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

This paper analyses the role of scientific evidence in environmental health governance following recognition of the environment's role in the emergence of antimicrobial resistance (AMR). It recounts events surrounding the Government of India's attempt to regulate antibiotic waste in the environment from pharmaceutical manufacturing in relation to a production site in north India where occupation, living conditions, and waste disposal practices drive unequal distributions of exposure. Drawing on qualitative findings from a research study (2020-2024) together with legal records and other secondary data, we analyse interpretations of scientific evidence among government regulators, civil society organisations, antibiotic manufacturers, scientists and judicial bodies to illustrate what happens when 'unsettled' science enters the public sphere. The 'contradictory logics' at play in attempts to regulate pharmaceutical pollution while enabling industrial production are identified and uses of evidence are shown to reflect stakeholders' social and economic interests, while polity and institutional structures shape approaches to environmental justice. The paper questions the centrality of scientific evidence in adjudicating threats of uncertain toxicity and suggests that scientific indeterminacy limits public engagement in environmental health protection. While antibiotic residues have been redefined as a form of hazardous waste, threshold paradigms which impose quantified limits to regulate emissions are poorly suited to the control of AMR.