Antibiotics are an integral part of our life today and used in the treatment of common infections to surgeries. But, we are witnessing the growing phenomenon of antimicrobial resistance or AMR, a key public health and environment concern due to multiple factors.
Antimicrobial resistance, as per World Health Organisation, occurs when bacteria, viruses, parasites and fungi develop resistance against medicines that were previously able to curb them. The causes include overuse of antibiotics, their increasing use in the food chain, non-treatment and improper management of pharma effluents.
Recently, H E Peter Thomson, President of the UN General Assembly, stated at the 71st session of the United Nations General Assembly (UNGA) that AMR today is a key threat to the achievement of sustainable development goals and requires a global response. Its scope gets exacerbated every passing year with 7 lakh deaths worldwide. With resistance to antimicrobials expecting to reach 10 million by mid of this century, medical experts now put drug resistance in the same bracket as the HIV/AIDS crisis.
It is for this reason that the UNGA Industry Roadmap on AMR was published on September 20, just ahead of the UNGA high-level meeting. This roadmap signed by 13 leading bio-pharmaceutical companies, placed the environmental impact of antibiotics manufacturing as the number one priority.
Signatory companies committed to reviewing their manufacturing and supply chains, establishing a common framework for managing antibiotic discharge and application across their own manufacturing and supply chain by 2018. Working with stakeholders to develop a practical mechanism to show that supply chains meet the standards; and working with independent experts to establish science-driven, risk-based targets for discharge concentrations on antibiotics and practices to reduce environmental impact of effluents by 2020.
These are proactive steps to move towards safer antibiotic manufacturing processes where sustainable manufacturing is an essential prerequisite.
It is significant that the UNGA has taken up the issue of AMR. This is the fourth time that the topic has been taken up for discussion and it shows the gravity of the situation.
Several studies have highlighted the grim situation in India and China — they bring out evidences drug-resistant bacteria breeding in pharmaceutical plants. These reports also highlight the fact that the pharma industry in India is one of the main contributors to industrial pollution and AMR, especially in the Hyderabad region.
Extreme resistance of antibiotics can be found in areas like Gaddapotharam industrial area and Isnapur Lake adjacent to the Pashamylaram industrial area in Hyderabad. Total resistance can be found in Musi river tributary at Edulabad on the outskirts of Hyderabad.
Alarming signs
These are alarming signs that signal urgent steps to be taken by all concerned if we are to save our environment and retain effectiveness of antibiotics for ourselves and our next generation. This is critical as new antibiotics are complex, costly to develop and will take years of research.
This year, the US government has announced the launch of BARDA (Biopharmaceutical Accelerator) to incubate antibiotics research programmes with joint funding from both industry and non-profit organisations. The UK and China together announced a Global Innovation Fund in the year 2015 to improve funding for AMR-related research.
These countries have committed an estimated amount of 100 million pounds. India in the year 2015 along with other countries has initiated the 68th World Health Assembly resolution for a Global Action Plan on AMR with member states committing to developing National Action Plans by 2017.
The Chennai Declaration (2012) has also strategised to ensure that there is complete ban on over- the-counter sale of antibiotics without prescription in major cities across India. It also emphasised the power of media in disseminating information about proper use of antibiotics.
Despite the above measures, AMR is yet to gain attention as a serious epidemic disease. A multi-sectoral effort is required from all – the government, pharma associations and bodies, manufacturers, enforcement authorities and Pollution Control Boards. The UNGA roadmap is a crucial step and now it remains to be seen how it is taken forward by stakeholders in respective countries.
(The writer is Business Unit Director, AsiaPacific, West Asia and Africa, DSM Sinochem Pharmaceuticals)
Published 22 November 2016, 17:48 IST