By Athanasia Kanli and colleague Dr Dale Iddon, HSE Consultant, Global Health, Safety and Environmental
10 years ago, if somebody told you it was possible to test sewage for by-products of illegal drug use, it might have seemed like science fiction. Today, police can pinpoint their drug fighting efforts on specific neighbourhoods. Well, in similar ways we can now test for traces of medicines in surface waters. And Europe is trying to harness that knowledge.
The European Commission is currently drawing up a strategy document outlining ideas for new ways to assess the impact of pharmaceuticals in the environment (PiE). Both cases – the Commission strategy and the police investigations on drug use – rely on the principle that what we ingest passes through the natural digestion process and can be found in waste water and sewage. They also illustrate that technology has allowed for lower concentrations to be detected normally now at parts per trillion levels. With better detection, we are better informed to address questions about the presence of trace residues in surface waters. Armed with this new knowledge about pharmaceuticals in the environment, the Commission is looking into individual and collective measures to manage any potential impact of PiE throughout the medicines’ lifecycle.
As in any environmental cycle, there is a shared responsibility between all the actors involved. For example, roughly 50% of unused medicine packages are not collected via pharmacies in the EU and could be disposed of improperly, say, flushed down the drain. Many patients are unaware of the ways of proper disposal. Raising awareness around proper disposal requires collective action, in which pharmacists have an important role to play. It is therefore no surprise that, in their annual meeting taking place this week (29 September – 3 October), the International Pharmaceutical Federation (FIP) will devote a session to green pharmacy practices.
Other efforts are afoot to manage these environmental challenges. Many pharmaceutical companies, including us here at Lilly, are adopting a responsible approach in our manufacturing processes and effluents management whilst moving to “green chemistry” solutions. We’ve even been winning awards for greening our manufacturing. These allow for a more efficient production of medicines by reducing the environmental footprint of manufacturing sites, but also hold the potential of designing medicines that act in a more targeted way or that are more biodegradable.
Moreover, Lilly is involved in the iPiE (Intelligence-led Assessment of Pharmaceuticals in the Environment) project of the Innovative Medicines Initiative (IMI). This multi-stakeholder project aims at developing and validating models to identify and prioritize legacy products for more in-depth environmental risk assessment. The iPIE project is one of the efforts our industry is undertaking so as to deliver on the Eco-Pharmaco-Stewardship (EPS) concept. EPS is the pharmaceutical industry’s proposal on improving the way environmental concerns are managed without jeopardising patient access to medicine, as well as the effectiveness and potency of medicines, which is what makes them medicines after all.
This topic will continue to be debated in Brussels and beyond. We are looking forward to hearing the discussion at the gathering of pharmacists next week and to an exchange of views with the European Commission and European water professionals in November at the annual 11th EWA Brussels Conference on "Water Challenges in Europe". As all actors strive to find solutions, it will be important that the new EU strategy connects the dots with existing initiatives around PiE and the importance of raising patient awareness.