Abstract
Background
Recognition is increasing globally regarding the role of the environment in the development and spread of antimicrobial resistance (AMR), including the potential contribution of pharmaceutical manufacturing waste. India bears one of the highest burdens of AMR globally and possesses a substantial manufacturing sector, but limited insight is available on how to practically mitigate environmental AMR-related risk in this context.
Objective
To understand barriers and opportunities in managing manufacturing waste for addressing AMR in the environment from the perspectives of stakeholders in India.
Methods
We conducted semi-structured interviews with a range of stakeholders from government, industry, and civil society following a stakeholder mapping and analysis process within the Indian context. We also undertook a series of stakeholder events to inform the study.
Results
Our findings indicate that: 1) Policy action is fragmentary and there are economic and capacity gaps that have implications for industry behaviours; 2) A One Health approach to addressing AMR in the environment requires leadership and that means AMR prevention needs to be institutionalised within government for them to steer, facilitate and coordinate; and 3) There is a need to enhance knowledge amongst policymakers in India about AMR in the environment, and robust ‘evidence’ is required to foster policy change.
Conclusions
The study underscores the need for a multifaceted strategy to address the contribution of pharmaceutical manufacturing waste to AMR in the environment in India. Greater prioritisation of AMR, stakeholder collaboration, and capacity building are essential to overcoming the challenges identified.
Recognition is increasing globally regarding the role of the environment in the development and spread of antimicrobial resistance (AMR), including the potential contribution of pharmaceutical manufacturing waste. India bears one of the highest burdens of AMR globally and possesses a substantial manufacturing sector, but limited insight is available on how to practically mitigate environmental AMR-related risk in this context.
Objective
To understand barriers and opportunities in managing manufacturing waste for addressing AMR in the environment from the perspectives of stakeholders in India.
Methods
We conducted semi-structured interviews with a range of stakeholders from government, industry, and civil society following a stakeholder mapping and analysis process within the Indian context. We also undertook a series of stakeholder events to inform the study.
Results
Our findings indicate that: 1) Policy action is fragmentary and there are economic and capacity gaps that have implications for industry behaviours; 2) A One Health approach to addressing AMR in the environment requires leadership and that means AMR prevention needs to be institutionalised within government for them to steer, facilitate and coordinate; and 3) There is a need to enhance knowledge amongst policymakers in India about AMR in the environment, and robust ‘evidence’ is required to foster policy change.
Conclusions
The study underscores the need for a multifaceted strategy to address the contribution of pharmaceutical manufacturing waste to AMR in the environment in India. Greater prioritisation of AMR, stakeholder collaboration, and capacity building are essential to overcoming the challenges identified.
| Original language | English |
|---|---|
| Journal | Global Health Action |
| DOIs | |
| Publication status | Accepted/In press - 5 Apr 2025 |
Keywords
- stakeholder engagement
- One Health
- manufacturing waste
- pharmaceutical pollution
- policy
- qualitative study
