Introduction:
Medicines are crucial tools to prevent or treat diseases, but there is growing evidence that residuals of pharmaceuticals can also be found in the water, atmosphere or soil, with possibly negative impact on the environment and health. Similarly, activities associated with the research, development, production, distribution and dispensing of medicines may also have an impact on the environment.
Such impact is influenced by changes observed globally in population demographics, migration and urbanisation among others.
It is critical that efforts to implement solutions do not compromise the availability of medicines and patient access to these medicines. Patient needs are of utmost importance.
The impact of pharmaceuticals on the environment is a challenge of global significance, and one in which individual pharmacists and professional associations can provide leadership that makes a difference. Throughout the pharmaceuticals supply chain efforts can be made to mitigate the negative impact of pharmaceuticals and related activities on the environment.
To make this difference it is important that pharmacists accept professional responsibility for the entire medicines-use process and take responsibility for mitigating the environmental risk of the medicines for which we are responsible. This responsibility extends across the entire medicines-use continuum, from manufacturing and distribution, prescribing, dispensing, pharmaceutical care, disposal of unused medicines and, ultimately, to the reduction in the discharge of metabolic waste into the environment. In all countries, regardless of place of employment or practice, pharmacists should seek to change the medicines-use process so as to minimise the adverse environmental effects of medicines and related activities.
By recognising the pharmacist’s role in, and accepting as the profession’s challenge, the reduction of medicines in the environment, our profession can provide meaningful leadership in an area that is virtually devoid of leadership. FIP believes that pharmacists and their associations are well positioned to provide the needed leadership in resolving many of the issues surrounding pharmaceuticals and the environment.
Against this background FIP recommends that:
Environmental effects of pharmaceuticals are considered in:
- Pharmacy school/college curricula
- The research, development, manufacturing and marketing of medicines
- The administrative and legislative processes regulating medicines
- All pharmacist practice areas
FIP member organisations:
- Lead in raising public awareness as well as that of other health care professionals of this issue.
- Provide leadership to their membership and governments in resolving the environmental issues surrounding medicines and their use.
- Develop and promote the use of “green-office” concepts for practices.
- Promote consumer- and practice-friendly pharmaceutical-waste disposal, including supporting take-back programmes and/or legislation that do not place the financial burden in pharmacy practices.
Schools of pharmacy:
- Teach green principles and pharmacist’s responsibility to educate patients on waste disposal as elements of pharmaceutical-care practice, and how to apply these.
Pharmacists:
- Implement green chemistry practices in all research and manufacturing and compounding processes.
- Collaborate with prescribers to raise awareness of the environmental classifications of medicines in their practices, where available.
- Adopt environmentally friendly procedures in procurement and distribution processes.
- Work with allied health professions to encourage rational prescribing practices such as starter doses (and limiting the number of doses prescribed and dispensed) to reasonable amounts.
- Work to incorporate counselling on the environmental impact and potential risks of all medicines as an integral part of medical and pharmacy practices.
- Recognise the contribution of non-adherence to prescribed regimens to the production of medicines waste.
Governments:
- Incorporate appropriate environmental risk assessments as part of the registration/approval process to assure proper handling of all medicines.
- Promote the global availability of environmental hazard data on medicines and support the development of national programmes on environmental-risk classification of pharmaceuticals.
Support the development of environmentally friendly practices in pharmacies aimed at limiting environmental hazards due to medicines.