Throwing away medicines? Maharashtra’s new plan says that habit could be deadly

As part of the plan, the state has initiated a baseline assessment to map household level practices around antibiotic use and disposal. Officials have also conducted sensitisation programmes for district level AMR nodal officers, microbiologists, and medical officers to strengthen stewardship.

Public health experts have long flagged overuse and misuse of antibiotics as key drivers of AMR, but growing evidence now points to pharmaceutical waste as an equally critical concern. Expired or unused medicines, when discarded in garbage, drains, or by burning, release active compounds into the environment.

A study in India found that 87 per cent of people store unused medicines at home, while 93 per cent eventually discard them improperly with little awareness of the risks.

“Behaviour change is key. Safe antibiotic disposal must become a routine practice at the community level,” said Dr Kailas Baviskar, Deputy Director, Information, Education and Communication Bureau, Department of Public Health, Maharashtra.

Improper disposal also reflects systemic inefficiencies such as over prescription, incomplete treatment courses, and frequent medication changes, leading to wastage and potential shortages.

Despite rules governing biomedical waste disposal in hospitals and pharmacies, India lacks a consumer facing system to return unused drugs, leaving households without clear guidance.

Kerala’s ‘nPROUD’ programme which uses drop boxes and collection drives is being looked at as a possible model, though awareness remains limited.

“Maharashtra aims to lead by example in combating antimicrobial resistance by integrating safe antibiotic disposal into routine public health systems. Through this initiative, we hope to build scalable models that contribute to India’s broader AMR strategy,” said Dr Sunita Golhait, Joint Director, Hospital Administration.

The state has also launched an AMR Safe Disposal Innovation Challenge, inviting startups, students, and public health innovators to develop field ready solutions, with selected ideas to be piloted at the district level.

“By the time over the counter sale of antibiotics without prescriptions is fully stopped, it may be too late to undo the resistance that has already built up. We cannot simply wait and watch. Tackling antibiotic waste appropriately is something that can begin immediately, and that is precisely what this initiative sets out to do,” said Dr Ankur Mutreja of PATH.