NHS Scotland’s Climate Emergency and Sustainability strategy (2022-2026) includes pharmaceuticals and medicines waste under the sustainable care priority area – highlighting the social, environmental, and climate benefits from changing prescribing behaviour and reducing waste. The draft strategy was released during the NHS Scotland sustainability conference (November 10th), and is open for consultation until February 10th 2022.
The strategy sets out new targets for NHS Scotland achieving net-zero emissions (by 2040), but also draws into sharp focus the connection between the climate emergency, biodiversity loss, and human health – and pharmaceutical pollution and medicines waste are at the heart of this.
In the Introduction, the strategy states: “many actions needed in response to the climate emergency and the environmental crisis have positive health impacts… Eliminating pharmaceutical residues from wastewater prevents harm to biodiversity and limits the growth in antimicrobial resistant bacteria, one of the most serious threats to our ability to treat illness.” – Introduction, page 1, paragraph 3
Under the Sustainable Care priority area – Medicines (pgs 51 & 52), the strategy highlights the environmental impact of pharmaceutical production and use. Approximately 80% of the health service’s carbon footprint is due to prescribing, however pharmaceutical waste can also cause significant ecotoxicological effects in the natural environment.
Following excretion (or disposal), pharmaceutical residues enter wastewater, and are unable to be completely removed from wastewater prior to discharge into surface water. Environmental effects from pharmaceutical pollution include behavioural changes, reduced fertility and reproductive failure, developmental defects, and growth inhibition in aquatic species – and can also contribute to the development and spread of antimicrobial resistance in bacteria.
Actions NHS Scotland will take to reduce the environmental harm caused by medicines:
- Work to reduce pharmaceutical waste through improved prescribing, dispending, and patient support
- Support clinicians to consider environmental impacts when making prescribing decisions by providing them with information they need
The strategy also highlights the multiple carbon benefits from reducing pharmaceutical waste. Including reduced emissions in up-stream manufacturing and distribution, and down-stream in waste disposal.
It is evident that pharmaceutical pollution is a serious global public health and environmental issue – that is intrinsically linked to the climate and biodiversity emergencies. This is a complex issue spanning many sectors, and thus requires cross-sector partnership working to develop sustainable solutions. The OHBP is one such group that is advancing the field.
You can find the draft strategy here: https://www.gov.scot/publications/nhs-scotland-draft-climate-emergency-sustainability-strategy/