After years of documentation and industry neglect, the World Health Organization (WHO) issued its first-ever guidance aimed at addressing wastewater and solid waste from antibiotic manufacturers that is linked to antimicrobial resistance (AMR).
The guidance lands on the doorstep of the United Nations General Assembly meeting set for Sept. 26, which is focused on AMR.
AMR caused by antibiotic pollution could undermine the effectiveness of antibiotics globally, including the very medicines produced at the manufacturing sites responsible for pollution, according to the WHO.
AMR can happen when bacteria, viruses, fungi and parasites no longer respond to medicines, making people sicker and increasing the risk of spread of infections that are difficult to treat.
“Pharmaceutical waste from antibiotic manufacturing can facilitate the emergence of new drug-resistant bacteria, which can spread globally and threaten our health,” Yukiko Nakatani, Ph.D., WHO assistant director-general for AMR ad interim, said in a Sept. 3 release. “Controlling pollution from antibiotic production contributes to keeping these life-saving medicines effective for everyone.”
The WHO’s new recommendations establish human health-based targets to reduce the risk of emergence and spread of AMR as well as targets to address risks for aquatic life caused by all antibiotics intended for human, animal or plant use. It covers all steps from the manufacturing of active pharmaceutical ingredients and formulation into finished products, including primary packaging.
Back in 2016, the Changing Markets organization issued a report (PDF) that said direct sampling of water from certain manufacturing sites found—for the first time—drug-resistant bacteria.
In its new guidance, the WHO said that although high antibiotic pollution levels have been widely documented, the problem has remained largely unregulated, and quality assurance criteria typically do not address environmental emissions.
Additionally, the health organization said there is also a a lack of information provided to consumers on how to dispose of antibiotics when they are not used or are left over from a prescribed treatment.
“The guidance provides an independent and impartial scientific basis for regulators, procurers, inspectors, and industry themselves to include robust antibiotic pollution control in their standards,” said Maria Neira, M.D., director of the department of environment, climate change and health at the WHO.