The summary report of the FEAM Forum event on Pharmaceuticals in the Environment, organised with the support of the Federation of Veterinarians of Europe (FVE) and the European Federation of Pharmaceutical Industries and Associations (EFPIA), is now available.
The document published today (2 May) gathers the conclusions from the discussion with expert policy makers, academics, industry and civil society representatives and contains six practical recommendations on how to better manage and reduce the waste of drugs in the environment:
1- Education and training
The overconsumption of pharmaceuticals is a huge source of waste. This can be greatly alleviated by increasing both public and healthcare professionals’ awareness of prudent medicine use. For example, personalised medicine, such as prescription requirements, can certainly help to limit waste. Furthermore, educating patients on what to do with their expired or unused medicine, and when to return it, would also help. Finally, training in the concept of ‘One Health’ should be developed further for patients and medical professionals.
2- Greener Manufacturing
The pharmaceutical industry can play a major role by designing more environmentally friendly alternatives. For example, MITHRA pharmaceuticals have produced an Estetrol (E4), which is a natural oestrogen used as an alternative to the synthetic version present in contraceptives. The results strongly indicate that E4 induces much fewer endocrine-disrupting effects on aquatic organisms, therefore this is an excellent example of a greener manufacturing alternative.
3- Better waste management
Urban wastewater treatment plants are not designed to remove micropollutants. Increasing the efficiency of wastewater treatment would be very costly and energy-intensive, but maybe necessary based on a cost-benefit analysis, at least in some cases as for pharmaceutical factories, and only as a complement to source-directed and use-orientated measures. The European Commission is hoping to alter the legislation on wastewater treatment to include a mechanism which ensures a fair contribution of the industry according to the polluter pays principle.
4- Strengthening environmental risk assessments
There is a limited scope of environmental risk assessment for pharmaceuticals. The current European guidelines were only introduced in 2005 for veterinary medicines and 2006 for human medicines, and they did not apply retroactively. In Germany, for example, environmental data is only available for around 40 percent of the pharmaceutical ingredients found in surface water.
5- Greater transparency
There is a need for greater transparency and a stronger legislative framework to regulate pharmaceutical production. Over 80 percent of the manufacturing of Western antibiotic demand takes place in India and China, yet there is a blatant lack of transparency within the supply chains that makes it difficult to hold the pharmaceutical industry accountable for the emissions of pharmaceutical residues that can occur during the manufacturing processes.
6- One Health Approach
The health of animals, humans, and the environment are interconnected. Environmental health contributes to public health and animal health and vice-versa. Therefore, at the heart of all joint efforts should be a ‘One Health’ mindset to tackle pharmaceutical waste at all stages of the life cycle to enhance human, animal, and environmental health.