The cost of cheap drugs? Toxic Hyderabad lake is 'superbug hotspot'
Centuries ago, Indian princes would bathe in
the cool Kazhipally lake in Medak. Now, even the poorest villagers here in
India's baking south point to the barren banks and frothy water and say they
avoid going anywhere near it. A short drive from the bustling tech hub of
Hyderabad, Medak is the heart of India's antibiotics manufacturing business: a
district of about 2.5 million that has become one of the world's largest
suppliers of cheap drugs to most markets, including the United States.
But community activists, researchers and some
drug company employees say the presence of more than 300 drug firms, combined
with lax oversight and inadequate water treatment, has left lakes and rivers
laced with antibiotics, making this a giant Petri dish for anti-microbial
resistance.
"Resistant
bacteria are breeding here and will affect the whole world," said
Kishan Rao, a doctor and activist who has been working in Patancheru, a Medak
industrial zone where many drug manufacturers have bases, for more than two
decades.
Drugmakers in Medak, including large Indian
firms Dr
Reddy's Laboratories Ltd, Aurobindo Pharma Ltd and Hetero Drugs Ltd, and U.S. giant Mylan Inc,
say they comply with local environmental rules and do not discharge effluent
into waterways.
National and local government are divided on
the scale of the problem.
While the Central Pollution Control Board
(PCB) in New Delhi categorizes Medak's Patancheru area as "critically
polluted", the state PCB says its own monitoring shows the situation has
improved.
The rise of drug-resistant
"superbugs" is a growing threat to modern medicine, with the emergence
in the past year of infections resistant to even last-resort antibiotics. In
the United States alone, antibiotic-resistant bacteria cause 2 million serious
infections and 23,000 deaths annually, according to health officials. Thirteen
leading drugmakers promised last week to clean up pollution from factories
making antibiotics as part of a drive to fight the rise of drug-resistant
superbugs, while United Nations member countries pledged for the first time to
take steps to tackle the threat.
Major
Earner
Patancheru is one of the main pharmaceutical
manufacturing hubs in Telangana state, where the sector accounts for around 30
percent of GDP, according to commerce ministry data. Drug exports from state
capital Hyderabad are worth around $14 billion annually.
Local doctor Rao pointed to studies by
scientists from Sweden's University of Gothenburg that have found very high
levels of pharmaceutical pollution in and around Kazhipally lake, along with
the presence of antibiotic-resistant genes.
The scientists have been publishing research
on pollution in the area for nearly a decade. Their first study, in 2007, said
antibiotic concentrations in effluent from a treatment plant used by drug
factories were higher than would be expected in the blood of patients undergoing
a course of treatment. That effluent was discharged into local lakes and
rivers, they said.
"The
polluted lakes harboured considerably higher proportions of ciprofloxacin-resistant
and sulfamethoxazole-resistant bacteria than did other Indian and Swedish
lakes included for comparison," said their latest report, in 2015,
referring to the generic names of two widely used antibiotics.
Those findings are disputed by local
government officials and industry representatives.
The Hyderabad-based Bulk Drug Manufacturers
Association of India (BDMAI) said the state pollution control board had found
no antibiotics in its own study of water in Kazhipally lake. The state PCB did
not provide a copy of this report, despite several requests from Reuters.
"I
have not seen any credible report that says that the drugs are no longer there,"
Joakim Larsson, a professor of environmental pharmacology at the University of
Gothenburg who led the first Swedish study and took part in the others, told
Reuters by email. "There might very
well have been improvements, but without data, I do not know."
Water
Treatment
Local activists and researchers say the
Common Effluent Treatment Plant (CETP) built in Medak in the 1990s was
ill-equipped to handle large volumes of pharmaceutical waste. After protests
and court cases brought by local villagers a 20-km (12-mile) pipeline was built
to take effluent to another plant near Hyderabad. But activists say that merely
diverted the problem - waste sent there, they say, mixes with domestic sewage
before the treated effluent is discharged into the Musi river.
A study published this year by researchers
from the Indian Institute of Technology, Hyderabad, found very high levels of
broad-spectrum antibiotics in the Musi, a tributary of the Krishna, one of
India's longest rivers.
Local government officials responsible for
the plants did not respond to Reuters' requests for comment.
Nearly a dozen current and former officials
from companies producing medicines in Patancheru told Reuters that factory
staff from various firms often illegally dump untreated chemical effluent into
boreholes inside plants, or even directly into local water bodies at night.
All the officials spoke on condition of
anonymity and Reuters was unable to independently verify those allegations. Major
manufacturers in the area, including Dr Reddy's and Mylan, said they operated
so-called zero liquid discharge (ZLD) technology and processed waste onsite.
"Mylan
is not dumping any effluent into the environment, borewells or the CETP,"
said spokeswoman Nina Devlin.
Dr Reddy's said it recycled water onsite and
complied with all environmental regulations.
The same industry officials who spoke to
Reuters said the pollution control board rarely checked waste-treatment
practices at factories, adding that penalties for breaches were meager.
The Telangana state government did not
respond to requests for comment.
"We
are aware some companies are releasing more than the allowed effluent, but they
are profit-making companies," said state PCB spokesman N. Raveendher.
"We do try and take action against
the offenders, but we cannot kill the industry also."
Many smaller companies also lacked the funds
to install expensive machinery for treating waste, he added.
Court
Battles
A series of local court cases have been filed
stretching back two decades, accusing drug companies of pollution and local
authorities of poor checks. In some cases, companies have been ordered to pay
annual compensation to villagers, but many are still grinding through India's
tortuous legal system.
Wahab Ahmed, 50, owns five acres of land near
the shores of Kazhipally lake, where he grew rice until a decade ago. He says
the worsening industrial pollution from several nearby pharmaceutical factories
left his land barren.
"We
have protested, sued, and done all sorts of things over the years ... that's
how some of us are now getting around 1,700 rupees (roughly $20) a year from
the companies," he said. "But
what can you do with that small sum today?"
More than 200 companies were named as
respondents in the case he was referring to, filed by a non-profit organization
on behalf of villagers. While pollution of farmland is a serious problem for
villagers who depend on it for their livelihood, the potential incubation of
"superbugs"
in Medak's waterways has wider implications. The risk is that resistant
bacteria would then infect people and be spread by travel.
So far, most of the focus worldwide on
antimicrobial resistance has been on over-use of drugs in human medicine and
farming. "Pollution from antibiotic
factories is a third big factor in causing antimicrobial resistance,"
the chairman of one of the world's largest drugmakers told Reuters. "But it is largely overlooked."
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