Indian authorities say it is unfair to associate the superbug that has surfaced in Great Britain to India, because a significant number of bacteria carrying the NDM-1 gene (DNA code) have been reported in several different countries, including Brazil, the USA, Canada, Puerto Rico, and Australia.

The accusation is politically motivated, triggered by concern at the number of people in industrialized nations, such as the UK, who are going abroad for medical treatment. Put simply, there is suspicion in India that Western doctors do not want to let business slip out of their hands – hence the motive behind the report (see below).

A report published in a British medical journal, The Lancet, says that a new superbug, resistant to virtually all types of antibiotics, has been detected in at least 50 cases in the UK – most of these patients had gone to India and Pakistan for non-elective surgery, such as cosmetic surgery. (Extremely Resistant Superbug Is Spreading Internationally).

NDM-1 stands for New Delhi metallo-beta-lactamase-1. “New Delhi” is in the term because that is where the first strand of the bacteria was reported (the Indian capital) – it does not mean there is an epidemic which originates from India.

Indian health authorities and medical experts say The Lancet’s scientific study has been reported incorrectly by the media.

The Indian Ministry of Health stress that there is no public health threat in the country.

Medical tourism – patients going abroad for treatment – is a growing industry, especially in India. An increasing number of British people are opting to have their treatment in India because it is cheaper. The Hindustani Times, an Indian newspaper, asked VM Katoch, director general, Indian Council of Medical Research (ICMR) whether this news might undermine medical tourism in India, he answered:

Of course, it will dent the image of the sector. But by providing proper knowledge and information we can tell the world that it’s a natural phenomenon and nothing to get scared about.

The Indian Government describes the report in The Lancet as “totally irrational”. In the Indian Government’s website, VM Katoch, Director General Indian Council for Medical Research, says:

When you link it to our antibiotics policy, say it is India specific, say it is dangerous to get operated in India then you will get more infections, that is totally irrational.

The Indian Government writes on its web site:

The Director General of Health Services R K Srivastava along with Katoch strongly refuted the naming of the enzyme as New Delhi metallo beta lactamase and also refuted that hospitals in India are not safe for treatment including medical tourism.

The Indian Ministry of Health says the conclusions of The Lancet articles are:

..loaded with inference that these resistance genes or organisms possibly originated in India and it may not be safe for the patients in the United Kingdom to opt for surgery in India.

The Ministry adds that the “frightening picture” presented by the article is not supported by scientific data.

Some parliamentarians in the Raiva Sabha (India’s Upper House) suspect that the hands of multi-national pharmaceutical companies and hospital chains are behind the scientists’ claims, the Indian Government web site writes. It added that the study was funded by The European Union “and two pharmaceutical companies, namely Wellcome Trust and Wyeth, who produce antibiotics for treatment of such cases.”

Medical tourism in India is expected to be worth $2.3 billion by 2012, according to an estimate.

Prof KN Prasad, a microbiologist at the Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, said:

So why should medical experts in Britain or other Western countries single out India?”

Already 40 types of bugs similar to NDM-1 are existing globally, that also includes the German Imipenem Resistant Metallurgical Strain. The Indian variant is just the 41st strain. These things happen.

Prasad added that antibiotics are easily available in India OTC (over-the-counter, no prescription required), leading to their indiscriminate consumption, and eventually making them less effective against bacteria. A single antibiotic in India is manufactured by 10 different companies, resulting in a problem with quality consistency. Bacteria are bound to evolve and eventually develop newer modes of resistance.

Further reading: What is NDM-1?

Sources: Hindustani Times, The Lancet, India.gov.in

Written by Christian Nordqvist