Evaluate India's One Health architecture, including NOHM and NAP-AMR, in addressing emerging and interlinked health threats. What federal bottlenecks persist?

One Health is the idea that human, animal and environmental health are linked. India has turned it into two main structures: the National Action Plan on AMR (2017) [3] and the National One Health Mission (NOHM) [1]. Together they have built real capacity. Their reach is still limited by weak data on animals and by uneven action in the states.

Strengths

• Multi-sector design: NAP-AMR was launched in April 2017 with a One Health approach. It was backed by the inter-ministerial Delhi Declaration [3].
• Institutions and labs: NOHM is setting up the National Institute for One Health, Nagpur. It has also built a network of 23 BSL-3/BSL-4 labs [1].
• Shared surveillance: Wastewater surveillance under NOHM tracks AMR [1]. A single sample picks up waste from people, farms and factories together.
• Course correction: NAP-AMR 2.0 (2025–29) targets the gaps of the first plan. It aims for clearer ownership, better coordination across sectors and more private-sector involvement [2].

Weaknesses

• Mostly focused on humans: The 2017 plan itself says AMR in livestock is "poorly documented". It also notes there are few rules on giving antibiotics to animals that are not sick [4].
• Limited data on antibiotic use: Data on how much antibiotic is used, for example in poultry, is limited [4]. Without it, the plan cannot link use to the spread of resistance.
• High stakes: India could face about 2 million AMR deaths a year by 2050 [5].

Federal bottlenecks

• State subjects: Health, animal husbandry, agriculture and water are all state subjects [5]. National plans therefore depend on what states do.
• Few state plans: Only Kerala, Madhya Pradesh and Delhi had formally launched a State Action Plan on AMR (SAPCAR) by 2022 [5]. In most states, nobody is formally responsible for the farm side of AMR.
• Budgets: The UNGA Declaration on AMR (2024) wants at least 60% of countries to have funded national plans by 2030. It also calls for less antimicrobial use in food and farming [6]. Plans that state governments have not funded would fall short of this test.

India's One Health system has the right design but does not yet reach evenly across sectors and states. NAP-AMR 2.0 needs a budget line for each action and a system to record antibiotic use on farms. States need SAPCARs with clear targets. These steps would help India meet the UN's 2030 goal of a 10% cut in AMR deaths [6] and move it towards SDG 3. They would also show cooperative federalism in practice.