Antibiotic Factories Compounding Superbug Spread

New tests reveal lethal drug-resistant bacteria in water found near multiple production sites in India

‘Dirty’ factories supply U.S. drug retailers

Washington, D.C.—A new report by campaigning organization Changing Markets published today reveals, for the first time, the presence of drug-resistant bacteria at pharmaceutical manufacturing sites in India. The report also casts light on the supply chain that links the factories investigated to companies, public health services and hospitals in the United States and Europe.

On-the-ground research by investigative agency Ecostorm, 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.

Out of 34 sites tested, 16 were found to be harboring bacteria resistant to antibiotics. At four of the sites, resistance to three major classes of antibiotics was detected, including antibiotics of ‘last resort,’ those used to treat infections that fail to respond to all other medicines.

Click to enlarge

Detailed examination of publicly available supply chain data, and evidence obtained through Freedom of Information requests, has uncovered how antibiotics manufactured at or near these sites are being exported to foreign purchasers, including pharmaceutical majors like U.S. distribution giant McKesson and French company Sanofi’s generics arm Zentiva, as well as the United Kingdom’s National Health Service (NHS) and French hospitals.

Click to enlarge

Growing antimicrobial resistance (AMR), which is a matter of particular concern in the case of antibiotics, is one of the gravest threats to human health. Global deaths as a result of drug-resistant infections are projected to reach 10 million per year by 2050, with cumulative economic losses of $100 trillion. Medical experts warn that in the near future, drug resistant infections could once again make common illnesses, minor surgery, and routine operations such as hip replacements a life-or-death gamble.

Natasha Hurley, Campaign Manager at Changing Markets said:

“The dumping of antibiotic manufacturing residues poses a grave threat to human health in light of the growing AMR crisis. The discovery of drug-resistant bacteria at Indian factories supplying European and U.S. markets also raises serious questions about pharmaceutical supply chains.

 “Major buyers of antibiotics, such as the NHS, must immediately blacklist suppliers that are contributing to the spread of AMR through industrial pollution and ensure that all drug companies take action to clean up their supply chains. NHS doctors and nurses are working around the clock to tackle AMR; it is shocking that the pharmaceutical industry is undermining their lifesaving efforts through shoddy and dangerous practices.”

One company in particular, Hyderabad-based Aurobindo Pharma, emerges as one of the worst offenders. A recidivist polluter at its own production sites in India, it also imports the raw materials used for making antibiotics from dirty factories in China. With clear links to McKesson, whose biggest customer is U.S. drug retailer CVS Health, and an international network of subsidiaries affording direct access to European markets, Aurobindo is fast becoming a significant global presence.

Click to enlarge

Reacting to the report, Bill Corr, Senior Advisor at Waxman Strategies and former Deputy Secretary of HHS said:

This report joins a growing body of evidence that makes it impossible to ignore pharmaceutical industry pollution as a source of antimicrobial resistance. We need U.S. drug makers, pharmaceutical retailers and relevant regulatory agencies to work together to eliminate this contributor to resistance. If any cause of AMR remains, our health systems continue to be at risk.

Superbugs in the supply chain: How pollution from antibiotics factories in India and China is fuelling the global rise of drug-resistant infections by Changing Markets is available here.

Notes to editors:

  • Freedom of Information requests were submitted by the Bureau of Investigative Journalism to NHS trusts in summer 2016 and partial results shared with Changing Markets for inclusion in this report
  • Antibiotic resistance is a complex phenomenon with multiple interlinked causes, including the rampant misuse of antibiotics in human medicine and farming. But environmental pollution from the production of antibiotics is also recognised as a serious threat. Many factories in China and India, which supply most of the world’s antibiotics, are failing to treat manufacturing discharges appropriately, resulting in the contamination of rivers and lakes and fuelling the proliferation of drug-resistant bugs. The substantial quantities of antibiotics released from polluting factories, which frequently combine with runoff from farms and human waste in water bodies and sewage treatment plants, provide a perfect breeding ground for drug-resistant bacteria.

About Changing Markets:

Changing Markets is a campaigning organisation formed to accelerate and scale-up solutions to sustainability challenges by leveraging the power of markets. Working with NGOs, companies and foundations, we create and support campaigns that shift market share away from unsustainable products and companies to environmentally and socially beneficial solutions. / @ChangingMarkets

About Waxman Strategies

Built on the legacy of Henry Waxman’s storied Congressional career, Waxman Strategies is a progressive-minded public affairs firm. Our core practice areas are health, the environment, technology, telecommunications and media. By harnessing advocacy, communications and campaigns, we’ve successfully improved access to health care, slowed the scourge of deforestation and helped democratize access to technology. To learn more, visit

Contact information:

Natasha Hurley
Campaign Manager
Changing Markets
[email protected]
+44 7585 663648

Nuša Urbančič
Campaigns Director
Changing Markets
[email protected]
+44 7479 015909

Casey Farrington
Account Coordinator
Waxman Strategies
[email protected]
(202) 899-2634 ext. 105