The COVID-19 pandemic has shined a spotlight on the importance of maintaining a robust global pharmaceutical supply chain. But combating the novel coronavirus is only one of the reasons we need a more effective, sustainable system for manufacturing and distributing the drugs the world needs. A critical element in keeping healthy supply chains is addressing the release of pharmaceuticals in the environment (PiE) and the interlinked potential for the emergence of antimicrobial resistance (AMR).
Most pharmaceuticals enter the environment as patients use and dispose of the medicines they consume. But the drug manufacturing process can also release emissions into the environment, primarily through discharges that elevate concentrations of pharmaceuticals downstream from production facilities.
For example, manufacturing facilities that don’t adhere to the best standards can contribute to excessive concentrations of pharmaceuticals in surface waters. This can impact aquatic organisms that live in these waters, as well as humans and wildlife that rely on these water supplies.
The improper containment of pharmaceutical antimicrobial agents can also increase the risk of antimicrobial resistance in environmental bacteria, creating super bugs that evade our ability to treat them. While the overuse and misuse of antibiotics in the care chain is the greatest driver of AMR development, high concentrations of antibiotics downstream from poorly managed manufacturing facilities can also contribute to this growing public health threat.
Over the past two decades, the manufacturing supply chain for medicines has become increasingly global, shifting its focus from US and Europe to other hot spots in the world. This process has highlighted the need for enforcement of rigorous manufacturing practices in countries where legislation is less stringent as some organizations in the massive global supply chain lack the expertise and resources to fully contribute to this effort.
Many pharma and biotech companies are actively working to tackle PiE and AMR issues head on, working with their local suppliers and sub-contractors on applying globally the highest manufacturing standards. Manufacturers are fulfilling their responsibilities by making public commitments to reducing emissions, adhering to strong global standards, and calling for greater accountability and enforcement actions by governments.
One example of this ongoing collaboration is the work performed by members of the Pharmaceutical Supply Chain Initiative (PSCI), 43 of the industry’s largest pharmaceutical companies, with drug manufacturers and suppliers to support the implementation of initiatives to limit the growth and spread of PiE and AMR and improve performance against global benchmarks.
These collaborations have benefited local companies as they have seen reductions in operating costs, better regulatory compliance and improvements to their manufacturing processes. Many partners also find that making strong environmental commitments and implementing measures to meet them enhances their reputation across many stakeholder groups, which can lead to new business opportunities.
Looking ahead, to make meaningful progress, we need to focus our collective efforts on three interlinked dimensions: first, we have to continue promoting responsible practices that continuously improve social, health, safety and environmental sustainability across the entire pharmaceutical manufacturing supply chain, including mitigating the impacts of antimicrobial resistance.
Second, we need to bolster education and training efforts, by building knowledge and expertise, and enabling companies to better understand how to calculate the impact of their manufacturing on surface waters and minimize drug releases into the environment. This is critical to cut down on local PiE “hotspots” and restore surface waters so that there are no adverse impacts on the ecosystem.
Finally, further dialogue is needed to increase global awareness of this issue, ensure stakeholders understand and are aligned with appropriate environmental and public health goals, which is why we have recently launched a public position outlining what private sector can do to address PiE and AMR.
Antimicrobial resistance is one of the next big threats the world must tackle after COVID-19. To effectively combat the looming threat, we must prioritize working together to strengthen and more responsibly manage global supply chains.
Manjit Singh is Pharmaceutical Supply Chain Initiative (PSCI) Board Chairman.