed topics ranging from the biology of AMR to the social aspects.

The course involved five days in the lecture theatre listening to lectures, trying out their microbiology skills in the lab (laughing at my disk diffusion assays) and fighting with the bioinformatics. On the sixth day we did not relax but Dr. Meenakshi Gautham (LSHTM) had organised an excellent range of site visits from informal health providers to regional hospital. I volunteered to go and do some social science on a backyard chicken farm. This was a first for me and truly a learning experience, shattering all my preconceptions. Here was a farmer caring for his chicks in a very pleasant environment, using WASH and vaccinations rather than antibiotics to keep his flock in health. However the chick food came in a bag written in English that did not list the ingredients and the interview revealed that the farmer believes there are ‘chemicals’ in the feed that help with growth and health. Whether these are antibiotics or not remains a mystery, even after some quick Google searches. I was, however, able to go and buy some Azithromycin, without a prescription, for a bargain 86p for 3 tablets (thankfully I didn’t need them!). Maybe it was because I was obviously not a local but demonstrating how easy antibiotics are to get. On reflection I wished I had asked for something more challenging, a cephalosporin perhaps.

I wanted to say a big thank you for all the enthusiasm of the Indian scientist who gave up their time to come and provided their expertise. It was really good to meet so many enthusiastic scientists working on all aspects of AMR. What really stood out were the course participants. These came from a range of backgrounds from clinical microbiologists, clinicians to veterinary students all of which brought their own experiences and really engaged with both lecturers and each other. After a talk on the WHO GAP (Global Action Plan) by Dr Anuj Sharma and how for countries like India a NAP (National Action Plan) will not get off the ground without action plans at the State level (SAP?!) one of the clinicians said he was pretty much unaware of these Action Plans and that it was not making any impact on him yet, bring home how far these plans have to go to really make an impact. Additionally I could not have done this without the help and enthusiasm of Simon Croft, Sam Willcocks (LSHTM and the AMR Centre) and Simanti Datta (IPGMER).

At the final review session it was good to hear that the majority feedback that their attitude to AMR had been challenged and changed and I hope that they are able to take this forward and spread the word. One of the lecturers even said that perhaps he should run a similar course back in his institution. Small steps but hopefully in the right direction.

Finally I want to thank the British Council for the original grant that allowed this course to run and be free of charge to the participants. And finally for the Big Ben pub for the much needed cold Kingfishers and bar snacks.

By Richard Stabler, AMR Centre Co-Director.