We, the signatories of this declaration, recognise and understand the concerns regarding the presence of pharmaceuticals in the environment.

We believe that these concerns can only be addressed through a dialogue with policy-makers, taking into account public health and environmental aspects, as well as their policy ramifications, and we pledge our commitment to remain open and constructive partners in this debate.

We look forward to the European Commission EU-wide strategy on pharmaceuticals in the environment. We call for a balanced approach that is mindful of the underlying essential role of medicines. We recognise that environmental protection contributes to safeguarding the health and safety of future generations; however, medicines also play a critical role in ensuring a high level of public health. As a matter of policy, we believe that any environmental-based measures should be clearly justified and guarantee patient access as well as access to the demonstrated benefits that medicines bring to public health.

We confirm our commitment to take actions in the areas where we can make a difference in order to reduce the presence of pharmaceuticals in the environment.

One such example of our commitment is the #medsdisposal campaign, a collaborative multi-stakeholder initiative aiming to raise public awareness about the correct disposal of unused and expired medicines. Around 8-10% of pharmaceutical substances in the environment originate from improperly disposed medicines - flushed down the toilet, poured into drains, or otherwise disposed inappropriately in household waste by patients or even by medical institutions [1],[2]. Educating citizens across the EU can therefore lead to a change in behaviour that can make a substantial difference.

While there is no evidence of harmful concentrations of active pharmaceutical ingredients in the European drinking water[3], we recognise that the possible impact of pharmaceuticals on the environment is generally unknown, and we support and encourage more research to identify and evaluate potential risks.

In addition, the representatives of the health sectors signing this declaration are taking additional actions in their own sectors to address the concerns around pharmaceuticals in the environment:

• The pharmaceutical industry, through AESGP, EFPIA and Medicines for Europe, has put forward the Eco-Pharmaco-Stewardship concept, an initiative aiming to effectively reduce the potential environmental risks that might result from our activities and throughout the medicinal products life- We support initiatives which aim to empower patients, and which include responsible attitudes and clear processes for disposing of unused and expired medicines. The #medsdisposal campaign provides all the right information to do so and we are fully behind the value of this very important awareness raising and education tool.

• GIRP, the European Healthcare Distribution Association, and its members in 34 European countries are strongly supporting European and national initiatives for a correct disposal of medicinal products. Healthcare distributors, in each European country, are directly involved in national waste management systems, working for a correct disposal of medicinal waste, together with their partners in the pharmaceutical value chain.

• Representatives of healthcare professionals, through CED, PGEU and EPSA, support their members by facilitating the exchange of best practices in the safe, rational and effective use of pharmaceuticals. This includes the prescribing, supply, storage, use and disposal of pharmaceuticals. Additionally, the healthcare professionals and their representative bodies engage in various public awareness and risk communication campaigns concerning the appropriate use and disposal of pharmaceuticals, for example, the annual European Antibiotics Awareness Day.

We would like to encourage more stakeholders to join and endorse the #medsdisposal campaign and pledge their commitment to address environmental concerns around pharmaceuticals. Should you be interested in doing so, do not hesitate to be in contact by email medsdisposal@gmail.com.

[1] Kümmerer, 2009: The presence of pharmaceuticals in the environment due to human use: present knowledge and future challenges. J. Environ. Manage. , 8:2354–2358.


[2] European Environmental Agency, Pharmaceuticals in the environment, 2010:

http://www.eea.europa.eu/publications/pharmaceuticals-in-the-environment-result-of-an-eea-workshop/at_download/file

[3] WHO, Pharmaceuticals in Drinking-water, 2011:

http://www.who.int/water_sanitation_health/publications/2011/pharmaceuticals_20110601.pdf