Time to hold pharmaceutical polluters to account

Impacts on health, environment and livelihoods – in India, local communities have for decades protested about the effects of pollution from pharmaceutical production. Our new report calls for increased transparency and stricter environmental standards in drug manufacturing.

Rising global demand for cheap medicine has increased the production of pharmaceuticals in low-cost countries. A large part of our antibiotics and other medicines are today made in India, a country with a well-documented history of alarming effluent releases linked to drug manufacturing.

In the report The Health Paradox, conducted in collaboration with the Swedish Society for Nature Conservation, Swedwatch met with local communities and environmental human rights defenders in Hyderabad – also known as “the bulk drug city of India” – who for decades have protested about adverse impacts from the pharmaceutical industry. Many suffer from respiratory problems and skin conditions as well as decreased access to water and threats to their livelihoods.

Residents who used to depend on nearby lakes for irrigation, fishing, drinking and household use, stopped using the water when it became discoloured and foul-smelling. There are also growing concerns over future water shortages as climate change is expected to amplify the regional drought cycle – which is already impacting lives and livelihoods – amid fears that it may spark water-related conflicts. Besides loss of income, residents say they have suffered from a general loss of productivity due to illness and increased costs of healthcare.

Releasing untreated effluents into the environment is also a threat to global health. In Hyderabad, studies have found extremely high concentrations of antibiotics and multi-resistant bacteria in local water supplies. According to experts, this is a neglected risk for the spread of antibiotic resistance (AMR). AMR is expected to cause 10 million deaths per year globally by 2050 unless action is taken, and is already today a serious issue in India. For instance, India faces the highest numbers of resistance-attributable neonatal sepsis deaths in the world; almost 57,000 neonates die each year owing to neonatal sepsis caused by bacteria resistant to first-line antibiotics.

Despite the alarming and well-known risks, the EU has no environmental requirements on the production of drugs sold on the European market, and there are few incentives for drug producing companies to monitor or report on pollution. The pharmaceutical sector is also infamous for its lack of transparency, which makes it nearly impossible for consumers to know how and where their drugs are manufactured – and to hold polluters to account.

While pharmaceutical pollution in India has drawn national and international attention and has led the Indian government to recently introduce a draft bill to limit concentrations of antibiotics in waste discharged by factories, experts stress that pharmaceutical pollution from manufacturing is a global problem. Due to a lack of transparency and data, it is not known how widespread the pollution is, but high concentrations of pharmaceutical effluents have been discovered also in other parts of the world. The industry has taken measures to improve production and supply chain sustainability, but progress is slow and the precautionary principle is still disregarded by many manufacturers.

In the report, Swedwatch and Swedish Society for Nature Conservation call on pharmaceutical companies and authorities in importing countries to introduce and enforce strict environmental standards in drug manufacturing. They also call on authorities in Sweden and the EU to enable the public release of supply chain information and environmental risk assessments for all pharmaceutical products available on their markets.