Scientists have been saying for years that polluting pharma plants are directly contributing to the spread of antibiotic resistance. Now, it looks as if they could have hard evidence in India, the world's biggest antibiotic producer.

A hard-hitting report by campaigning organization Changing Markets says direct sampling of water from manufacturing sites operated by Aurobindo, Orchid Pharma and Asiatic Drugs and Pharmaceuticals has--for the first time--uncovered drug-resistant bacteria.

The researchers behind the work say the testing proves pharma pollution ranks alongside excessive consumption of antibiotics in human medicine and profligate use in livestock as a key driver for resistance. And their focus on Indian producers is warranted, as India is the world's largest maker--and consumer--of antibiotics.

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Worryingly, out of 34 Indian manufacturing sites tested, almost half (16) were harboring resistant strains of bacteria. At four of these, resistance was detected to three widely-used and important antibiotic classes--cephalosporins, carbapenems and fluoroquinolones--including drugs generally reserved for use as a last resort.

At eight sites, resistance to cephalosporins and fluoroquinolones was detected, while another four sites had evidence of either cephalosporin or fluoroquinolone resistance.

The report singles out Aurobindo for particularly harsh criticism, claiming the company is a "recidivist polluter" at its plants in India and also imports the raw materials used for making antibiotics from dirty factories in China.

FiercePharma contacted both Aurobindo and Orchid Pharma for reaction to the new report, but has not yet received a response.

"Every year, nearly 1 million people worldwide die from drug-resistant infections," says Changing Markets. That figure is projected to climb to 10 million a year by 2050, it adds, causing cumulative economic losses of $100 trillion.

But despite increased attention for the problem at the G20 and United Nations, "concrete action on tackling drug resistance remains slow and incomplete, and many seasoned observers fear that we are doing too little, too late."

"The dumping of antibiotic manufacturing residues poses a grave threat to human health in light of the growing antimicrobial resistance crisis," said Natasha Hurley, campaign manager at Changing Markets, which would like purchasers of antibiotics to blacklist known polluters.

The World Health Organization published a global action plan on antimicrobial resistance last year, which called for improving surveillance of antibiotic-resistant bacteria, reducing infection rates and making sure antibiotics are used only when needed. That plan did not mention a need to monitor drug manufacturing facilities.

Some pharma companies have said they will take steps, however. Last month, 13 Big Pharma and contract manufacturing organizations vowed to review their manufacturing and supply chains and develop standards for cleaning up antibiotic waste discharge.

Details of the drive remain a little sketchy, but the move is seen as a step in the right direction. The companies stepping up to take the pledge were Allergan ($AGN), Cipla, DSM, Sinochem Pharmaceuticals, GlaxoSmithKline ($GSK), Johnson & Johnson ($JNJ), Merck & Co. ($MRK), Pfizer ($PFE), Roche ($RHHBY), Ulrike Engels-Lange, Sanofi ($SNY), Shionogi and Wockhardt.

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