Antibiotic pollution and lack of regulation will have dire global consequences

Given the hot topic of antimicrobial resistance, one could only be shocked at reading New Scientist’s article ‘How antibiotic resistance is driven by pharmaceutical pollution’ (22 May 2019), which details the prolific dumping of antibiotic waste by factories into waterways in India.

The global demand for antibiotics is having grave consequences — not just on resistance as we know in the Western world, but also in the environment surrounding these factories in India. Joakim Larsson, an environmental pharmacologist from the University of Gothenburg, wanted to see how much of the antibiotic compounds being produced in the manufacturing processes end up in the local lakes and streams. In effluent at the local industrial waste-water treatment plant, the concentration of ciprofloxacin was 1000 times higher than the concentration required to kill the bacteria it targets — and a million times higher than the levels typically found in sewage outflows elsewhere in the world. 

There are serious consequences of this dumping. Individuals living near the factory carry bacteria that are resistant to ciprofloxacin. Larsson and others have shown that antibiotic contamination promotes the propagation of resistance genes and accelerates their spread among bacteria. When bacteria reside in high concentrations, those without resistance will quickly die; only those with resistance genes will survive and multiply.

If antibiotic pollution continues unabated in developing nations, such as India, it will be a huge problem — and not only in places where the waste is being dumped. Some pharmaceutical companies have openly and repeatedly said that, while they recognise the need to address pollution from manufacturing, they prefer a ’voluntary’ approach to a legislated one. The authors believe the lack of regulation is ‘largely down to lobbying’. We may think things are bad now, a pharmaceuticals industrial park called ‘Pharma City’ is currently being constructed near Hyderabad, India, which will host between 900 and 1,000 companies. The article suggests that local authorities are using the rather ominous slogan ‘minimum inspection, maximum facilitation’ to describe this venture. As the world demands cheap antibiotics, who knows what the real long-term consequences will be for all of us.

Dave Sharma, pharmacist, Reading