A 24-year-old American University of Antigua (AUA) student is bringing attention to a critical global health concern that she calls “a little silent killer moving through our communities”: the growing crisis of antibiotic resistance linked to pharmaceutical pollution.
The student, Nathalie Camacho, has presented her research on antibiotic resistance at both the International Young Researchers Symposium in Germany and Antigua and Barbuda’s Chemical Control Week, receiving publication in a German medical journal.
“When you really start to dig deeper and see where the proliferation is coming from, you start to notice that it’s on the pollution of the pharmaceutical factories,” she explains. “I saw a gap in how much studies are done tracking this.”
Her research highlights how pharmaceutical waste management practices contribute to the development of antibiotic-resistant bacteria, often referred to as “superbugs.”
“They’re making these drugs, these pharma drugs, these antibiotics, and when they’re done, they release into the atmosphere, into their aquifers, their water reservoirs, all of the water that they used to make said drugs,” she explains. “This water is heavily contaminated with those drugs.”
The consequences of this pollution extend far beyond the immediate environment surrounding these factories. According to her research, the contamination enters the food chain through multiple pathways.
The research estimates that antibiotic-resistant illnesses (ARI) will cause not only 10 million deaths by 2050 but also potential GDP losses of up to $100 trillion, according to Reuters data cited in her work.
Her comprehensive study examined pharmaceutical pollution across multiple regions with alarming findings. In the USA (Midwest and Northeast regions), researchers identified elevated concentrations of azithromycin, ciprofloxacin, sulfamethoxazole, and trimethoprim. European studies of the Danube River revealed 7 different antibiotic-resistant bacteria across a 2,311 km stretch.
Italian research discovered 258 active pharmaceutical ingredients in rivers with 7-14 tons discharged annually. Chinese factory studies identified 1,043 viral operational taxonomic units, with 27 resistant genes, 9 of which correlated with 16 highly infectious clinical illnesses.
“Bacteria is very very smart. Bacteria is always trying to learn how to overcome whatever system it’s invading to get stronger,” she says. Her research explains the specific mechanisms through which bacteria develop resistance: genetic mutations allowing bacteria to analyse and render antibiotics ineffective, Horizontal Gene Transfer (HGT) where bacteria acquire resistance genes, and biofilm formation that protects bacteria by reducing antibiotic penetration.
“When you have a giant aquifer right outside of a chemical plant with vast amounts of concentration of antibiotics, everything is going to soak that water—the soil, the air, the animals.”
The research documents antibiotic-resistant genes (ARGs) in multiple environments beyond water, including wildlife (48 multi-drug-resistant genes found in 24 parrots; 8-10 ARG compounds in Chilean fish), office spaces (higher Colony Forming Units of ARGs in air samples), beaches (microplastics in sand harbouring distinct bacterial communities), soil where food is grown, and air in common places.
What makes this issue particularly concerning is the lack of regulatory oversight. “Only eight of these large pharmaceutical factories actually set regulations on how much antibiotics can be found specifically in the wastewater,” she notes. “When we talk about regulations, there’s little to none.”
Her research confirms that manufacturing plants are predominantly located in lower socioeconomic areas with lax regulations for waste management.
The implications are dire, with projections showing substantial future mortality rates. “By 2050, there’ll be 10 million deaths worldwide. That’s surmountable up to cancer,” she warns. “This is this other topic that’s preventable… and it’s going to equal to the same amount of death.”
The researcher also points to everyday practices that exacerbate the problem. “We have this great habit of just going to the doctor and getting antibiotics for anything and stopping them when we feel better,” she observes. “We are undermining the power of antibiotics and the power of those drugs that we’re putting in our body.”
Her proposed solutions include water reuse in pharmaceutical manufacturing, advanced filtration systems using gravel, sand, soil, and soil+biochar combinations, global standards for contaminant levels, greater transparency and accountability between pharmaceutical companies and governing bodies, and governmental regulations wherever these large pharmaceutical factories exist in the highest concentrations.
The research explicitly frames antibiotic resistance as an issue affecting humans, animals, and the environment simultaneously, requiring an integrated “One Health” approach to solutions.
Despite the scale of the challenge, she remains hopeful that awareness can drive change. “I think there’s great power in public awareness of these kinds of issues. And I think only through our general knowledge, we are able to impact some kind of change hopefully in the future more globally.”
The Cuban-American researcher, who would be the first doctor in her family, intends to continue her advocacy work. “I want to continue to talk about this topic because we need more research. I would love to see more research done here in Antigua.”
