The economic and social consequences of the Covid-19 pandemic have reiterated the destructive capacity of untreatable infectious diseases. While we actively find various mitigation strategies to control this pandemic, we must pause to reflect on the veiled public health emergency — antimicrobial resistance (AMR), threatening public health and economies worldwide.
Increased AMR in microbes like bacteria, fungi, and parasites diminish the efficacy of antibiotics in treating simple infections. A recent WHO-supported report has found high rates of AMR in the bloodstream and urinary tracts among the population of countries with reported data on AMR. The rising of AMR in common infections would offset medical advancements made over the years, as pre-pandemic estimates suggested AMR will induce 10 million deaths every year by 2050. It is already being discussed that the extensive use of antibiotics for clinical management of the pandemic has driven up AMR even further.
One Health Approach
Combating AMR calls for a multi-sectoral strategy nestled in the One Health Approach. Apart from the collaboration between governments and multi-lateral agencies, the pharmaceutical sector is a key player for the One Health Approach to have the desired impact. The functioning of our healthcare systems depend on sustained access to medicines. Disruptions like a pandemic or geopolitical crisis can lead to critical drug shortages and escalate adverse patient outcomes.
While stabilising the supply chain to absorb future shocks is important, the industry must pivot towards environmentally responsible ways of manufacturing APIs and drugs in finished dosage forms. This is imperative to mitigate AMR resulting from drug manufacturing.
The Pharmaceutical Supply Chain Initiative (PSCI) has been working with industry members for excellence in safety, environmental, and social outcomes for the whole of the global pharmaceutical and healthcare supply chain.
Recently, 51 pharmaceutical companies from various regions aligned with PSCI’s vision of holistic improvements in the supply chain. Additionally, there are 19 PSCI members with Indian suppliers and over 300 PSCI suppliers in India to propel the industry's growth while ensuring sustainable pharma supply chains.
With support of its government, the Indian pharmaceutical sector is acting as an engine of growth. The Indian pharmaceutical industry is the third largest in value, set to be valued at around $130 billion by 2030. Additionally, the Indian Active PharmaceuticaI Ingredient (API) industry is ranked third largest in the world. Recently, the government announced a slew of policy measures and incentives for the pharma sector to leverage the industry’s growth potential with incentives for domestic production of APIs and Key Starting Materials (KSMs) and incentivisation of setting up bulk drug parks. A reassessment of environmental regulations will make the Indian pharma industry self-reliant and more sustainable. A farsighted view and approach to embrace sustainability will go a long way in increasing benefits to businesses, public health, and the economy.
Strengthening of localised manufacturing capacities is required for the supply chain to be more resilient. However, there should be equal focus on limiting the environmental impact of API and finished drug products. In the absence of laws restricting antibiotic residue concentration limits in water bodies, irresponsible production practices continue to drive environmental AMR and weaken the One-Health Approach.
Responsible procurement and production hold more relevance as the industry expands to new geographies. Industry members must focus on long-term sustainability over short-term profits.
The pharmaceutical industry has shaped the lives of millions world over through their medicines. However, the unsustainable procurement and production practices can offset benefits of these medicines due to increased AMR. Aided by the agencies and governments, the industry must play its role in AMR mitigation.
The writer is Associate Director- Corporate Sustainability at Centrient Pharmaceuticals, and Chair, Pharmaceutical Supply Chain Initiative