Water

Flash Mob Infects Pharma Conference with Spirit Of Change

Hey, hey, ho, ho, pharma pollution has got to go!

Draped with artificial bacteria that have been known to show resistance—purple balls of MRSA, yellow fuzzy tassels of E. coli—a flash mob of dancers helped kick off a day of action to stop pharmaceutical manufacturing pollution. The activists started at Philadelphia City Hall, then marched to the Conference Center where CPhI North America, one of the largest pharmaceutical conferences in the world, was taking place.

Activists and pharmaceutical executives met on the sidewalk. Signatories of the Industry Roadmap, which promises action by 2020 on this issue, handed activists their card; various conference attendees stopped to watch the dance. It was an opportunity to engage directly with pharmaceutical manufacturers on manufacturing pollution, which they have in their power to eliminate.

After the dance, we asked Philadelphians to show their support by tweeting at the conference and jamming their social media feed with calls to stop #pharmapollution. We were delighted by the volume of love our cause received, not just on Twitter but on Facebook and Instagram. Side note: there’s still time to sign our petition.

Read more about the action in the Philadelphia Inquirer.

Within the last ten years, pharmaceutical manufacturing pollution has been recognized as a contributor to the rise of antibiotic-resistant “superbugs.” Bacteria overexposed to the antibiotics in factory effluent can develop resistance to those antibiotics and then proliferate.

Though most of these polluting factories are in India and China, where the bulk of antibiotics taken in the U.S. are produced, resistance grown abroad can easily pass over our borders. In the past year, a patient in Pennsylvania was diagnosed with the first Colistin-resistant infection in the U.S. (a strain commonly found in China). A patient in Nevada died after an India-acquired infection failed to respond to 26 different antibiotics.

The Philadelphia action is part of a broader campaign to stop pharmaceutical pollution that drives the development and spread of superbugs. The goal is to encourage major US retailers like CVS Health to eliminate serial polluters from their supply chains. Aurobindo, an Indian manufacturer, has been identified as one of the worst actors on antibiotic manufacturing pollution. The manufacturer has relationships with CVS Health, Walmart, and McKesson.

We’d like to thank all the dancers and activists that supported us on Wednesday, whether in person or online. If our grassroots action didn’t catch pharma’s attention, this definitely will: right now, Rep. Louise Slaughter of New York is circulating a sign-on memo calling attention to this issue. Together, we can help close the back door to resistance and stop superbugs NOW.

Featured photo Kristen Tomkowid/Little But Fierce

by Mighty Earth

Campaign for Action on Pharmaceutical Pollution

In partnership with Waxman Strategies, Mighty helped coordinate a series of letters to the Food and Drug Administration and pharmaceutical companies to encourage action on antimicrobial resistance caused by pharmaceutical pollution. Pollution of active pharmaceutical ingredients by antibiotic manufacturers creates the perfect conditions for antimicrobial resistance to develop and spread. Our letters, echoing an op-ed published in STAT, pressed for change on three fronts:

1. U.S. drug makers should require their suppliers to stop polluting.
2. The FDA and other relevant agencies should pressure their counterparts in India and China to toughen pollution regulations and crack down on violators.
3. Major pharmaceutical retailers should pressure their manufacturers to ensure their supply chains are not contributing to this problem.

Pharmaceutical pollution that contributes to antimicrobial resistance is a multifaceted problem that requires action on multiple fronts to be adequately addressed. Some pharmaceutical companies have made commitments on the issue. Others, like Mylan and McKesson, have not. Read samples of the letters below.

by Mighty Earth

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.

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.

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.

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. www.changingmarkets.org / @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 www.waxmanstrategies.com.

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

by Mighty Earth

Waste From Pharmaceutical Plants in India and China Promotes Antibiotic-Resistant Superbugs

STAT First Opinion by Henry Waxman and Bill Corr

Pharmaceutical pollution of any type can be deadly, threatening habitats and poisoning drinking water. But antibiotic pollution doubles down on the dangers. The release of antibiotics into soil, streams, rivers and lakes creates a perfect storm for antimicrobial resistance to develop and spread.

This isn’t just a local disaster, because superbugs have no respect for national borders. Microbes travel freely through air and water. Bacteria are carried in livestock and agricultural products, which move across countries and continents as part of the global food system. And the ubiquity of international aviation means that antibiotic-resistant bacteria in people can travel thousands of miles in a matter of hours.

No physical barrier can be erected to prevent the spread of superbugs. Instead, they must be stopped at their source. Four vital steps can help reduce, if not eliminate, antibiotic pollution due to drug manufacturing.

Read more on STAT.

by Mighty Earth

Public Health Leader Responds to Pledged Commitment to Address Superbug-Producing Waste

The following is a statement by Bill Corr, Senior Advisor at Waxman Strategies and former Deputy Secretary of Health and Human Services, on the announced commitment by thirteen major drug makers to reduce pollution from antibiotic factory supply chains which can contribute to antimicrobial resistance (AMR) and superbugs:

“It is encouraging to see these thirteen companies acknowledge that this is a problem and map out a path to protecting public health and the environment. When it comes to AMR, it’s all or nothing. As long as any source of resistance is allowed to persist, so does the risk to our health. To date, major pharmaceutical companies are contributing to antimicrobial resistance by failing to protect their supply chains. This failure creates a risk to the public health that can be easily addressed.

“While it is still too early to validate the approach outlined by the thirteen drug makers including Pfizer, Novartis, and Merck, public health advocates like myself remain committed to focusing on this issue to see that others connected to antibiotic pollution like Aurobindo, McKessen and Mylan follow suit. Mylan is the company testifying before the House Oversight and Government Reform committee tomorrow on its practices around pricing of the life-saving EpiPens.

“Drugs from Mylan end up in store shelves across the country, as they are a major supplier to retail giant CVS. Retailers like CVS have remained silent on the issue of supplier conduct. Retailers have an important role to play in this and should move to suspend their business relationships with laggards.”

by Mighty Earth

Pharmaceutical Companies Exposed as Contributors to Antimicrobial Resistance

Washington, DC—Ahead of the first-ever United Nations high-level meeting on antimicrobial resistance (AMR) in New York on Wednesday, a coalition of environmental and public health organizations released a major report connecting specific major pharmaceutical companies to the development of superbugs.

“Drug resistance through the back door” sheds light on how industry heavyweights like Pfizer, Teva and McKesson contribute to the AMR crisis through commercial ties with serial polluters in China and India. Careless waste management by factories producing antibiotics contaminate local water supplies, leading to the kind of interaction between antibiotics and bacteria that fosters resistance. Ironically, many of the same companies fuelling resistance by failing to protect their supply chains are demanding investment from governments to develop new antibiotics to fight resistance.

Speaking ahead of the UN meeting, Bill Corr, Senior Advisor at Waxman Strategies and former Deputy Secretary of Health and Human Services said, “When it comes to AMR, it’s all or nothing. As long as any source of resistance is allowed to persist, so does the risk to our health care systems. Major pharmaceutical companies are contributing to antimicrobial resistance by failing to protect their supply chains. This failure creates a risk to the public health that can be easily addressed.”

Growing drug resistance is one of the gravest threats to human health this century. In the United States alone, the CDC estimates that at least 2 million people are infected with resistant bugs each year, and at least 23,000 people die each year as a direct result. Globally, annual deaths 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, common illnesses, minor surgery, and routine operations such as hip replacements could become high risk procedures.

A 2015 report on AMR from the UK government states that pharmaceutical manufacturing pollution is “a supply chain problem that pharmaceutical companies and their suppliers need to solve together.” However, most companies display a shocking lack of concern about pollution in their supply chains by failing to implement, or demand that their suppliers implement, environmentally sound manufacturing and waste treatment techniques.

Natasha Hurley of UK-based Changing Markets said “Big Pharma’s role in fuelling drug resistance is all too often overlooked when policies to curb the spread of AMR are being discussed. Our research has shown that the industry is failing to take the necessary action to address the threat of a looming environmental and public health crisis in which it is playing a key part. This is why we are calling for major purchasers of antibiotics to blacklist the worst offenders and send a message to the market that failure to bring antibiotic manufacturing discharges under control will directly impact companies’ bottom line. With drug supply chains shrouded in mystery, we also need more transparency on the origin of our antibiotics.”

The report recommends major buyers of antibiotics stop purchasing from pharmaceutical companies contributing to the spread of AMR through irresponsible manufacturing practices. One company it scrutinizes is Aurobindo, a Hyderabad, India -based drug manufacturer with numerous international subsidiaries, including Auromedics Pharma LLC in the United States. Aurobindo has been involved in many pollution scandals in India, and also has commercial ties with antibiotics factories operated by some of China’s largest drug companies, including NCPC, the country’s biggest State-owned pharmaceutical group.

For more information on pharmaceutical pollution and antimicrobial resistance, consult the following resources:

•  Impacts of Pharmaceutical Pollution on Communities and Environment in India: Swedish investment bank Nordea investigates Indian generics manufacturers (2015)

• Bad Medicine: Sum of Us exposes antibiotic pollution hotspots in China (2015)

• United Nations High-Level Meeting on Antimicrobial Resistance: UN discusses AMR issues. (9/21/2016)

Featured photo from Dr. Graham Beards.

by Mighty Earth

Bad Medicine

It’s likely that antibiotics sold in the US are products of factories that pollute antibiotics into the atmosphere in China and India. 2015’s Bad Medicine report from SumOfUs and Changing Markets connects the dots.

Even as some major players in the pharmaceutical industry make commitments to stem the threat of antimicrobial resistance (AMR) by developing new antibiotics or reforming prescribing recommendations, many are likely aggravating the crisis in their supply chains. According to Bad Medicine, pharmaceutical pollution is a driver of AMR, along with overuse in humans and livestock. The report connects major companies like Pfizer, McKesson, Teva and Aurobindo to factories that have repeatedly been sanctioned for environmental infractions and likely polluted antibiotic active ingredients into adjacent waterways, poisoning local populations and opening the door to a global health crisis.

Read the jaw-dropping report here.

by hifron

Action on AMR Can't Wait

The CDC estimates at least 2 million people in the US are infected with resistant bacteria each year, and 23,000 people die from those infections. This isn’t a crisis to worry about someday—it’s happening now, and without action, the frequency and severity of AMR will only get worse.

Antimicrobial resistance is an existential threat to modern health care. It has been since shortly after penicillin was discovered. Alexander Fleming had his eureka moment in 1928. By 1940 bacteria were already exhibiting resistance to the drug.

The development of superbugs is evolution we can track in real time. When bacteria come into contact with an antibiotic, most are killed off. But some bacteria survive and develop resistance to that antibiotic, like the microbial version of a flu shot. Fighting these stronger bacteria with the same antibiotic as before won’t be as effective. After enough mutations, a strain completely resistant to that antibiotic—a superbug—could emerge and pass its immunity on to others.

The Evolution of Bacteria on a “Mega-Plate” Petri Dish (Kishony Lab)

Thankfully, people are speaking up. Last year, President Obama introduced the National Action Plan for Combating Antibiotic-Resistant Bacteria and laid out clear goals for our country to fight back the threat of AMR. In September 2016, the UN will host a High-Level Meeting on the issue. From health care professionals to animal rights activists, people are advocating against the practices that exacerbate AMR, like over-prescription, the lack of research into new alternatives, and misuse in livestock. Too many people are taking antibiotics incorrectly or unnecessarily. For too long, pharmaceutical companies have failed to develop new antibiotics, or other alternatives to fighting bacterial infections. And too many farms rely on antibiotics not to heal their keep, but to fatten them up before they go to market.

Polluting manufacturers, however, have flown relatively under the radar in attempts to address the AMR crisis. Waxman Strategies and Changing Markets have identified factory locations primarily in India and China that are linked to massive environmental degradation in the form of pharmaceutical pollution. Independent studies of regions in India, Pakistan, South Korea and Taiwan have found extremely high concentrations of antibiotics (at times surpassing their maximal therapeutic concentrations) in water sources downstream of antibiotic manufacturers. There are also numerous examples of manufacturers that have been sanctioned for environmental malfeasance, yet continue to produce antibiotics for a mass market without proper waste disposal methods in place.

The effects of this contamination are already public health crises in the factories’ locales, effectively poisoning local populations. In the context of antimicrobial resistance, however, this local injustice is also an international one. High concentrations of antibiotics released into the environment from factories create reservoirs of antimicrobial resistance. The impact is similar to that of human and animal waste, but without having been diluted by the digestive process. Superbugs, cultivated in China and India by careless waste disposal and lack of oversight, can then be exported worldwide.

We need action on all of these issues—discovery, over-prescription, misuse in livestock and pollution—to keep the devastating effects of AMR at bay. With any contributor to AMR out there, the efficacy of antibiotics is threatened, and with it modern medicine.

by hifron