India’s water crisis calls for immediate action. Situation analysis of the manufacturing of antimicrobials (AMR) and strict implementation of existing policies is the way forward
A report by the Government’s think-thank, Niti Aayog, titled, ‘Composite Water Management Index: A Tool for Water Management’, released in June this year, warned that India is facing its “worst” water crisis in history. Further, it states that by 2030, water demand in the country is projected to be twice the available water supply unless comprehensive steps are taken to reverse the current scenario. Substantiating the positive relationship between water stress and economic growth, the report highlights that water scarcity will lead to a six per cent GDP loss to the country. The issue of sustainable management of our water resources is an essential need today, especially in view of its limited availability and rising demand.
Other than inefficient usage and over consumption, one key factor leading to water crisis is industrial pollution. Water bodies stand endangered due to unbridled dumping of toxic industrial waste. Recent reports around pollutants causing methane fires in Bengaluru’s Bellandur lake; release of untreated industrial waste into Yamuna and Musi rivers, Maharashtra’s Ambazari lake as well as the choking of Hyderabad’s Patancheru lake by the bulk drug industry, are testament to this. As a result, no city is able to provide clean drinking water due to water contamination and inadequate wastewater treatment. This unabated crisis can severely hamper India’s industrial, environmental and economic health.
A crucial but often ignored consequence of water pollution is a rise in antimicrobial resistance (AMR). Multiple studies conducted (by Nordea, IIT Hyderabad etc.) around pharmaceutical industries near Hyderabad, Bhiwadi and Vizag, have shown that copious amounts of antibiotics are being released as wastewater into the surrounding water bodies. These serve as ‘hotspots’ for the development of resistant superbugs that do not respond to antibiotic treatment, causing untreatable infections and diseases. The proliferation of antibiotic residues in the environment, due to inadequate regulation of wastewater, leads to contamination of water sources and groundwater. Moreover, a plethora of bacterial infections or diseases, caused by a lack of access to clean water and sanitation or poor Wash standards, gives rise to increased antibiotic consumption, which is compounded by inappropriate self-medication.
As per a 2016 World Bank report, ‘Drug Resistant Infections: A Threat to our Economic Future’, inability to treat infections will not only cost human lives, but will also result in GDP losses of over five per cent in low-income countries and push 28 million people in developing countries into poverty by 2050, thereby causing a crisis potentially worse than the 2008 economic meltdown. Global health care costs may increase to $300 billion to one trillion dollar, annually. The regulation of wastewater treatment can be a cost-effective means to prevent AMR as well as alleviate the water crisis, provided efforts are made to ensure that both sets of measures are sufficiently interlinked. In the Indian context, more research needs to be done to obtain actionable information and understand the complex linkages between the environment, AMR and Wash standards.
There have been some policy interventions related to the overuse or misuse of antibiotics in human and animal consumption. Overall waste management by industries must be monitored by the State pollution control boards. However, existing regulations need effective enforcement. Moreover, sufficient attention is not given to irresponsible manufacturing of antibiotics and uncontrolled release of active antibiotics via wastewater. Existing environmental regulations account for the presence of heavy metals in water but there are no minimum standards for the levels of APIs (active pharmaceutical ingredients) in the discharged industrial effluents. Thus, pharmaceutical industries are not mandated to treat the antibiotic content in the wastewater released during the manufacturing processes.
In order to strengthen the policy focus on the AMR challenge in India, and establish it as a State-level priority, the health ministry launched the National Action Programme on the Containment of Antimicrobial Resistance (NAP-AMR) in April 2017. The scheme recognises the need to mandate environmental standards for antibiotic residues in pharmaceutical and hospital effluents. The NGT has ordered a status report to determine the AMR levels in water bodies as an impact of the pharmaceutical industry but this has been delayed due to lack of funds. In adherence to the NAP-AMR, this dual AMR and water crisis in India demands immediate action towards a situation analysis of the manufacturing of antimicrobials as well as increased surveillance standards, alongside strict policy advocacy and implementation. The development of specific antibiotic policies, supported by sensitisation and awareness workshops can drive home the magnitude of this dual challenge. Such interventions can help shape frameworks for participation by other relevant stakeholders. Any gaps in adequate policy responses vis-à-vis regulations, monitoring and implementation will result in severe economic and environmental impacts as well as loss of human lives.
(The writer is independent consultant for development issues)