Three economic sector value chains profoundly influence the development and spread of AMR:
- Pharmaceuticals and other chemicals manufacturing,
- Agriculture and food including terrestrial animal production, aquaculture, food crops
- Healthcare delivery in hospitals, medical facilities, community healthcare facilities and in pharmacies where a range of chemicals and disinfectants are used.
In addition, poor sanitation, wastewater and related waste effluent in human and animal waste systems, such as municipal wastewater is an important source of AMR.
Management options to address releases, effluent and waste, include:
In Pharmaceutical manufacturing
- Ensure adequate waste and wastewater containment and treatment, and incorporate waste management into standard operating procedures used in the production of antimicrobials with a lifecycle approach.
- Promote sustainable procurement and reimbursement systems for manufacturers.
In Food and agriculture
- Limit use and reduce discharges to protect water sources from pollutants, resistant microorganisms, and antimicrobial residue contamination.
- Apply infection control and prevention measures.
In Healthcare
- Install hospital-specific wastewater treatment systems, especially in locations without modern community wastewater treatment plants.
- Leverage hospital stewardship and infection prevention control programmes to limit environmental contamination by AMR pollutants.
In Municipals
- Increase waste containment and optimize wastewater treatment and sludge management processes.
- Innovate and adapt wastewater treatment options, including technologies for different resource settings.
