The microbe menace

Even before the Covid-19 pandemic, antimicrobial resistance (AMR) was among the key priorities for global public health and the world economy. The pandemic will further exacerbate the AMR crisis because of increased use of antibiotics.

Antimicrobial Resistance is already a complex challenge caused by several factors beyond overuse and misuse of antibiotics in humans, agriculture, and poultry. Environmental transmission of AMR is an understated concern, especially in countries like India and China which manufacture 70-80 per cent of the world’s antibiotics. While AMR will account for 10 million mortalities by 2050, its economic costs would escalate to $90 trillion. The pharmaceutical industry can longer ignore environmental sustainability.

When effluents from pharmaceutical manufacturing units are released without checks, antibiotic residue seeps into the water bodies and soil, eventually ending up in the human and animal food chain.

High concentrations of antibiotics like ciprofloxacin, norfloxacin, oxytetracycline, and ofloxacin have been found in water bodies worldwide. Such high concentrations facilitate the non-resistant bacteria to be carriers of resistant genes, which help proliferate superbugs. With the support of regulatory authorities, the pharmaceutical industries need to build in practices to check their wastewater discharges.

Intergovernmental institutions like the European Union (EU), the World Health Organisation (WHO), and the World Trade Organisation (WTO), and nation-states too have a role to play.

The pharma manufacturers should continue to invest in R&D to reduce the discharge concentrations of antibiotics. Industry leaders must take the lead in innovating a range of Active Pharmaceutical Ingredients (APIs) which meet the Predicted No Effect Concentration (PNEC) criteria set by the AMR Alliance.

Centrient Pharmaceuticals line of semi-synthetic penicillin (SSP) APIs that meets the PNEC criteria underscores our commitment towards sustainable production. While innovation towards more sustainable APIs is timely, attention should be duly paid towards wastewater discharge.

On the other hand, the industry leaders should pursue innovation in wastewater treatment to reduce their carbon footprint.

Role of regulators

The regulators, too, need to support the smaller and the bigger companies. Intergovernmental agencies and nation-states should incentivise green procurement to boost smaller manufacturers. This would further improve the global realisation of the United Nations Sustainable Development Goal 12 (Sustainable Consumption and Production). Often the local generic industry of pharmaceuticals in countries like India operates on low-profit margins and therefore has to resort to unsustainable practices.

The regulators should build in labour and tax incentives in a comprehensive sustainability plan, pushing these smaller companies towards an environmentally friendly production and supply chain. Further, various governments should come together to set global standards for antibiotic discharge. When materialised, these standards will not only measure progress but also aid in motivating likely incentives.

The EU and countries like the UK and India have already taken initial steps in this direction, but more is to be done.

The government had introduced a draft of a notification that prescribed limits for antibiotics discharge in industrial effluents. Once adopted and implemented, these guidelines would be a torchbearer for other countries.

The mitigation of AMR requires synergy between the regulators and the pharmaceutical industry as both the actors have critical roles to play. With climate change a reality now, the efforts to combat AMR will play a pivotal role in conserving our planet.

The writer is CEO, Centrient Pharmaceuticals

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