By Sascha Marschang, Director of Operations and Membership
‘Nightmare’ pathogens, able to resist every type of antibiotic on today’s market, are no longer a hypothetical threat. Drug-resistant strains of deadly bacteria are on the rise across the globe. If left unchecked, they have the potential to unravel a century’s worth of medical advancement. Excessive prescribing in the healthcare sector, as well as overuse of antibiotics in agriculture, are known to accelerate the development of resistance. However, these are not the only causes of the growing problem of antimicrobial resistance (AMR).
Ironically, the very production of life-saving anti-infective drugs is yielding a lethal by-product: multidrug resistant bacteria. Pollution from pharmaceutical manufacturing sites releases antimicrobial drug residues into rivers, lakes, and groundwater putting ‘selective pressure’ on bacteria present in the water to develop resistance to antibiotics.
While pharmaceutical companies are often headquartered in Europe or the United States, the vast majority of their drugs are manufactured in third countries, such as China and India, where factory environmental regulations are lenient or poorly enforced. While this industry rakes in billions of dollars each year, irresponsible practices in the supply chain come at a heavy cost for the environment as well as for the health of crops, livestock, and humans alike.
In 2016, researchers from Ecostorm, commissioned by the Changing Markets Foundation, travelled to India to assess the situation and determine the extent to which pharmaceutical pollution is impacting communities on the ground. Water was tested at several sites in Hyderabad, New Delhi, Viskhapatnam, and Chennai. Over half of the samples contained antibiotic-resistant bacteria, some of which were resistant to at least three major groups of antibiotics. Locals from the surrounding areas are feeling the effects of the hazards that they are being exposed to as a result of this pollution, which also contains toxic chemicals and heavy metals. Individuals report a noticeably heightened incidence of cancer, miscarriage, and infant mortality. Herds of cattle are falling ill from the contaminated water, and those who rely on subsistence farming of the polluted lands are suffering the effects as well.
The national and local governments are unable to effectively regulate the industry, since many of their politicians have corporate interests. Dr. K. Muthyam Reddy, professor of economics in Hyderabad, states: “Now governments are not serious. The links with politicians, with industry… you have to break that nexus.”
Governments and industries with vested interests cannot be counted on to solve the problem on their own. However, due to the position of European companies in the pharmaceutical supply chain and the importance of European patients as consumers introducing binding policy at the European level has the potential to vastly change pharmaceutical manufacturing practices globally for the benefit of human and environmental health.
Decisive action must be taken immediately in order to slow down the development and spread of drug-resistant bacteria. The EU can demonstrate global leadership in the fight against AMR by holding European-based pharmaceutical companies accountable. Environmental criteria on disposal of antimicrobial waste must be included in Good Manufacturing Practice rules, so that inspectors are empowered to crack down on pollution offences. The long-awaited European Commission’s Pharmaceuticals in the Environment Strategy should go beyond EU borders and address environmental impacts along the supply chain of any medicines approved and consumed in the EU, wherever they are produced. Enforcing these regulations through frequent and thorough site inspections will hold manufacturers to higher standards of clean production and ultimately benefit the health of populations in India, Europe, and across the globe.
Watch the video on the Changing Markets Foundation website (also available with French and German subtitles) to learn more about the impact of pharmaceutical pollution in India.