The Indian Council of Medical Research (ICMR) is proposing a new priority pathogen testing framework to tackle antimicrobial resistance (AMR), according to a scientist familiar with the plan and documents reviewed by Mint.
AMR, which occurs when microbes such as bacteria and viruses, among others, develop resistance to antibiotics and other effective drugs. Due to the high number of related deaths, it is considered a major public health crisis in India.
The ICMR framework aims to standardize how hospitals and laboratories across India detect and diagnose infections and is being developed in extensive consultation with doctors, scientists and public health experts, according to the scientist.
The first step was to create a list of priority pathogens across four categories that require immediate attention.
“The priority pathogen lists were created during a series of 44 meetings, consulting with prominent clinicians, laboratory experts and epidemiologists from across the country,” said a government scientist, who spoke on condition of anonymity. “The working groups reviewed the literature and drew on individual experiences to develop lists of syndromes based on factors such as prevalence, outbreak potential and availability of diagnostics.”
The timeline and mechanism for implementing the plan across hospitals and laboratories are still under discussion, according to the scientist.
Inquiries sent to a spokesperson for the Ministry of Health remained unanswered as of press time.
Why is such a framework needed?
ICMR’s initiative seeks to fill long-standing diagnostic gaps and help doctors make faster, evidence-based diagnoses, curb irrational use of antibiotics and direct domestic manufacturers to cost-effective India-specific diagnostics.
“The initiative addresses the fragmented state of infectious disease diagnostics in India,” said the scientist quoted above, pointing out that laboratories’ testing algorithms are currently varied, specific to particular institutes or regions, and often focus on testing individual diseases sequentially.
“This inconsistency means that pathogen testing in clinical microbiology laboratories often varies based on the requirements and resources available at each institution,” the scientist added. “As a result, laboratories often miss common or critical pathogens.”
According to Dr. According to Harsh Mahajan, founder and chairman of Delhi-NCR-based Mahajan Imaging & Labs and also chairman of Ficci’s Health Services Committee, identifying the right pathogen at the right time can completely change the way an infection is treated. He added that when the diagnosis is quick and accurate, the treatment becomes much more effective and the patient’s recovery improves.
Dr. Lauding ICMR’s move, Mahajan said such a framework would help create uniform standards across the country and make reliable, evidence-based diagnostics a routine part of healthcare rather than something confined to a few centres.
“It will also lead diagnostic providers and clinicians to work within a common framework, improving treatment accuracy and public health surveillance,” he added. “Over time, such a framework can help India build a stronger foundation for antimicrobial stewardship and make targeted treatment accessible to all levels of care.”
What exactly is the plan
According to an ICMR document titled “Syndromic Surveillance of Infectious Diseases: Priority Pathogens to be Tested in Indian Clinical Settings,” the agency’s manual classifies priority pathogens into four categories to guide diagnostic and surveillance efforts in India. Priority 1A lists commonly detected pathogens that need to be diagnosed before starting treatment, such as plasmodium, dengue virus, salmonella typhi, etc.
Priority 1B covers other commonly detected pathogens such as bacterial sepsis. Priority 2 includes less common pathogens found in clinical settings, such as Borrelia burgdorferi. Finally, Priority 3 lists rare/exotic pathogens that are not typically detected in routine clinical settings and can only be found during specialized surveillance testing, such as bacillus anthracis or yersinia pestis (for AUFI).
Dr Manohar KN, Senior Consultant, Department of Internal Medicine and Infectious Diseases, SPARSH Hospital, Bengaluru, called the plan “timely and transformative”.
“India is at the epicenter of this global health crisis due to infectious diseases and overuse of antibiotics and it needs change,” he said. “The plan, which includes a standardized priority-based pathogen testing manual, addresses the current fragmented diagnostic practices.”
He emphasized the importance of introducing syndrome-focused testing protocols to enhance early detection and lead to rational use of antibiotics. This systemic shift from reactive to proactive treatment of infections will not only improve patient outcomes through faster and targeted treatment, but also reduce the use of broad-spectrum antibiotics, which are a major driver of resistance.
