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Why is it said that AMR is a “global and multisectoral issue”?

AMR is global: Indeed, with globalisation and the movement of people and animals across the globe, microbes that ‘hitch a ride’ can also spread globally. If resistant bacteria develop somewhere in Europe, Asia etc., they could very quickly be transported by a carrier (human, animal, food) to another continent. A Swiss study demonstrated that 75% of 38 tourists travelling to India returned home with antibiotic-resistant bacteria in their guts. In addition, 11% of tourists had bacteria resistant to the last-resort antibiotic colistin (Bernasconi O, et al. 2016).

AMR is a multisectoral issue: The causes of AMR have roots in a variety of sectors, including health, food safety, agriculture, environment, and trade, making it a truly multisectoral issue. If these sectors do not act on the threat of AMR, it will not be solved (WHO,2018). To this end, the WHO has proposed their “One Health” approach which is designed to facilitate communication and cooperation between all relevant sectors in order to implement programmes, policies, legislation, and research to combat AMR (WHO).

What is the role of pharmaceutical companies in propagating AMR?

Unchecked manufacturing discharge into water systems has had a major impact not only on the safety of those water sources, but also on the people and animals that encounter the resistant bacteria. This problem is particularly salient in India and China where most active pharmaceutical ingredients (APIs) are manufactured (Changing Markets, 2016).

Studies from Hyderabad in India have shown that concentrations of pharmaceuticals routinely exceed the maximum regulatory limits or safe exposure levels (Larsson et al., 2007). Point-source pollution occurs when APIs and finished-dose antibiotics are produced in specific areas and cause excessively high concentrations which, in turn, encourages the development of drug resistance. Vulnerable populations living near manufacturing facilities and wastewater treatment plants are the most at risk for the damaging impacts of resistance. (Lübbert et al., 2017) (Al Jazeera, 2016) (Larsson, 2014)