One frequently overlooked cause of anti-microbial resistance (AMR) is environmental pollution from raw materials used to make antibiotics at the very beginning of the supply chain. Our campaign focused on this, exposing the links between polluting factories in China and India and some of the biggest global pharmaceutical companies. On-the-ground investigations and desk research have uncovered a complex and murky web of commercial relations between Chinese suppliers, Indian middle-men and trusted global brands.
Our ‘Bad Medicine’ report published with SumOfUs in June 2015 describes how many large pharmaceutical companies in the EU and US are outsourcing production of active pharmaceutical substances (APIs) to polluting factories in China and India, fueling a major public health threat. The report calls on the pharmaceutical industry to take responsibility for their supply chains by introducing appropriate waste management and cleaner production processes. It also calls on governments to include environmental criteria in the rules regulating pharmaceutical production, such as Good Manufacturing practices.
Download the report
Impacts of Pharmaceutical Pollution on Communties and Environment in India
An on-the-ground-investigation commissioned by Nordea Asset Management and carried out by Changing Markets and Ecostorm uncovered the considerable environmental and human costs of severe pollution at pharmaceutical manufacturing sites in Hyderabad and Visakhapatnam in India. The report documented pollution on the ground and highlighted a compelling body of scientific evidence that is linking this with the emergence of AMR, which represents a potential overseas health threat.
Drug Resistance through the Back Door
“Drug Resistance through the Back Door: How the Pharmaceutical Industry is fuelling the Rise of Superbugs through Pollution in its Supply Chains,” summarises key information about pollution in global pharmaceutical supply chains for health professionals and purchasers of medicines. The briefing calls on major purchasers of medicines in EU countries, including the UK NHS, to blacklist pharmaceutical companies with manufacturing practices that contribute to the spread of AMR, and to implement procurement policies that include environmental criteria. This is extremely important, as dirty production and inadequate waste disposal in China and India – where most antimicrobials used in the UK and other European countries are produced – are fuelling the global rise of drug-resistant ‘superbugs’. Whilst health services and authorities are increasingly required to devote resources to stop the spread of AMR at home, their influential purchasing power could bring about a significant change in the way drugs are sourced and produced for European markets. Taking measures at home without tackling causes further afield is akin to locking the front door while leaving the back door wide open.
Superbugs in the supply chain
This report reveals the presence of drug-resistant bacteria at pharmaceutical manufacturing sites in India and casts light on the supply chain that links the factories investigated to companies, public health services and hospitals in the United States and Europe. On-the-ground research by investigative agency Ecostorm, and subsequent analysis of water samples under the supervision of Dr. Mark Holmes from the University of Cambridge, found high levels of drug-resistant bacteria at sites in three Indian cities: Hyderabad, New Delhi and Chennai. Out of 34 sites tested, 16 were found to be harbouring bacteria resistant to antibiotics. At four of the sites, resistance to three major classes of antibiotics was detected, including antibiotics of ‘last resort’, those used to treat infections that fail to respond to all other medicines.