Maya recently highlighted how production of inexpensive meat, bolstered by widespread use of antibiotics to keep farmed animals from developing infections, may indirectly cause humans substantial harm through the development of antibiotic resistance. These animal farming operations, as well as our own healthcare systems, rely on antibiotics to be available at fairly low prices. It turns out that many of these drugs are imported from manufacturers who don't seem to mind threatening human health and causing serious environmental damage in the production of their low-price medicines.

In Hyderabad, India, pharmaceutical wastewater flowing into streams was recently found to contain enough of the antibiotic ciprofloxacin to treat 45,000 people each day, the highest drug levels ever detected in the environment. The pollution, a byproduct of pharmaceutical plants in the area, many of which export drugs to the United States at low cost, was associated with serious developmental problems in tadpoles and zebrafish in the area, and local physicians have indicated that the constant exposure to pharmaceuticals in the area has made infections in humans more difficult to treat, as local bacteria have developed antibiotic resistance. The full effects of these enormous levels of pharmaceutical pollution, both locally and to larger ecological systems, both short- and long-term are not known, although it is clear from these reports that this inexpensive production of antibiotics carries serious clinical and environmental costs that are not being incorporated into the costs of the drugs themselves.

Pharmaceutical production in India is largely a product of demand in other markets, and the US is the largest importer of Indian drugs, with $1.7 billion spent on Indian pharmaceuticals in 2007. Extending the Cure frames antibiotic use as a shared resource problem, because individuals using antibiotics do not bear the full societal costs of their use -- in particular the costs associated with the emergence of antibiotic resistant strains of bacteria. These reports of antibiotic pollution in India highlight that the problem is not confined to end use of antibiotics. Demand for cheap antibiotics in other markets drives a substantial share of pharmaceutical production in India. This production in India appears to be able to supply these antibiotics cheaply at the cost of surrounding ecological systems. Inexpensive antibiotic production may not only encourage overuse of the end product -- whether in human medicine or animal farming operations -- but also itself contribute to the problem of antibiotic resistance through inefficient, negligent production processes.