Perhaps most of us have been guilty of it at one point or the other. We often gulp down unnecessary antibiotics even for fever, cold, cough and diarrhoea. Rather dangerously, these drugs can easily be purchased over the counter in one of the pharmacies and clinics mushrooming throughout the country. What’s more, many people also self-medicate with leftover medicines without any prescriptions from doctors. As a result, our bodies fall into the trap of antimicrobial resistance (AMR), which decreases the effectiveness of drugs used to treat specific ailments. No wonder AMR has now become a global burden. According to The Lancet, a medical magazine, AMR directly caused 1.27 million global deaths (6,400 in Nepal) in 2019 while indirectly contributing to around five million deaths (23,200 in Nepal).

In 2023, a Nepal Health Research Council study found that of all the medicines prescribed in the country, 37.8 percent were antibiotics. This exceeded the World Health Organization’s threshold of less than 27 percent antibiotics recommendations. Acknowledging their rampant misuse, the country’s drugs regulator, the Department of Drug Administration (DDA), has recently decided to prohibit the sale of six last-resort fourth and fifth generation antibiotics—Meropenem, Polymyxin B, Piperacillin+Tazobactam, Vancomycin, Colistin and Linezolid—other than through the hospitals. These antibiotics are listed in the government’s most essential medicines, and the ban adheres to the WHO’s global Antimicrobial Resistance Action Plan.

Even beyond antibiotics, Nepal’s history of failure to regulate and monitor the selling and distribution of drugs is concerning. Last year, Nepal’s drugs regulator was unaware of the availability of two entirely different drugs of the same brand name in the country. This points to poor oversight. Concomitantly, the department often recalls substandard drugs from the market only when most of the stock has sold out or is about to expire. By the time the recall notice is issued, most of the iffy drugs have already been sold out. In any case, these recalls are too few and far between. And the same faulty monitoring regimen will now supposedly oversee the new antibiotics regulation.

The World Bank warns that if governments around the world don’t take action against AMR immediately, 10 million people will die annually by 2050. Preventing such a crisis in Nepal requires close monitoring of indiscriminate use of antibiotics. As vital is spreading awareness, as many people in the country—in rural and urban areas—have no clue about how the frequent use of antibiotics leads to antimicrobial resistance. The government bodies must acknowledge that the problem has primarily surfaced due to their failure to hold the dispensaries that sell drugs without prescription accountable, as well as their lack of monitoring. Now that the DDA has finally geared up to ban the said antibiotics outside hospitals, it must ensure that the new drive does not become another symbolic gesture. For the government’s part, increasing the agency’s manpower and allowing it to conduct more and faster tests of medicines, therefore, should be a priority.

Addressing antimicrobial resistance is also the responsibility of individuals. We should all thus resist the temptation to pop pills without consulting doctors. Short-term health fixes can lead to dangerous long-term complications—or worse.