The One Health Breakthrough Partnership (OHBP) is gearing up to celebrate World Water Day on 22nd March 2023 at the Scottish national event titled ‘Accelerating Change through Partnerships and Cooperation’. The conference will focus on exploring emerging trends and opportunities for water to act as a catalyst for accelerating change through intersectoral interactions, policy, research, and innovation to safeguard water sustainability and resilience worldwide. The free hybrid event is hosted by the Hydro Nation International Centre and supported by the Scottish Government and the James Hutton Institute.
Access to safe water and sanitation is a basic human right that remains out of reach for billions of people around the world. This is why Sustainable Development Goal (SDG) 6, which aims to achieve water and sanitation for all by 2030, is so crucial. Unfortunately, global progress towards this goal has been slow, and millions of schools, businesses, healthcare centres, farms, and factories still lack access to safe water and toilets.
The rate of progress towards SDG 6 has far-reaching implications that extend beyond access to water and sanitation. Dysfunctions throughout the water cycle undermine progress on all major global issues, including health, hunger, gender equality, education, and industry. Therefore, achieving SDG 6 is not just about ensuring access to safe water and sanitation but also about addressing larger systemic issues that affect people’s lives worldwide.
In 2015, the world committed to SDG 6 as part of the 2030 Agenda, making World Water Day 2023 a crucial moment. This year marks not only the 30th anniversary of this observance but also the halfway point for the International Decade for Action, “Water for Sustainable Development” 2018-2028. This conference aims to explore emerging trends and opportunities for water to act as a catalyst for accelerating change through intersectoral interactions, policy, research, and innovation to safeguard water sustainability and resilience worldwide. It will focus on how water can act as a catalyst for change, bringing together experts from various sectors to explore emerging trends and opportunities. Through intersectoral interactions, policy, research, and innovation, the conference aims to safeguard water sustainability and resilience worldwide. The goal is to accelerate progress towards SDG 6 and address the larger systemic issues that affect people’s lives worldwide.
The aims and objectives of the pioneering OHBP align closely with those of World Water Day, with current activities contributing to the goal of sustainable development. At the conference itself Professor Sharon Pfleger, Consultant in Pharmaceutical Public Health at NHS Highland, and co-founder of the One Health Breakthrough Partnership, will be presenting a talk titled “Working together to protect the health of Scotland’s population and water environment”. The presentation will showcase how partnership working and co-operation is accelerating changes to protect our water environment. It will focus on the collaborative path and outputs that have led to eco-directed policies in Scotland and report how environmental data on medicines will be modelled alongside clinical and cost effectiveness data for the first time in Scotland and the UK, in a step towards improving medicine prescribing to reduce pharmaceutical pollution.
Medical Research Council grant
In-line with the ambition to drive water research and innovation within sustainable development , members of the OHBP including NHS Highland and UHI North Highland’s Environmental Research Institute (ERI), together with the University of Nottingham, have been awarded a £100,000 Medical Research Council grant to develop a framework for an eco-directed formulary that incorporates environmental data on medicines into the prescribing process. This ground-breaking initiative is the first of its kind in the UK and will help decision-makers take into account the environmental impact of a medicine, along with environmental monitoring data, excretion profiles, and wastewater information. Each health board has a list of preferred prescribing choices for clinicians called a formulary. Currently, these formularies consider patient safety, clinical effectiveness, and cost effectiveness, but they do not consider the environmental impact of a medicine. The research team will work in partnership with the James Hutton Institute, Scottish Water, the Scottish Environment Protection Agency (SEPA), and the University of Uppsala to embed effective cross-organisational engagement throughout this project.
Pharmaceutical pollution is a global public health and environmental issue that negatively impacts the environment through water pollution and large carbon emissions. Medicines contribute 25% of the NHS carbon footprint, exacerbating the spread of antimicrobial resistance (AMR) through the environment. Pharmaceuticals enter the water environment when people taking medicines go to the toilet, and when partially used or expired medicines are inappropriately flushed down toilets/sinks instead of being returned to a pharmacy for proper disposal. Medicines like antibiotics, anti-inflammatories, and anti-depressants have been detected in rivers and lochs in Scotland. The wastewater treatment facilities were not designed to remove such pollutants from wastewater, and medicines may have biological effects on aquatic life.
With this funding, the research team and partners will adopt a novel, trans-disciplinary approach integrating public health, prescribing, environmental science, and social science methods and data. A framework will be developed to help decision makers take account of the environmental impact of a medicine, along with environmental monitoring data, excretion profiles, and wastewater information (e.g., how much gets removed during wastewater treatment). The framework will enable better informed and more sustainable prescribing choices, while at the same time ensuring the chosen medicines will result in the desired clinical outcomes.
The framework developed will enable better-informed and more sustainable prescribing choices, ensuring the chosen medicines result in the desired clinical outcomes. This project is the first step towards improvement of medicine prescribing in Scotland to reduce pharmaceutical pollution. The research will generate new knowledge sharing and awareness of the environmental impact of medicines, and help develop new solutions to complex sustainability issues while benefitting the NHS, prescribers, patients, and the environment we rely on.
For more information, please visit the project page
Data visualisation tool
The OHBP has developed and launched a data visualisation tool that aligns with the ambition of the Scottish World Water Day conference to developing intersectoral interactions and help safeguard water sustainability. Known as ‘Pharmaceuticals in the Water Environment,’ Scotland’s first open-access interactive tool designed to help reduce the impact of pharmaceuticals on the water environment has been launched by SEPA on behalf of the OHBP. It combines environmental and prescribing data, including data for 60 medicines detected in river water, raw wastewater and treated wastewater. The tool will be used by researchers, academics, health professionals and environmental scientists to help them better understand the relationship between medicine use and the presence of pharmaceuticals in the environment.
Pharmaceuticals primarily enter the water environment through toilets and can affect aquatic life and contribute to the spread of antibiotic resistance in people. The tool will be used to identify and prioritise the medicines that pose the greatest risks to Scotland’s water environments and explore ways in which such information might be used to inform prescribing of medicines or future regulatory standards. It will also guide monitoring efforts as the group continues to improve understanding of the environmental occurrence and impact of these pollutants. Scottish Water is working on the Chemicals Investigation Programme Scotland (CIP Scotland), identifying chemicals of concern, including pharmaceuticals, and their sources, to improve the removal of these pollutants.
A key part of reducing the quantity of pharmaceuticals that enter sewerage systems is through educating people about the possible environmental effects of what they stock in their medicine cabinet and encouraging them to return unused medicines to pharmacies for proper disposal. Pharmaceuticals in the water environment is a global environmental issue, and it is hoped that this innovative tool will allow a better understanding of the relationships between the prescription of pharmaceuticals and their presence in natural waters. The tool is designed to improve the wider understanding of this issue by making the data contained within the visualisation tool easily accessible.
SEPA, as a founding member of the OHBP, is working with other UK partners to explore ways in which such information might be used to inform prescribing of medicines or future regulatory standards. NHS Highland, another founding member of the OHBP, is committed to helping keep the environment as well as the public healthy and to making the use of medicines as sustainable as possible.
“Pharmaceutical pollution of waters has become a globally recognised environmental issue. We have been monitoring pharmaceuticals in natural and waste waters in Scotland for many years now, and have demonstrated their undesirable presence in some rural, as well as urban, water environments. This innovative tool, developed with our OHBP partners, will allow a better understanding of the relationships between the prescription of pharmaceuticals and their presence in natural waters. It should also therefore aid our ability to focus where and how interventions should be made to reduce pollution, and protect the integrity of our water resources”
Professor Stuart Gibb, Director of the Environmental Research Institute at UHI