Waste-ing antibiotics: Antimicrobial resistance, environmental pollution and unsettled science in the governance of pharmaceutical manufacturing

This paper examines how scientific evidence is used—and contested—in regulating environmental drivers of antimicrobial resistance (AMR), focusing on efforts by the Government of India to control antibiotic pollution from pharmaceutical manufacturing. Drawing on qualitative research, legal cases, and stakeholder perspectives, it shows that “unsettled” science leads to conflicting interpretations among regulators, industry, civil society, and courts, often reflecting underlying economic and social interests. The study highlights tensions between enabling industrial production and protecting environmental and public health, and argues that reliance on conventional, threshold-based regulatory approaches is inadequate for AMR, where toxicity and risk are uncertain and diffuse. Overall, it underscores how scientific uncertainty, institutional structures, and issues of environmental justice complicate effective governance of AMR-related pollution.