Published in The Lancet - Planetary Health - FREE DOWNLOAD
ALL AUTHORS: Kelly Thornber, Matthew Bentham, Sharon Pfleger, Claas Kirchhelle, Fiona Adshead, Stewart Owen, Hayden Holmes, A Ross Brown, Caroline Farmer, Min Na Eii, Lydia Niemi, Lara Wöhler, Edward C F Wilson, Matthew J Wade, Wendy Tyler-Batt, Matthew Taylor, Georgina Sowman, Paul Southall, Richard Smith, Carol Routledge, John Redshaw, Emma Pitchforth, Melissa Pegg, Keith Moore, George Kirkham, Barbara Kasprzyk-Hordern, Karin Helwig, Stuart Gibb, Lora E Fleming, Sean Comber, Rob Collins, Heather Brown, Sinead Brophy, Richard E Brazier, Hannah Blitzer, Julie Barnett, Rosalie Arendt, Julius Cesar Alejandre, Charles R Tyle
Human pharmaceuticals are increasingly detected in environments around the world, with growing international calls to mitigate the ecological and human health risks posed by these novel entities. Exposure to pharmaceutical pollutants can negatively affect the behaviour, reproduction, and health of wildlife, contributing towards declining ecological health and global biodiversity loss. Pharmaceuticals in the environment are also driving rising levels of antimicrobial resistance, a major public health threat. Developing strategies to mitigate these public and environmental health risks has been greatly limited by diverse and often conflicting stakeholder interests and the need to retain the major human health and socioeconomic benefits that pharmaceuticals provide. In this Personal View, we propose a multistakeholder, systems-based approach for high-income countries to develop transformational national mitigation strategies. Applying this approach to a UK case study highlighted the growing risks caused by the unsustainability of the current UK health-care pharmaceutical system and enabled us to identify 37 synergistic intervention points that target both the tangible easy wins and the deep-rooted social drivers of the issue. We believe our approach will support high-income countries in minimising the public and environmental health risks associated with pharmaceutical pollution, by driving long-term sustainability across the pharmaceutical lifecycle, for a positive pharmaceutical future.
