WHO Sets New Standards to Combat Antibiotic Pollution

The World Health Organization (WHO) has issued its first guidance on antibiotic pollution, setting environmental standards for pharmaceutical wastewater and waste management to combat antimicrobial resistance (AMR). This initiative aims to prevent the spread of drug-resistant bacteria and underscores the need for industry transparency and stronger regulation to protect public health and the environment.

This guidance, released ahead of the United Nations General Assembly (UNGA) High-Level Meeting on AMR scheduled for Sept. 26, 2024, addresses the management of wastewater and solid waste from antibiotic production facilities. These facilities are significant contributors to antibiotic pollution. By exposing bacteria to low levels of antibiotics, this pollution fosters the development of resistance over time, threatening the effectiveness of critical medicines worldwide, according to a study titled “Origin of Antibiotics and Antibiotic Resistance,” published in the National Library of Medicine.

Yukiko Nakatani, Assistant Director General for AMR ad interim, WHO, highlighted the severity of the issue: "Pharmaceutical waste from antibiotic manufacturing can facilitate the emergence of new drug-resistant bacteria, which can spread globally and threaten our health. Controlling pollution from antibiotic production contributes to keeping these life-saving medicines effective for everyone."

The urgency of addressing AMR is further emphasized by a study from Lancet Regional Health, as reported by MBN. This study reveals that AMR has become a severe public health emergency, with 569,000 deaths linked to it in 2019 across 35 countries in the Americas. In this region, more than two out of every five deaths were associated with infections tied to AMR, representing 11.5% of all global AMR-associated deaths.

Despite the well-documented risks, regulations remain limited, and existing quality assurance standards often overlook environmental emissions. WHO reports that inadequate consumer awareness about proper disposal methods for unused or expired antibiotics exacerbates the issue.

To address these gaps, the newly published WHO guidance provides a comprehensive framework for managing the environmental impact of pharmaceutical manufacturing. “The guidance provides an independent and impartial scientific basis for regulators, procurers, inspectors, and the industry to include robust antibiotic pollution control in their standards,” Maria Neira, Director of the Department of Environment, Climate Change, and Health, WHO, explained. She stressed that increased transparency will enable buyers, investors, and the public to evaluate manufacturers’ efforts to mitigate antibiotic pollution.

This call for enhanced regulation has been supported by various international bodies, including the WHO Executive Board, G7 health ministers, and the United Nations Environment Programme (UNEP). WHO’s guidance sets health-based targets to reduce the risk of AMR emergence and spread, while also aiming to protect aquatic life from antibiotic contamination. It covers all stages of manufacturing, from the production of active pharmaceutical ingredients (APIs) to the final packaging of products, ensuring a comprehensive approach to reducing environmental impact.