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Report: Drug Companies Contribute to Rise in Antibiotic Resistance

‘Dirty’ factories produce raw materials for antibiotics, authors claim

Major pharmaceutical companies may have contributed to the global rise of antibiotic-resistant “superbugs,” according to a new report from Sum of Us, a consumer watchdog group. Most antibiotics are manufactured in China and India, according to the report, but recent investigations reveal that the byproducts of that manufacturing include pollutants that contribute to antibiotic resistance.

Antimicrobial resistance (AMR) has been singled out as one of the main risks to mankind by the World Health Organization (WHO), the authors say. In 2014, the Chairman of a major U.K. government-backed review into AMR estimated that by 2050, drug-resistant infections could kill 10 million people per year globally. AMR is also costly, with studies showing that the world could lose up to US $100 trillion worth of economic output between now and mid-century if it is not addressed, lowering projected GDP by 2.0% to 3.5%.

Several factors are fueling the AMR crisis, according to the report. “An inexpensive and seemingly endless supply of antibiotics, coupled with financial incentives encouraging their prescription, are leading to inappropriate use and overconsumption in humans and in animals reared for food. The lack of investment by industry in new drug discovery is further exacerbating the situation,” the authors state.

One frequently overlooked cause of AMR, and the focus of the new report, is environmental pollution from the production of the raw materials used to make antibiotics at the beginning of the supply chain.

Most of the world’s antibiotic drugs are manufactured in China and India. China is now the top manufacturer of penicillin industrial salts, a vital building block in the production of many antibiotics, and produces 80% to 90% of antibiotic active pharmaceutical ingredients (APIs), the report says. India, which has the world’s third largest pharmaceutical industry, represents a smaller but still significant share of global antibiotic API manufacturing. Indian companies have also positioned themselves as leaders in the production of “finished dose” antibiotic products using APIs mainly imported from China. The trade in antibiotic drugs between China and India is now worth billions of dollars, with large pharmaceutical companies in the U.S. and Europe among their biggest clients.

In 2014, China was rocked by a series of investigations exposing pollution from antibiotics factories. Hot on the heels of these scandals, the new report claims to document links between some of the global pharmaceutical industry’s biggest names and “dirty” antibiotic factories in China. On-the-ground investigations and desk research also uncovered a web of commercial relationships among Chinese suppliers, Indian middlemen, and global brands, the authors say.

“It is essential for pharmaceutical companies to lift the veil on their supply chains and stop buying antibiotic APIs from polluting Chinese factories. In an age when AMR is threatening to destroy the health system as we know it, there is simply no excuse for turning a blind eye,” according to the report’s executive summary.

Sources: FierceHealthcare; June 12, 2015; and Bad Medicine; June 2015.

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