Cameron Anishka, Connolly John, Esiovwa Regina, Henriquez Fiona L, Hursthouse Andrew, Mukherji Suparna, Mukherji Soumyo
School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire, Paisley, UK.
Glasgow School for Business and Society, Glasgow Caledonian University, Glasgow, UK.
Glob Health Action. 2025 Dec;18(1):2491200. doi: 10.1080/16549716.2025.2491200. Epub 2025 May 1.
There is growing global awareness of the pivotal role environmental factors, including pharmaceutical manufacturing waste, play in the development and spread of antimicrobial resistance (AMR). 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.
To understand the barriers and opportunities in managing manufacturing waste for addressing AMR in the environment from the perspectives of stakeholders in India.
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.
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.
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.
全球日益认识到包括制药生产废物在内的环境因素在抗菌药物耐药性（AMR）的产生和传播中所起的关键作用。印度是全球AMR负担最重的国家之一，拥有庞大的制造业，但对于如何在这种背景下切实降低与环境AMR相关的风险，了解有限。
从印度利益相关者的角度，了解在管理生产废物以应对环境中的AMR方面存在的障碍和机遇。
在印度背景下，我们通过利益相关者映射和分析过程，对来自政府、行业和民间社会的一系列利益相关者进行了半结构化访谈。我们还举办了一系列利益相关者活动以支持该研究。
我们的研究结果表明：1）政策行动零散，存在经济和能力差距，这对行业行为产生影响；2）采用“同一健康”方法应对环境中的AMR需要领导力，这意味着AMR预防需要在政府内部制度化，以便政府进行引导、促进和协调；3）有必要提高印度政策制定者对环境中AMR的认识，并且需要有力的“证据”来推动政策变革。
该研究强调需要采取多方面战略来解决制药生产废物对印度环境中AMR的影响。更加重视AMR、利益相关者合作和能力建设对于克服所确定的挑战至关重要。
