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Managing pollution from antibiotics manufacturing: charting actors, incentives and disincentives

Journal article
Authors Niels Nijsingh
Christian Munthe
D. G. Joakim Larsson
Published in Environmental health
Volume 18
ISSN 1476-069X
Publication year 2019
Published at Department of Philosophy, Linguistics and Theory of Science
Centre for antibiotic resistance research, CARe
Institute of Biomedicine, Department of Infectious Medicine
Language en
Links https://doi.org/10.1186/s12940-019-...
https://gup.ub.gu.se/file/207947
Keywords antibiotic resistance, antimicrobial resistance, ABR, AMR, Environmental health, Global health, bioethics, health policy, environmental policy, pharmaceuticals, pharmaceutical industry, pollution, sustainability
Subject categories Pharmaceutical Sciences, Social and Clinical Pharmacy, Pharmaceutical microbiology, Health Care Service and Management, Health Policy and Services and Health Economy, Public health science, Public health medicine research areas, Environmental medicine, Medical Ethics, Practical philosophy, Globalization Studies, Law and Society

Abstract

Background Emissions of high concentrations of antibiotics from manufacturing sites select for resistant bacteria and may contribute to the emergence of new forms of resistance in pathogens. Many scientists, industry, policy makers and other stakeholders recognize such pollution as an unnecessary and unacceptable risk to global public health. An attempt to assess and reduce such discharges, however, quickly meets with complex realities that need to be understood to identify effective ways to move forward. This paper charts relevant key actor-types, their main stakes and interests, incentives that can motivate them to act to improve the situation, as well as disincentives that may undermine such motivation. Methods The actor types and their respective interests have been identified using research literature, publicly available documents, websites, and the knowledge of the authors. Results Thirty-three different actor-types were identified, representing e.g. commercial actors, public agencies, states and international institutions. These are in complex ways connected by interests that sometimes may conflict and sometimes pull in the same direction. Some actor types can act to create incentives and disincentives for others in this area. Conclusions The analysis demonstrates and clarifies the challenges in addressing industrial emissions of antibiotics, notably the complexity of the relations between different types of actors, their international dependency and the need for transparency. The analysis however also suggests possible ways of initiating incentive-chains to eventually improve the prospects of motivating industry to reduce emissions. High-resource consumer states, especially in multinational cooperation, hold a key position to initiate such chains.

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