THE United Nations has recently declared ​antimicrobial resistance, or the resistance of viruses, bacteria, fungi and parasites to medicines designed to kill them, as a major health problem, estimating that infections from these drug-resistant microbes could kill up to 10 million people annually and cost the global economy $412 billion a year by 2050. This is according to an in-depth report by the German network Deutsche Welle (DW) at the end of last month, and within that report, there is a rather alarming finding. According to the scientific study cited by DW, one that was first conducted in 2022 and updated in 2025, the Philippines is among the countries with the highest amount of pharmaceutical contamination in its waters.

Antimicrobial resistance happens in two ways. The first is from over-prescription or overuse of antimicrobial medicines, usually antibiotics intended to fight bacterial infections. A common example of this is the taking of antibiotics to fight cold or flu-like illnesses. In most cases, these are caused by viruses that are not at all affected by antibiotics, with the result being that the illness is not relieved in any way, except perhaps through the placebo effect, while the bacteria in one’s system are able to evolve to resist the antibiotic.

Pharmaceutical pollution

The second and more pernicious way that antimicrobial resistance is growing stronger is through contamination of water and soil. The study cited by the DW report, titled “Pharmaceutical pollution of the world’s rivers,” was carried out in 2021–2022, and surveyed more than 1,000 sites in 104 countries, testing for 61 different kinds of common pharmaceutical compounds. The study, which can be found in the journal PNAS, was later updated to include additional data. There were two sites in the Philippines that were tested, both in the Pasig River drainage system around Metro Manila.

The study found that, out of all the testing locations, only two — one in Iceland, and one in a remote part of Venezuela inhabited only by native people who had no exposure to modern medicine — were completely free of pharmaceutical contamination. The Philippines, although not the highest on the list of contaminated countries (that dubious honor went to Pakistan), ranked in the 78th percentile of contaminated countries, meaning that the pharmaceutical contamination here is higher than 78 percent, or 81 other countries (out of 104) in the study.

The water and soil contamination comes from two different sources. First, there is the use of medicines by people. When a person takes an antibiotic or other antimicrobial medicine, most of it is actually excreted by the body’s digestive system. This then passes into wastewater, and even if that wastewater is treated, the pharmaceutical chemicals are not removed, and subsequently pass into rivers and groundwater. Second, the heavy use of antibiotics in agriculture, mostly for cattle, pigs, chickens, goats, fish ​and other food animals, means that huge amounts are finding their way into waters via that route. Then, when farmers use animal manure for fertilizer or irrigate their crops with pharmaceutical-contaminated water, these chemicals pass into the food that we eat, and the cycle begins again.

To the government’s credit, the Department of Health along with the Food and Drug Administration have exerted a great deal of effort over the past several years to curb the excessive and irresponsible use of antibiotics, and that does help to reduce the risk of antimicrobial resistant infections. However, there has been very little effort along the same lines by the Department of Agriculture and related agencies with respect to the farming sector, and that may be a bigger problem. While it is understandable that safe food production should be prioritized, particularly in the face of continuing threats such as the African swine fever and bird flu, the longer-term risks to human health must be taken into account.

There is promising research being conducted into “safer” antibiotics for both human and animal use, compounds that will degrade into harmless chemical components after they pass through the body’s system and prevent microbes from developing drug resistance. That research, however, is only in the earliest stages of development, and might take a decade or more to reach the market. In the meantime, the government, and health and agricultural stakeholders need to think deeply and judiciously about the use of antimicrobial medicines, and consider the longer-term unintended consequences.