The superbugs of Hyderabad 

The superbugs of Hyderabad

Context

• The Kazipally well, a temporary containment facility for toxic effluents from a dozen pharmaceutical companies, is not leak-proof. A natural rivulet takes the fluid in the well to the nearby Gandigudem lake, where harming mostly farmers and some pharma industry workers raise fish to sell.

What is happening?

• Deep inside the Kazipally industrial area of Hyderabad, the capital of Telangana, is an open well into which empties a thin stream ‘Industrial Effluent’.
• The effluent gets transferred to Patancheru Enviro Tech Limited (PETL), an effluent treatment plant, where it gets be treated and released into Hyderabad’s Musi river.
• On October 3 this year, when heavy rains lashed Hyderabad, it flooded, poisoning around 2.3 lakh fish in the lake.
• Environmental pollution is happening since the pharmaceutical industry took root in the city in the 1970s, threatening agriculture, aquaculture and the health of Hyderabadis. But new research in the last few years shows this pollution to be a threat of a larger, more terrifying scale.

A whole new species of danger

• The Kazipally well, along with ditches, lakes and rivers around the pharmaceutical cluster, receives large doses of antibiotics, along with the traditionally monitored pollutants. When these antibiotics come in contact with pathogenic bacteria (which cause disease in humans), the latter learn to resist the former, making human infections by these pathogens extremely hard to treat.
• Antibiotic resistance is arguably the biggest threat to global health in the 21st century.
• A big driver of resistance is the overuse of these drugs. When people take antibiotics they don’t need, for a viral flu, but resistance genes don’t come out of nowhere – some of them have existed for decades in soil and water, helping environmental bacteria fight natural antibiotics.

Forced evolution

• Studies in Hyderabad’s pharmaceutical cluster now show that the large doses of man-made antibiotics in pollution hotspots like Kazipally force these environmental bacteria to evolve by boosting the numbers of resistance genes.
• Hyderabad’s pharmaceutical industry has responded to the science linking antibiotic pollution with resistance by questioning the motives of the researchers.

Shocking findings

• In 2005, Cecilia de Pedro, a student of environmental sciences at Sweden’s University of Gothenburg, began testing the effects of industrial waste water on a tiny transparent crustacean, the water flea using samples from PETL’s plant.
• Pedro found out how poisonous the treated discharge from PETL was to the flea, no one was surprised. De Pedro’s findings intrigued D.G. Joakim Larsson, an eco-toxicologist at the same university. He wanted to find out if the culprits were pharmaceuticals.
• So Larsson and team decided to jump in and tested this treated output for 59 pharmaceuticals. The findings were a bombshell.
• The team found 11 drugs in high quantities, of which six were antibiotics. But the real surprise was the quantity of antibiotics found.
• PETL was dumping ciprofloxacin at a rate of 31,000 micrograms per litre. It was more than the concentration of ciprofloxacin in the blood of people who were being treated with the drug. It was enough to kill aquatic species such as algae.
• In the next few years, Larsson collaborated with other researchers to publish a series of papers analysing data from Hyderabad. But merely finding antibiotics along with resistant bacteria doesn’t prove that the former caused the latter. So, the researchers did another study, comparing lakes in Kazipally with the Himayath Sagar and Osman Sagar lakes of Hyderabad, both far from the pharma industry and unlikely to be as polluted.
• For good measure, they sampled two unpolluted Swedish lakes too. The analysis was telling. Neither the Indian nor Swedish controls had resistant bacteria in numbers as high as the lakes in the pharma cluster.
• The microbes in the Kazipally lake had integrons and plasmids, which are bits of genetic material that let resistance genes hop from one bug to another. When lake bacteria were mixed in the lab with the Escherichia coli bacterium (some strains of which can cause diarrhoeal disease in humans), the genes jumped across with alacrity, turning the E. coli multidrug resistant.

Rebuttals and loopholes

• In May this year, the BDMA published a rebuttal which, challenging the idea that pharmaceutical pollution causes resistance.
• For the study, Dayananda Siddavattam, a professor at the University of Hyderabad, collected water and soil samples from near the facilities of companies like Aurobindo Pharma, Hetero Drugs and Virchow Laboratories. He then cultured bacteria from them, and tested for resistance against ten antibiotics. For comparison, he carried out the same exercise in the Nallagandla lake 50 km away from these companies.
• The report says that there was no difference in the numbers of antibiotic-resistance bacteria near the companies and away from them.
• In general, evidence that antibiotic pollution leads to resistance is strong enough to take action, said Sumanth Gandra, a researcher who studies the problem at New Delhi’s Centre for Disease Dynamics, Economics and Policy.

Cleaner, but not clean enough

• The government began a number of initiatives, especially to control liquid pollution.
• Around 86 of the 220 bulk drug makers in Hyderabad today have zero liquid discharge facilities, which means that they recycle all the liquid effluent. The only waste they generate is solid, which is incinerated or buried in landfills.
• Meanwhile, PETL has spruced up too. Today, it does not dump its discharge into the local Isakavagu creek, shipping it instead in an 18 km pipeline to a domestic sewage treatment plant near the Musi river.
• The discharge gets mixed with treated sewage and diluted before being released into the Musi. The quality of effluent that comes to PETL today is more tightly controlled too, as pharma companies pre-treat it.