Consumer watchdog SumOfUs.org has released a new report exposing the link between several multinational drug companies — including major industry leaders such as  Pfizer — and Chinese factories, which are dangerously contributing to antimicrobial resistance (AMR) by improperly disposing of their pharmaceutical waste.

Antimicrobial resistance occurs when bacteria become resistant to certain types of antibiotics and could potentially render treatments for highly contagious illnesses like gonorrhoea and pneumonia ineffective. The World Health Organization and many international governments have singled out AMR as a major threat to global public health.

The report from SumOfUs.org reveals that Pfizer is among the well-known brand names that have sourced antibiotics from a polluting Chinese factory. It further reveals links between three polluting Chinese companies and one of the world’s largest generic drug manufacturers, McKesson, which owns several European brands (Lloyds Pharmacy in the UK, Ireland, France and Sweden, Celesio in Germany and OCP in France and Portugal). The world’s largest generics manufacturer, Israeli company Teva, which has a presence in over 60 countries, was also found to be sourcing antibiotics from several polluting factories.

The findings, which uncover a complex and murky web of commercial relationships between Chinese producers, Indian middlemen, and trusted global brands, is based on customs data, import licenses, databases and company financial and legal documents, reports from regulatory bodies in several countries and first-hand evidence obtained from an undercover investigation in China.

In September 2014, President Obama launched a National Strategy for Combating Antibiotic-Resistant Bacteria. According to the Centers for Disease Control and Prevention (CDC), antibiotic-resistant infections are associated with 23,000 deaths and 2 million illnesses in the United States each year.  Estimates of annual impact of antibiotic-resistant infections on the US economy vary but have ranged as high as $20 billion in excess direct healthcare costs, and as much as $35 billion in lost productivity from hospitalizations and sick days.

According to studies by UK Government-sponsored Review on Antimicrobial Resistance, AMR could result in up to 10 million deaths and a loss of up to US$100 trillion worth of economic output between now and mid-century if it is not addressed. The UK’s Chief Medical Officer Dame Sally Davies has spoken of the “catastrophic threat” posed by AMR and called for global action to address this problem.

The main causes of AMR are overprescription and misuse of drugs in humans and over consumption in industrial animal farming, where antibiotics are routinely given to animals as growth promoters or to prevent disease. Today’s report reveals a new, so-far overlooked cause of AMR: dirty and irresponsible production methods which lead to the dumping of large quantities of antibiotic effluent in the environment and the proliferation of resistant bacteria in land and waterways surrounding production sites.

SumOfUs’ report calls on pharmaceutical companies to embrace transparency throughout their supply chains and to immediately stop purchasing active pharmaceutical ingredients (APIs), the raw materials used to make antibiotics, from polluting factories.

“This is a huge problem with a simple solution: Pharmaceutical companies must reveal where they source their antibiotics from and stop buying from polluting factories” explained Paul Ferris, Campaign Director for SumOfUs.org  “Good environmental stewardship and health are intrinsically linked: dumping antibiotics in the environment could be harming the health of everyone on this planet.”