Further Reading

Bracing for Superbugs: Strengthening environmental action in the One Health response to antimicrobial resistance- UNEP, 2023

Bracing for Superbugs: Strengthening environmental action in the One Health Response to antimicrobial resistance- Available here

"This report provides evidence that the environment nt matters in the development, transmission and spread of AMR. It offers solutions to address the development and spread of AMR in the environment, particularly by preventing and managing chemical and biological pollution from the pharmaceuticals, agriculture and healthcare sectors and municipal waste. Changes to reduce the risk of superbugs include solid regulation
of discharges, strengthening wastewater treatment, realigning incentives to reduce the use of antimicrobials and the private sector stepping up corporate responsibility" - Inger Andersen, United Nations Environmental Programme 2023 


Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report - WHO, 2021

GLASS Report - (available here) 

"Launched by the World Health Organization (WHO) in 2015 to support the strengthening of the antimicrobial resistance (AMR) evidence base, the Global Antimicrobial Resistance
and Use Surveillance System (GLASS) is the first system that enables harmonized global
reporting of official national AMR and antimicrobial consumption (AMC) data"  - WHO, 2021

2020 Progress Report - AMR industry alliance, 2020

2020 Progress Report - (Available here)

"The report contributes to the global response to the AMR challenge by documenting Alliance members’ activities in the areas of research & science, access, appropriate use, and manufacturing. It not only offers consolidated data on member companies’ AMR-related actions and partnerships, but it also gives an account of a variety of antimicrobial products and diagnostic tools that are already available on the market or in development. The report includes a number of case studies from all four sectors of the life sciences industry. The case studies present efforts by individual member companies and demonstrate their strong commitment to investing in AMR-related
research & science; improving access to and optimizing use of antimicrobials, vaccines, and diagnostics tools; and promoting the responsible manufacture of antibiotics." - AMR Industry Alliance, 2020

Bad Medicine: How the pharmaceutical industry is contributing to the global rise of antibiotic-resistant superbugs - SumOfUs, 2020

Bad Medicine: How the pharmaceutical industry is contributing to the global rise of antibiotic-resistant superbugs - (Available here). 

"The report reveals that the largest pharmaceutical corporations are complicit in fuelling one of the most serious public health crises facing society today. 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." - SumOfUs, 2020

Reducing Emissions from Antibiotic Production - SIWI, 2020

Reducing Emissions from Antibiotic Production:  Whitepaper on policies, technologies, and enabling conditions for sustainable antibiotics manufacturing - (Available here)

"This whitepaper summarizes the findings of the project  Reducing Emissions from Antibiotics (REAP), that
SIWI has run in partnership with UNDP, funded by the Swedish Postcode Foundation. It analyses AMR policies and strategies and practical solutions to address emissions of antibiotics from manufacturing sites as well as the enabling factors required to implement the solutions. While the solutions should be globally applicable, the focus is on practices, challenges and regulations in India, with India being one of the key global suppliers of antibiotics and several regulative and industry initiatives already addressing these factors." - SIWI, 2020

Antimicrobial Resistance Benchmark 2020 - Access to Medicine Foundation, 2020

Antimicrobial Resistance Benchmark 2020 - (Available here)

"The impact of drug resistance is already being felt today. Antibiotic resistance causes more than 500,000 deaths each year, including more than 200,000 infant deaths. In India, for example, resistance exceeds 70% for many widespread bacteria. Most at risk are patients living in the poorest countries, where medicine choices are limited." - Access to Medicine Foundation, 2020

Pulling Together to Beat Superbugs: Knowledge and Implantation - World Bank, 2019

 Pulling Together to Beat Superbugs Knowledge and Implementation Gaps in Addressing Antimicrobial Resistance - (Available here).

"AMR is not just a health problem, it’s a development problem. Unchecked, it will impact people’s health and life
prospects, and ultimately, countries’ human capital. It will also hamper progress towards the 2030 Sustainable Development Goals and harm economies. If unabated, AMR’s economic impact is projected at more than US$ 1 trillion annually after 2030" - World Bank, 2019

Hyderabad’s pharmaceutical pollution crisis - Changing Markets, 2018

Hyderabad’s pharmaceutical pollution crisis: Heavy metal and solvent contamination at factories in a major Indian drug manufacturing hub- (Available here)

"This report explores the impacts of pollution from pharmaceutical production sites in the Indian city of Hyderabad, one of the world’s largest “bulk drug” manufacturing hubs, which supplies tonnes of medicines to markets across the European Union and United States every year. As part of its ongoing engagement with drug companies and their suppliers regarding pollution in the pharmaceutical supply chain, and following the publication of “Impacts of Pharmaceutical Pollution on Communities and Environment in India” in March 2016, Nordea commissioned the Changing Markets Foundation to conduct a follow-up investigation in India, the results of which are presented here." - Changing Markets, 2018

The Environmental Impact Of Pharmaceutical Manufacturing - HCWH, 2018

The Environmental Impact Of Pharmaceutical Manufactoring: How does industry address its own waste - (Available here) 

"Pharmaceutical pollution is increasingly recognised as a threat to ecosystems and human health globally. Pharmaceuticals can enter the environment at all stages of their life cycle (production, use, and disposal), meaning they can ultimately end up in our drinking water as well as accumulate in vegetables and fish. Pharmaceutical residues have been detected in surface water, sewage effluents, groundwater, drinking water, manure, soil, and other environmental matrices globally" - HCWH, 2018

Initiatives for Addressing Antimicrobial Resistance in the Environment - Wellcome, 2018

Initiatives for Addressing Antimicrobial Resistance in the Environment: Current Situation and Challenges - (Available here)

"AMR—when microbes (i.e., bacteria and fungi) develop the ability to defeat the drugs designed to combat them—is a threat to public health and a priority across the globe. Pathogenic antimicrobial-resistant microbes can cause
infections in humans that are difficult, and sometimes impossible, to treat. This report highlights data identifying the potential for the environment (waterways and soils) to be a source of pathogenic antimicrobial-resistant microbes that could affect human health. The report also highlights significant knowledge gaps and measures that could be most important for mitigating risks." - Wellcome, 2018

Scoping Report on Antimicrobial Resistance in India - CDDEP, 2017

Scoping Report on Antimicrobial Resistance in India - (Available here)

"The aims of the mapping exercise are to understand the current situation of AMR, with particular focus on ABR in India, and to identify the current research gaps todetermine the future research priorities in India." - CDDEP, 2017

Superbugs in the Supply Chain - Changing Markets, 2016

Superbugs in the Supply Chain: How pollution from antibiotics factories in India and China is fuelling the global rise of drug-resistant infections - (Available here)

"This report, for the first time, exposes the occurrence of resistant bacteria surrounding pharmaceutical manufacturing plants in India and maps out the supply chain which delivers antibiotics from the dirty factories where they are produced to patients in Europe and the United States. An on-the-ground investigation by the investigative agency Ecostorm which took place in June 2016 and subsequent analysis of water samples under the supervision of Dr Mark Holmes from the University of Cambridge found high levels of drug resistant bacteria at sites in three Indian cities: Hyderabad, New Delhi and Chennai" - Changing Markets, 2016

Impacts Of Pharmaceutical Pollution On Communities and Environment In India - Changing Markets, 2016

Impacts of Pharmaceutical Pollution On Communities and Environment in India -  (Available here)

"As is explored at length in this report, people living in the vicinity of dirty pharmaceutical manufacturing sites, who are often poor and reliant on subsistence farming, are those whose health is at most immediate risk from the toxic effluents and API-laden waste being deposited in their rivers, lakes, groundwater and fields. However, because of the way in which antibiotic manufacturing discharges trigger resistance in bacteria present in the environment, spreading to human pathogens which then travel the world, antibiotic pollution puts everyone at risk, wherever they live. This is why AMR is often compared to climate change, given the scale of the challenge it poses, and the coordinated global response which is required to tackle it" - Changing Markets, 2016