In 1986, Citizens against Pollution (CAP) launched the Patancheru Anti Pollution Committee. The following year, nearly 2,000 people marched 40km from Patancheru to the Andhra Pradesh State Assembly and presented a list of demands to then Chief Minster N. T. Rama Rao. Another high point of this conflict was in July 27, 2005 when Greenpeace activists delivered bucket-loads of toxic sludge from the industrial estates in Medak district to the office of the Andhra Pradesh Pollution Control Board (APPCB) in Hyderabad.
Unfurling a banner demanding that the APPCB 'Protect our Lives, Not the Polluters', the activists spread the sludge across the doorstep of the office to expose the Board's inability to deal with the chemical contamination that the local population has to face everyday. After five hours of protest, the APPCB Member Secretary met the activists along with the pollution-affected villagers, admitted the severity of the pollution and offered to discuss possible solutions to the problem. In October 2004, Greenpeace had released an epidemiological report on 'The State of Community Health at Medak District'. The study, encompassing a large sample of 10,874 people, shows an overwhelming increase in most types of systemic diseases across the study group. The background to such protests goes back to the 1980s when the Government of Andhra Pradesh encouraged the installation of medium and large industries, becoming in the nineties the second state of India for number of registered factories. The Medak district holds 40% of the industries of Andhra Pradesh and is one of the most industrialized of all India. Most of the industries are chemical and pharmaceutical. There are more than 90 Industries involved in pollution, the main ones for water pollution are: Sai Baba Cellulose, Bollaram Industrial Estate, Paks Trade Centre. For air pollution: Voltas Limited, Qure Drugs, Hindustan Fluorocarbons, Andhra Pradesh Metallurgical Eng, Chadra Pharmaceuticals. The industrial waste (treated and untreated) is discharged outside the industrial area polluting the groundwater. Much of polluted water ends up in the Nakka Vagu creek which in turn flows into the river Godavari, the second longest river India. The pollution of groundwater affect directly natural resources and consequently the health of people, their work and the food chain, in fact Nakka Vagu is the lifeblood of farmers, herders and fishermen who live in the villages affected by pollution along the Nakka Vagu. The water cannot be used for irrigation of the fields anymore.
Isnapur Lake also lake receives waste flowing in through open nallahs from the Patancheru Industrial Area. Air pollution is significant mainly because of the gases released by the chemical industries. Air and water pollution has a direct impact on crops (reduction and quality of production) on livestock (quantity and quality of milk, death of thousands of animals) on fishing and on human health. Despite the representation in the Court by the farmers themselves, a Division Bench on technical ground opened all closed industries. Disheartened by this, the farmers decided to approach the Supreme Court, after a long battle of 5 year, the Supreme Court delivered interim orders- an historical judgment. It had ordered the National Environmental Engineering Research Institute (NEERI), to study the impact of industrial pollution in this area. Subsequently, NEERI submitted a report. This report acknowledging the problem of pollution, suggested a compensation to be paid to the affected people affected. In addition to this, other benefits, which resulted from people’s participation are the following interim orders given by the Supreme Court of India at various times: stoppage of effluent flow into water bodies immediately, provide drinking water to the affected villages, restoration of cultivable land by application of suitable conditioner, remedial action in respect of 13 Tanks, rectification of CETP, discharge of treated effluents into sewer line, medical care to pollution victims.... The situation is not good. In 2012, the Citizens Forum for Better Patancheru Constituency went to the Andhra Pradesh High Court highlighting the plight of villagers in Kazipally, Sultanpur and 15 surrounding villages on the banks of the Nakka Vagu River as a result of pollution from bulk drug manufacturing industry. In 2013, they filed a complaint regarding bulk drug manufacturers in Patancheru-Bollaram before the National Green Tribunal (NGT) in Chennai.
A report of 2016 (Nordea) that focuses on the Patancheru area among other clusters of the pharmaceutical industry, states that "inhabitants living and working in the vicinity of drug manufacturing units in Hyderabad, Visakhapatnam, and other locations have borne the brunt of this. It has affected their livelihoods in the form of livestock deaths and decreased agricultural yields, and damaged their health, with reported impacts ranging from higher abortion rates to birth defects and stunted growth in children, as well as greater incidence of skin diseases".