I have travelled extensively over the past three decades and never once fallen sick outside India — until my visit to Brazil last month for COP30. A simple viral infection ended up becoming a mirror, revealing how differently India and Brazil approach antibiotic use, and why this difference matters.
In India, like most people, I rely on a familiar ecosystem of doctors, chemists and well-meaning advisors. Over time, one becomes comfortable with this formal-informal health care network. For routine illnesses like coughs and colds, I consult them, weigh their advice, and take (or avoid) medication accordingly. The advice, however, is predictable. Every time I have had a viral infection, the prescription has included an anti-allergic and an antibiotic — even when the doctor clearly diagnosed it as viral.
The justification was always the same: “Take antibiotics to prevent a secondary bacterial infection.” It never mattered that antibiotics do not treat viruses. Prevention became a catch-all excuse. A couple of years ago, this approach backfired. After one course of antibiotics, I developed a lingering cough that lasted months. Since then, I have been cautious with antibiotics.
The prescription On my fourth day in Brazil, I fell ill. You never truly know where viral infections come from — long flights, crowded airports, air-conditioned taxis, or poorly ventilated conference halls. I followed my usual routine: steam inhalation, saline gargles, warm fluids and paracetamol. But by Day Six, the fever and congestion worsened, so I consulted my doctor in India.
As expected, he prescribed paracetamol, an anti-allergic, a broad-spectrum antibiotic, throat soothers, vitamins and a cough suppressant. Armed with the prescription, I went to a chemist — and what followed was eye-opening.
First, the chemist refused to accept my Indian prescription. Brazilian law requires a prescription from a local doctor. Second, he separated what he could sell without a prescription — lozenges, vitamins, paracetamol — from what he could not: antibiotics. Third, he directed me to a 24×7 government urgent-care centre and advised me to consult a Brazilian doctor. Reluctantly, I went.
The centre was spotless, efficient and welcoming. Though I spoke only English and the staff only Portuguese, a translation app bridged the gap. They took basic details and a copy of my passport. There was no consultation fee.
The doctor examined me thoroughly. I showed him the Indian prescription. He glanced at it politely and set it aside.
“You have a viral infection,” he said. “It will resolve on its own in 10-12 days.”
His prescription was astonishingly simple: paracetamol in case of high fever, a throat lozenge, and a saline nasal rinse. No antibiotics. No anti-allergic.
When I mentioned that my sputum had turned yellowish-green — something many Indian doctors treat as a sign of bacterial infection — he smiled gently. “That is a myth. Viral infections can also produce coloured sputum,” he said. In effect, he refuted much of what I had been told about cough and cold management in India.
I returned to India still mildly symptomatic. Out of curiosity, I got a sputum culture done. After three days of incubation, the report showed moderate growth of a bacteria. My Indian doctor immediately advised me to start antibiotics. The Brazilian doctor, however, responded: “This does not require antibiotics. Minor bacterial growth often resolves naturally.”
This time, I chose to trust him. Thirteen days after falling sick, I have recovered — without taking a single antibiotic or anti-allergic.
A systemic failure I share this not to criticize Indian doctors, but to highlight a systemic failure. Across the world, antibiotics are viewed as curative medicines — to be used only when truly necessary. In India, they are used preventively, routinely prescribed for viral infections that the human body is fully capable of handling.
This misuse and overuse are key reasons India is now the epicentre of the global antimicrobial resistance (AMR) crisis. The numbers are alarming:
λ An estimated 300,000 deaths in India are directly attributable to AMR.
λ Indian Council of Medical Research surveillance shows widespread resistance to commonly used antibiotics like ciprofloxacin, amoxicillin and azithromycin.
λ Many Indian hospitals report 40-70 percent resistance rates among bacteria causing pneumonia, bloodstream infections and urinary tract infections.
And this is not solely due to human misuse. India is also indiscriminately pumping antibiotics into its food chain. In poultry and livestock production, antibiotics are used not just to treat illness but as growth promoters to fatten animals quickly. These drug-resistant bacteria travel from farms to food to humans.
The result? As my own test result suggested, most Indians are walking reservoirs of resistant bacteria. When we eventually contract a serious infection — one that truly requires antibiotics — we may find our options limited or ineffective.
Implementation paralysis The tragedy is that we already know what to do. In 2016-17, the Government of India convened a committee to develop the National Action Plan on Antimicrobial Resistance (NAP-AMR). I was a member of that committee. We created a multi-sectoral plan for 2017-2021, spanning human health, agriculture and environmental waste. A revised plan for 2025-29 was released in November 2025.
Yet, the first plan largely remained on paper. Implementation was hampered by weak regulation, inadequate surveillance and a health care culture that favours quick fixes over medical discipline.
The real difference between India and countries like Brazil is not medical expertise but strict enforcement of a policy. It is the refusal to prescribe and sell antibiotics unless absolutely necessary. My Brazilian doctor summed it up best: “Use antibiotics when they are needed, not when you are worried.” We need this culture of medical discipline and strict enforcement to solve the AMR crisis.
