A comparative analysis of how the media in the United Kingdom and India represented the emergence of NDM-1

Vanessa Saliba, Peter Washer, Philippa Pett, Manish Kakkar, Syed Abbas, Bhavna Raghuvanshi, Martin McKee*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


Research papers on New Delhi metallo-β-lactamase (NDM-1) provoked considerable but very different media coverage in the United Kingdom (UK) and India. We describe how the media represented this research using qualitative thematic analysis of contemporary coverage by daily newspapers in the UK and India. Fifty-four UK and 187 Indian articles mentioned NDM-1, describing it as the 'new super superbug' resistant to most antibiotics. They emphasised the role of medical tourism to the Indian subcontinent. In both countries, blame was framed abstractly as arising from the general misuse of antibiotics. In India, controversy about using New Delhi to name the organism dominated coverage, with officials seeking to discredit the two studies and media coverage characterised by denial and outrage, developing into theories of conspiracies to undermine tourism. Researchers must seek to anticipate the way that their work may be reported and proactively engage with the media to maximise the public health impact of their findings.

Original languageEnglish
Pages (from-to)1-19
Number of pages19
JournalJournal of Public Health Policy
Issue number1
Publication statusPublished - 1 Feb 2016

Bibliographical note

Funding Information:
English Health Protection Agency (HPA) issued a National Resistance Alert to raise awareness of the emergence of carbapenem resistance and to urge referral of possible isolates to the HPA19 HPA issued an addendum to the National Resistance Alert specifically highlighting NDM-1 and the link to the Indian subcontinent20 NDM-1 described for the first time in a paper published in Antimicrobial Agents.21 A Swedish patient of Indian origin travelled to New Delhi, India, in 2008 and acquired a urinary tract infection caused by a carbapenem-resistant Klebsiella pneumoniae strain carrying the blaNDM-1 gene. In addition blaNDM-1 was also found on a plasmid in an Escherichia coli strain isolated from the patient’s faeces, inferring the possibility of in vivo conjugation. The broad resistance carried on these plasmids was described as a worrying development for India Indian scientists published a paper in the Journal of the Association of Physicians of India on production of NDM-1 enzyme in Enterobacteriaceae at a tertiary care centre in Mumbai18 ● Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: A molecular, biological, and epidemiological study6 was fast tracked to online publication in TLID. This study investigated the prevalence of NDM-1, in multidrug-resistant Enterobacteriaceae isolates from India, Pakistan, and the UK ● The Government of India responded by forming a 13-member National Task Force to assess, review, and suggest measures on antimicrobial resistance. The Task Force built upon the recommendations of a 2003 committee22 but with greater emphasis on regulation and enforcement. A report was produced by the end of 2010 although not published until April23,24 The HPA in conjunction with the Advisory Committee on Antimicrobial Resistance and Healthcare-Associated Infections issued new guidance entitled ‘Advice on Carbapenemase Producers: Recognition, infection control and treatment’25 ● Dissemination of NDM-1 positive bacteria in the New Delhi environment and its implications for human health: An environmental point prevalence study was published online in TLID on World Health Day. This study attempted to measure the prevalence of the NDM-1 gene in drinking water and seepage samples in New Delhi ● World Health Day, held on 7 April, was dedicated to the theme of antimicrobial resistance, No Action today, no cure tomorrow. WHO Director-General Dr Margaret Chan, said: the world is heading towards a post-antibiotic era, in which many common infections will no longer have a cure and, once again, kill unabated. A call for action was issued for all countries to combat antimicrobial resistance through the introduction of a 6-point policy package ● Indian Government published their National Policy for Containment of Antimicrobial Resistance

Funding Information:
Syed Shahid Abbas is a Senior Research Associate with Public Health Foundation of India and a PhD candidate at the Institute of Development studies.

Publisher Copyright:
© 2016 Macmillan Publishers Ltd.

Copyright 2016 Elsevier B.V., All rights reserved.


  • antimicrobial resistance
  • framing
  • India
  • media coverage


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