The Responsible Antibiotics Manufacturing Platform

Antimicrobial resistance (AMR) is one of humanity’s greatest health threats. Reducing emissions from antibiotics production is a critical factor in the fight against AMR. In 2020, the Responsible Antibiotics Manufacturing Platform, RAMP, was launched to find solutions, with pioneers from both suppliers and buyers joining forces to set a new standard for the industry.

The Responsible Antibiotics Manufacturing Platform, RAMP, is a unique collaboration between pioneers among procurers, regulators, and companies. Together we co-create the business-case for sustainably produced antibiotics. Here you can follow the progress and learn about ways to get involved.

Awareness is growing that pharma production contributes to the spread of antimicrobial resistance (AMR), one of humanity’s greatest health threats. But the problem has been difficult to tackle.

So far, the relatively few relevant attempts to change industry practices have not been linked to market demands or incentives, preventing a true transformation of the sector. RAMP aims to break the current stalemate through an innovative approach where the progressive part of the pharmaceutical industry joins forces with the most forward-thinking buyers or regulators to set new standards for more sustainable manufacturing.

What is special about RAMP is that it brings together pioneers from three fields: procurers, regulators, and companies. This is probably the only way to overcome the obstacles that have so far prevented progress in an industry that is infamous for its lack of transparency. As things stand, many companies refuse to disclose information about manufacturing practices, making it impossible for procurers and consumers to choose products that are sustainably produced. In turn, companies have few incentives to shift to more responsible practices, which may come with additional costs and no rewards. To reverse this trend, all related stakeholders have an important role to jointly define standards for emissions as well as for information and transparency.

RAMP can overcome these challenges by bringing together pioneers from different fields to co-create a sustainable business case. Companies that join the platform are expected to provide information, including access to their factories, and all partners should contribute to mutual learning and improvements. In turn, this flow of information enables procurement criteria, and verification of foreseeable regulative efforts, giving companies real incentives to shift to sustainable production methods.

With RAMP, the many disparate voices advocating for sustainable manufacturing can join forces and effect real change.

Join RAMP!

RAMP brings together procurers, regulators, and companies to co-create a business case for sustainable manufacturing, in everybody’s long-term interest.

All partners should contribute to mutual learning and improvements:
Companies that join the platform are expected to provide information, including access to their factories.

Procurers in the platform are expected to engage in the development of procurement criteria that give companies real incentives to shift to sustainable production methods.


Quick facts about RAMP

Started: by SIWI as an inception phase during 2020. The project is expected to run 2021-23.

Partners and funders: Swiss Agency for Development and Cooperation (SDC), Centrient Pharmaceuticals, GlaxoSmithKline (GSK) and Shawview Consulting. The AMR Industry Alliance is a key technical advisor to the project.

Actions: Partners provide information, including access to their factories and insights into the procurement process., All stakeholders contribute to mutual learning and improvements. The aim is to contribute to higher standards in production, procurement, and regulations.

Vision: By 2030 the release of antibiotics to the environment from manufacturing is minimized, and broader sustainability gains have been achieved in partnership with industry and governments, international agencies and other related stakeholders to provide a competitive advantage to the implementing companies, ensuring access to functional antibiotics that have been manufactured in a manner that does not promote antimicrobial resistance.

Antimicrobial resistance is one of the world’s greatest health threats and we are starting to understand how it is fuelled by emissions from pharma manufacturing. People living close to production plants are immediately affected but the consequences will soon be felt across the world if we don’t act now.

The World Health Organization warns that antimicrobial resistance (AMR) could wipe out many of the health gains made in the past century. It is estimated that AMR could claim 10 million lives per year by 2050, if urgent action is not taken.

Over-subscription of antibiotics to humans and overuse in intensive animal farming and food supply chains are among main culprits behind the dramatic rise in AMR, but pharmaceutical production is increasingly seen as another important driver.

In 2007, researchers from the University of Gothenburg, Sweden, were the first to discover shockingly high levels of antibiotics in rivers downstream from a wastewater treatment plant in India’s pharmaceutical hub, Hyderabad. The concentration of antibiotics in the water was not only the highest ever recorded in the environment, it exceeded what can be found in the blood of patients undergoing treatment.

All antibiotics released into the environment drive antimicrobial resistance world-wide and must be addressed globally. At the same time, we must not forget the high human and environmental price paid locally, in the areas of production. People living near pharmaceutical production hubs such as Hyderabad in India report skin diseases, fish kills and poisoned livestock. A recent NGO investigation described serious human rights impacts and environmental damage related to unregulated release of effluent. Scientific studies have also shown high levels of pharmaceutical residues in surface and ground water systems near drug manufacturing facilities.

Compared to the risks of antimicrobial resistance caused by overconsumption of antibiotics, the role of waste and wastewater emissions from pharmaceutical production is less understood and remains insufficiently addressed. But to stand a fighting chance against resistant bacteria, we need swift action to curb all drivers of AMR, including the pollution from pharma production.

Attitudes are however changing compared to when SIWI first started to promote safer antibiotic manufacturing. One interesting example is India, where RAMP was first launched. As one of the world’s major antibiotic producers, India is among the countries most impacted by emissions from manufacturing facilities. This, in combination with excessive use of antibiotics, has led to extreme levels of antimicrobial resistance. In response to this, India in 2017 launched an ambitious National Action Plan on Antimicrobial Resistance and could now become the first country in the world to regulate industrial effluents of antibiotics. The country’s Ministry of Environment, Forest and Climate Change (MoEFCC) recently announced a draft notification on environmental standards for bulk drug and formulation (pharmaceutical) industry.

Other positive developments include how the progressive part of the pharmaceutical industry has formed the AMR Industry Alliance and started to develop voluntary standards for responsible antibiotics manufacturing, including a Common Antibiotics Manufacturing Framework. Countries like Sweden and Norway, as well as the UN Initiative on Sustainable Procurement in the Health Sector, have begun requesting information about how antibiotics are produced in their procurements.

The RAMP project builds on these experiences but with a broader approach, so that the many disparate voices advocating for sustainable manufacturing can join forces and effect real change.

Join RAMP!

RAMP brings together procurers, regulators, and companies to co-create a business case for sustainable manufacturing, in everybody’s long-term interest.

All partners should contribute to mutual learning and improvements:
Companies that join the platform are expected to provide information, including access to their factories.

Procurers in the platform are expected to engage in the development of procurement criteria that give companies real incentives to shift to sustainable production methods.


Quick facts about RAMP

Started: by SIWI as an inception phase during 2020. The project is expected to run 2021-23.

Partners and funders: Swiss Agency for Development and Cooperation (SDC), Centrient Pharmaceuticals, GlaxoSmithKline (GSK) and Shawview Consulting. The AMR Industry Alliance is a key technical advisor to the project.

Actions: Partners provide information, including access to their factories and insights into the procurement process., All stakeholders contribute to mutual learning and improvements. The aim is to contribute to higher standards in production, procurement, and regulations.

Vision: By 2030 the release of antibiotics to the environment from manufacturing is minimized, and broader sustainability gains have been achieved in partnership with industry and governments, international agencies and other related stakeholders to provide a competitive advantage to the implementing companies, ensuring access to functional antibiotics that have been manufactured in a manner that does not promote antimicrobial resistance.

Photo: River outside Hyderabad

In the white-paper Reducing Emissions from Antibiotic Production, you can learn more about the results of SIWI’s previous project on reducing emissions from antibiotics production REAP, in partnership with UNDP and funded by the Swedish Postcode Foundation.

Download publication

The role of pharmaceutical production for the spread of antimicrobial resistance was the theme of several articles in Stockholm WaterFront magazine 3-4 2018, with interviews with leading actors.

Download publication

The project builds to a large extent on experiences from the previous Swedish cluster group on water and pharmaceuticals, hosted by Swedish Water House, summarized in a report, policy brief and study on sustainable procurement.
Cluster group report
Policy Brief
Procurement study

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