Abstract

BackgroundEmissions 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.MethodsThe actor types and their respective interests have been identified using research literature, publicly available documents, websites, and the knowledge of the authors.ResultsThirty-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.ConclusionsThe 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.

Highlights

  • 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

  • It is still uncertain to what extent the levels found from such sources select for resistant bacteria [9]

  • This paper aims to take a first step of contributing to such understanding by presenting a map of the relevant types of actors with their respective interests, and describe possible incentives as well as disincentives

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Summary

Introduction

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. Antibiotic resistance presents a serious and growing threat to global health. Misuse and overuse of antibiotics in humans and animals, together with insufficient hygiene and infection control, are the most important drivers of resistance on a global basis. The environment plays a role both in the transmission of resistant pathogens and as a source for resistance factors that over time are transferred horizontally to pathogens. In both cases, antibiotics emitted into the environment create a selection pressure likely to favour resistant strains [8]. Antibiotic pollution occurs, partly, as a result of excretion from humans and domestic animals.

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