UNEA 5.2: Pharma, health sectors among 5 major sources of AMR, says UNEP report

AMR could kill up to 10 million people per year by 2050, says report

By Gauri Arora
Published: Thursday 03 March 2022
UNEA 5.2: Pharma, health sectors among 5 major sources of AMR, says UNEP report Photo: iStock

The United Nations Environment Programme (UNEP) identified five major contributors to the global development, transmission and spread of antimicrobial resistance(AMR) in a new report February 28, 2022.

The spread of antimicrobial resistance (AMR) in the environment is increased by pollution from human activities, which affects both humans and animals. 

The major sources of AMR mentioned in the UNEP report released on the sidelines of the fifth session of the UN Environment Assembly include: Poor sanitation, sewage and waste effluent; Effluent and waste from pharmaceuticals manufacturing; Effluent and waste from healthcare facilities; Use of antimicrobial and manure in crop production; Releases, effluent and waste in animal production.

Poor sanitation, sewage and waste effluent: Over 56 per cent of domestic and industrial wastewater globally is released into the environment with little or no treatment. The lack of sanitation, poorly functioning sanitation or fragmented systems (open defecation, poorly contained pit latrines, septic tanks and sewers) that contaminate water sources spread AMR. 

This also includes releases from unused drugs disposed of in toilets, bins or waste dumps and leaching from open waste dumps. 

Pharmaceuticals manufacturing: Release of active pharmaceutical ingredients and high concentrations of antimicrobials in the environment without its proper treatment is one of the critical drivers of AMR. This also includes the solid waste and effluents from these institutions because of the presence of residual antimicrobials.

Healthcare facilities: As antimicrobials are frequently used in healthcare, effluent and hospital solid waste from healthcare facilities is an important source of discharges of resistant microbes, antimicrobial pollution and antibiotic resistance genes (ARG) into the environment.

Antimicrobials and manure in crop production: Pesticides with antimicrobial properties such as antibiotics and fungicides are widely used in industrial crop production and could impact AMR in the environment. This includes untreated manure and wastewater that may contain pharmaceuticals residues, ARGs and resistant microbes intentionally applied to soil and crops.

Releases, effluent, waste in animal production: The report emphasises the environmental contamination caused by pharmaceuticals residues, ARGs and resistant microbes derived from aquatic as well as terrestrial animal production manure and effluent.

Another source of concern in aquaculture is the use of antibiotics and parasiticides, which are then released into the environment. The improper disposal of unused drugs, which results in these drugs entering the environment, is a source of concern for the entire animal production industry.

Pollution from antimicrobial agents disrupts the microbial composition of environmental media and affects biodiversity and ecosystem services. Water, soil and air then serve as vehicles for spreading antimicrobial resistant microbes and affects human, animal and other environmental reservoirs.

AMR could kill up to 10 million people per year by 2050, according to the report. The economic impact is also expected to be substantial: By 2030, the shortfall in gross domestic product caused by AMR could be $3.4 trillion per year, with an additional 24 million people pushed into extreme poverty, the report estimated.

The report identifies focus areas for reducing the burden of AMR by focusing on prevention and mitigation actions, as well as promoting sustainable production and consumption. These include:

  1. Enhancing environmental governance, planning and regulatory frameworks
  2. Identifying and targeting priority AMR-relevant pollutants
  3. Improving reporting, surveillance and monitoring
  4. Prioritising financing, innovation and capacity development

The report chalks out the need to act in an environmental dimension collaboratively. 

UNEP works at the global, regional, and country level to support the implementation of AMR-related measures that will also contribute to the achievement of Agenda 2030 and the sustainable development goals. The report is a summary for policy makers and a more detailed version of it is inline for dissemination. 

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