A recent study on pharmaceutical pollution of the world’s rivers concluded that higher levels of antibiotic-resistant pathogens were found in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing.
By Baher Kamal
People around the world are unknowingly being exposed to water laced with antibiotics, which could spark the rise of drug-resistant pathogens and potentially fuel another global pandemic, warns a new report.
The study, elaborated by the United Nations Environment Programme (UNEP), found that, globally, not enough attention is being focused on the threat posed by antimicrobial resistance with most antibiotics being excreted into the environment via toilets or through open defecation.
Already in 2015, 34.8 billion daily doses of antibiotics were consumed, with up to 90 percent of them excreted into the environment as active substances. Since then the amount of daily consumed antibiotics has been increasing considerably.
Wastewater
While 80 per cent of wastewater in the world is not treated, even in developed countries treatment facilities are often unable to filter out dangerous bugs.
Untreated wastewater could breed superbugs that can evade modern medicine and trigger a pandemic, the report’s authors warned.
In 2019, antibiotic-resistant infections were linked to the deaths of nearly 5 million people. Without immediate action, those infections could cause up to 10 million deaths per year by 2050, the report found.
“Another pandemic is hiding in plain sight,” the report said. “The consequences of the continuing development and spread of antimicrobial resistance could be catastrophic.”
According to a study, Pharmaceutical manufacturing facility discharges can substantially increase the pharmaceutical load to U.S. wastewaters – drug manufacturing facilities are a source of environmental pollution.
“Wastewater treatment plants are unable to filter out chemical compounds used to manufacture personal care products and drugs, so these chemicals seep into freshwater systems and into the oceans.”
Birguy Lamizana, Programme Management Officer at UN Environment and expert on wastewater and ecosystems, explains that modern wastewater treatment plants mostly reduce solids and bacteria by oxidising the water. They were not designed to deal with complex chemical compounds.
Antimicrobials
Antimicrobials are agents intended to kill or inhibit the growth of pathogens. They include antibiotics, fungicides, antiviral agents, parasiticides, as well as some disinfectants, antiseptics and natural products.
Antimicrobial resistance occurs when microbes, such as bacteria, viruses, parasites and fungi evolve to become immune to the drugs to which they were previously susceptible, explains the report.
The more microbes are exposed to pharmaceuticals, the more likely they are to adapt to them.
According to the report, this global threat can be tackled by curbing the release of antibiotic-tinged pollution, including through improved wastewater treatment and more targeted use of antibiotics – too often these drugs are used when they need not be.
The report also called for enhanced environmental governance and national action plans to limit the release of antimicrobials.
One strategy, for example, calls on countries to “limit deforestation, which often brings humans face-to-face with virus-carrying wild animals, giving pathogens a chance to jump species.”
The COVID-19 pandemic provides lessons learned, one of which is the need to prevent and tackle various health threats concurrently, especially their environmental dimensions, said the report.
A recent study on pharmaceutical pollution of the world’s rivers concluded that higher levels of antibiotic-resistant pathogens were found in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing.
According to the UNEP report, the main pollutant sources contributing to the development and spread of antimicrobial resistance stem from poor sanitation, sewage and waste effluent, aggravated, for example, by open defecation and the overuse of antibiotics to treat diarrhoea. Besides these, effluent from pharmaceutical manufacturing and waste from healthcare facilities too contaminate these water sources as do livestock farming.
Higher temperatures are also associated with increased antimicrobial resistant infections, says the report.
“Many diseases are climate-sensitive, and changes in environmental conditions and temperature may lead to an increase in the spread of bacterial, viral, parasitic, fungal and vector-borne diseases.”
On 2 March 2022, the United Nations Development Programme (UNDP) explained that although pandemics are a fact of human life, the world was blindsided by the impact and devastation of COVID-19.
Modern medicine a curse?
Back in 2018, the world environmental body had already warned that the aquatic and human health consequences of pharmaceutical drugs entering the environment through wastewater treatment plants is not yet well understood.
As the world’s population expands and we become wealthier, drugs and chemical-based care products become more prevalent.
“While pharmaceuticals are essential for human health and well-being, less is known on the effects they have on the freshwater sources on which we depend for our existence, and their impact on human health and biota”.
The occurrence of pharmaceutical substances in the environment is of global concern.
This piece has been sourced from Inter Press Service.
Image: WHO