Sustainable procurement of pharmaceuticals: a tool to combat global antimicrobial resistance

Research output: Contribution to book/anthology/report/proceedingBook chapterResearchpeer-review


The ability of humans to fight bacterial infections has been a success story. Combined with the improvements in access to treatment, it induced an increase in antimicrobials’ use. While improving the health and life of patients, we have been side-tracking the threat of developing antimicrobial-resistant bacteria when treatments enter the natural environment. Nowadays, due to the number of deaths associated with antimicrobial resistance (AMR) and its economic consequences, both states and international organizations are developing policies and tools to address it. The toolbox includes raising public awareness, supporting reasonable use, and measures concerning pharmaceutical waste. While of utmost importance, these measures fight AMR primarily at the locus of the medicines’ use, omitting the problem of dangerous effluents from pharmaceutical manufacturing. The present chapter addresses this gap first by discussing the need for governance by contract in the AMR context. Then, taking the starting point in the EU law, it reviews the use of sustainable public procurement as a tool to fight global AMR. It then presents lessons from private responsible procurement before turning to the possibility of mutual learning between ‘developing, but authoritative’ public and ‘more experienced, but based on voluntary participation’ private sustainable procurement practices. The chapter argues that the use of sustainable procurement as a part of the global governance regime for combatting AMR has a lot of potential, but it requires both legislative changes, and intensified cooperation between the private and public sectors. The chapter concludes with reviewing policy implications for the use of contractual governance to contain AMR.

Original languageEnglish
Title of host publicationSteering against Superbugs : The Global Governance of Antimicrobial Resistance
EditorsOlivier Rubin, Erik Baekkeskov, Louise Munkholm
Number of pages14
Place of publicationOxford
PublisherOxford University Press
Publication date2023
ISBN (Print)9780192899477
Publication statusPublished - 2023


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