The economic and social consequences of the Covid-19 pandemic have reaffirmed the destructive capacity of incurable infectious diseases. As we actively find various mitigation strategies to control this pandemic, we must pause to reflect on the veiled public health emergency – antimicrobial resistance (AMR), threatening public health and economies around the world.
Increased resistance to antimicrobials in microbes such as bacteria, fungi and parasites decreases the effectiveness of antibiotics in treating uncomplicated infections. A recent WHO-supported report found elevated levels of AMR in the blood and urinary tract among the population in countries that reported AMR data. The increase in AMR in common infections would offset medical advances made over the years, as pre-pandemic estimates suggested that AMR would cause 10 million deaths each year by 2050. It is already discussed that use intensive antibiotics for the clinical management of the pandemic boosted AMR even further.
One Health Approach
The fight against AMR requires a multisectoral strategy nested in the One Health approach. In addition to collaboration between governments and multilateral agencies, the pharmaceutical sector is a key player for the One Health approach to have the desired impact. The functioning of our health systems depends on sustained access to medicines. Disruptions such as a pandemic or geopolitical crisis can lead to critical drug shortages and worsen adverse patient outcomes.
While it is important to stabilize the supply chain to absorb future shocks, the industry needs to move towards environmentally friendly methods of manufacturing APIs and drugs in finished dosage forms. This is imperative to alleviate AMR resulting from drug manufacturing.
The Pharmaceutical Supply Chain Initiative (PSCI) has worked with members of the industry for excellence in safety, environment and social outcomes for the entire global supply chain of pharmaceuticals and health care.
Recently, 51 pharmaceutical companies from various regions aligned with PSCI’s vision of comprehensive supply chain improvements. In addition, there are 19 PSCI members with Indian suppliers and over 300 PSCI suppliers in India to propel industry growth while ensuring sustainable pharmaceutical supply chains.
With the support of its government, the Indian pharmaceutical sector is acting as a growth engine. India’s pharmaceutical industry is third in value, which is expected to be valued at around $ 130 billion by 2030. Additionally, India’s active pharmaceutical ingredients (API) industry is ranked third in the world. Recently, the government announced a series of policy measures and incentives for the pharmaceutical sector to take advantage of the industry’s growth potential with incentives for domestic production of APIs and key raw materials (KSMs) and an incentive for the creation of bulk drug parks. A reassessment of environmental regulations will make the Indian pharmaceutical industry self-sufficient and more sustainable. A far-sighted vision and approach to embracing sustainability will go a long way in increasing the benefits for business, public health and the economy.
Building localized manufacturing capacity is needed to make the supply chain more resilient. However, equal attention should be given to limiting the environmental impact of APIs and finished pharmaceutical products. In the absence of laws restricting the concentration limits of antibiotic residues in water bodies, irresponsible production practices continue to fuel environmental AMR and weaken the One Health approach.
Responsible sourcing and production is more relevant as the industry expands to new geographies. Industry members need to focus on long term sustainability rather than short term benefits.
The pharmaceutical industry has shaped the lives of millions of people around the world with its drugs. However, unsustainable sourcing and production practices may outweigh the benefits of these drugs due to increasing antimicrobial resistance. With the help of agencies and governments, industry must play its part in mitigating AMR.
The author is Associate Director – Sustainability at Centrient Pharmaceuticals and President of the Pharmaceutical Supply Chain Initiative