Owning up to the onus

Pharmaceutical majors, including top names in India, commit to a new road map to combat antimicrobial resistance. Putting proper effluent treatment protocols in place would be a good start

November 20, 2016 02:12 am | Updated December 02, 2016 04:32 pm IST

CLEAN-UP NEEDED Indian antibiotics plants pose a dangerto human health and environment by causing drug-resistant bacteria.

CLEAN-UP NEEDED Indian antibiotics plants pose a dangerto human health and environment by causing drug-resistant bacteria.

Something quite significant happened this last quarter that is likely to have a huge impact on the healthcare industry globally. Ahead of the United Nations General Assembly (UNGA) High-Level Meeting on Antimicrobial Resistance (AMR), 13 pharmaceutical companies came up with a new road map, assigning to themselves four key commitments that they will deliver by 2020 to reduce resistance.

Companies that have signed up to the scheme include some of the top names in drug production, including Pfizer, Merck, Novartis, GlaxoSmithKline and Allergan, and Indian drug makers Cipla and Wockhardt.

The presentation they made was cognisant of, and allowed itself to be guided by the principles identified and agreed upon in the industry declaration made at the 2016 World Economic Forum in Davos earlier this year, and reflect the companies’ intent to continue to proactively contribute to the global efforts to address AMR. One of the key commitments on the list was to “reduce the environmental impact from the production of antibiotics, including a review of the companies’ manufacturing and supply chains, and work with stakeholders to establish a common framework for assessing and managing antibiotic discharge”. While awareness on use/misuse and abuse of antibiotics is common knowledge, as is the impact of dosing poultry with antibiotics, the environmental impact of antibiotics-manufacturing companies not treating their wastes has scarcely been discussed at any length or seriousness thus far.

Towards sustainable antibiotics

As they begin delivering on their commitments, a fresh hope emerges in a world that is literally down to its last effective bunch of antibiotics with the emergence of resistance even to last-line drugs.

Changing Markets, a global organisation working in the environment sector, came up with a report in October detailing just how grave the problem is. The report, ‘Superbugs in the Supply Chain: How pollution from antibiotics factories in India and China is fuelling the global rise of drug-resistant infections’, exposed the “occurrence of resistant bacteria surrounding the pharma manufacturing plants and maps out the supply chain which delivers antibiotics from the dirty factories where they are produced to patients in Europe and the United States”. The field investigation took place in June 2016 and subsequent water samples were analysed under the supervision of Dr. Mark Holmes from the University of Cambridge. They were found to contain high levels of drug-resistant bacteria at sites in three Indian cities: Hyderabad, New Delhi and Chennai. In total, out of the 34 sites tested, 16 were found to be harbouring bacteria resistant to antibiotics.

Anurag Roy, business unit director of DSM Sinochem Pharmaceuticals, says the situation is indeed grave in the country. While his company has made a voluntary commitment to sustainable antibiotics and spends higher to deliver on this goal, he says currently without regulatory systems in place, the responsibility rests with the manufacturer. Five of their production units globally, including in India, have gone clean.

“In the last four-five years, we have seen a lot of traction, and we have started to educate several stakeholders. If you do not have these systems in place, then wastes from the plant seep into the ground and enter the ecosystem,” he explains. “We need to make a fundamental change in dealing with such wastes. Three areas need attention: treating water wastes, incinerators, and evaporators,” he adds, indicating the path ahead for manufacturers. Without interventions, substandard manufacturing and waste treatment methods at Indian antibiotics plants pose a danger to human health and environment by causing drug-resistant bacteria.

As the World Health Organisation’s Director General Margaret Chan says, the emergency is now: “With few replacement products in the R&D pipeline, the world is heading towards a post-antibiotic era in which common infections will once again kill. If current trends continue, sophisticated interventions, like organ transplantation, joint replacements, cancer chemotherapy, and care of pre-term infants, will become more difficult or even too dangerous to undertake.”

Government to the rescue?

Invested with every manufacturer is the responsibility not only of developing new molecules to take on the challenge of AMR but also preventing the spread of AMR directly in their processes.

Abdul Ghafur, co-ordinator, ‘Chennai Declaration’, a document prepared in 2012 to tackle the AMR challenge from an Indian perspective, comments: “It is true that reputed companies follow proper effluent treatment protocols. At the same time, many drug manufacturers are not so careful about this important aspect.”

Mr. Roy sums it up with a clear inward eye: “Clearly, the onus lies with us pharma companies… we need to be mindful, watchful and proactive. The government should step in to regulate, especially in a price-sensitive market such as ours. In more regulated markets, people are willing to pay extra if they know that clean systems drive production.” In India, he reckons, costs may go up 20-30 per cent initially after making changes to the infrastructure in factories.

A challenge all right, but not one the antibiotics industry with the heft of billions of dollars behind it cannot overcome.


0 / 0
Sign in to unlock member-only benefits!
  • Access 10 free stories every month
  • Save stories to read later
  • Access to comment on every story
  • Sign-up/manage your newsletter subscriptions with a single click
  • Get notified by email for early access to discounts & offers on our products
Sign in


Comments have to be in English, and in full sentences. They cannot be abusive or personal. Please abide by our community guidelines for posting your comments.

We have migrated to a new commenting platform. If you are already a registered user of The Hindu and logged in, you may continue to engage with our articles. If you do not have an account please register and login to post comments. Users can access their older comments by logging into their accounts on Vuukle.