On Wednesday 21^st June 2017 HCWH Europe and Highlands and Islands Enterprise (HIE) held a joint workshop in Inverness, Scotland, on ‘Pharmaceuticals and priority chemicals in the Highlands and Islands Environment’. The workshop brought together experts from Scotland and around Europe in order to discuss, debate, strategise, and work together to come up with innovative potential solutions to protect the Highlands and Islands environment and people from pharmaceutical pollution.

The workshop was opened by Diane Duncan, Head of Low Carbon & Clean Technologies for HIE, who welcomed participants and set the scene in Scotland, presenting the work of HIE in bringing together stakeholders to work towards a ‘Green and Healthy Highlands and Islands’. This vision is based on the four pillars of inclusive growth, international collaboration, innovation, and investment, and ten low carbon and circular economy priorities: Leadership, Water, Pharmaceuticals, Chemicals, Waste, Procurement, Food, Construction, Transport, and Energy. In her address, Ms. Duncan also spoke about how a circular, low carbon economy presents a great opportunity for economic development for the region and about how each of the ten priorities in the strategy are interlinked and will require collaboration from a number of stakeholders.

Next, HCWH Europe Executive Director, Anja Leetz gave an overview of HCWH Europe and the organisation’s work throughout Europe in bringing the voice of health professionals to the European policy debate and educating the health sector to understand the importance of the environment, encouraging public health and healthcare leaders and professionals to advocate for broader social policies and changes.

In the first session of the day, Elaine Mead, Chief Executive of NHS Highland introduced the organisation and their work in delivering high quality healthcare for a fairer, healthier Scotland. In her presentation, Ms. Mead spoke about how NHS Highland felt a very strong “social, economic, and environmental responsibility” to the communities they serve, reiterating their commitment to delivering low carbon, environmentally responsible healthcare.

This was followed by Dr Ian Rudd, Director of Pharmacy for NHS Highland, and Dr Sharon Pfleger, a Consultant in Pharmaceutical Public Health, who spoke about why there is a need to tackle the problem of pharmaceutical waste in the Highland region, and about how pharmaceutical pollution needs to be tackled by taking a more ‘upstream’ approach. Dr. Pfleger also spoke about the need for international collaboration and agreement in tackling these important problems.

These sentiments were echoed by Prof Dr Stewart Gibb, Director of the Environmental Research Institute at the University of the Highlands and Islands, who also outlined how “global environmental change is likely to be our biggest humanitarian challenge”. 

The morning session finished with a group discussion and brainstorming session, lead by facilitators 5Deep, about what is missing in the debate and discussions about pharmaceuticals in the environment.

The workshop continued with a range of case studies from across Europe regarding pharmaceuticals in the environment. Firstly, Dr Tim aus der Beek, Department Manager of Water Resource Management with IWW Water Centre in Germany gave the global perspective, highlighting the prevalence of pharmaceuticals in various environmental matrices across the world and the problems that may arise from this.

Siv Martini and Helena Ramström from Stockholm County Council presented the Council’s 15 years of experience of developing and using the ‘Wise List’ – a list of recommend essential medicines for common diseases in patients aimed at promoting the rational use of medicines, with an environmental perspective included.

Prof Dr Alistair Boxall from the Environmental Department at the University of York then presented the latest scientific evidence relating to the risks of medicines in agricultural systems, stating the risks arising from the use of veterinary medicine to the environment and the potential effects on human health, including a potential increase in incidences of antimicrobial resistance (AMR).

Former Deputy Director of the NHS Sustainable Development Unit in England, Sonia Roschnik then told the ‘carbon story’ – about engaging pharmaceutical companies in developing voluntary guidelines on reducing carbon during production.

Next, Dr Issa Nafo, Head of Department, Development and Support of Funding Projects with the Corporate Communication Unit at Emscher Genossenschaft, a publicly owned water company in Germany, then spoke about how stakeholder’s behaviour regarding pharmaceuticals in the environment could be influenced. Dr. Nafo presented a number of initiatives that were developed to engage young people to take action in raising awareness about the issue of pharmaceuticals in the environment. 

In the final session of this part of the workshop, Adrian Sim, CEO of the Alliance for Water Stewardship in Scotland spoke about the growing problem of pharmaceutical pollution of water, and about how water was a precious resource in the Highlands and Islands region that needed to be protected through joint stakeholder activity.

The afternoon session of the workshop focused on presenting a number of possible solutions for the Highlands and Islands region.

First to present was Elise Cartmel, Chief Scientist with Scottish Water - who run the most wastewater treatment plants in Scotland – about how the optimisation strategies in these plants being developed an implemented to reduce pharmaceutical and other water pollution.

Next, Cath Preston and John Redshaw from the Scottish Environment Protection Agency spoke about their ‘One Planet’ strategy – aimed protect public health and the environment in Scotland.

In the penultimate presentation, Dr Adela Maghear, Pharmaceuticals Policy Officer with HCWH Europe spoke about the current state of EU policy regarding pharmaceuticals in the environment, and HCWH Europe’s work to influence key policies and legislation. To this end, Dr. Maghear presented the Safer Pharma campaign, aimed at challenging the pharmaceutical industry to clean up their supply chains, raising awareness amongst health professionals about the impact of pharmaceuticals in the environment, helping citizens to understand the impact of pharmaceuticals in the environment and how to dispose of unused medicine, and working towards transnational agreement to ensure the minimisation of pharmaceuticals in the environment.

HCWH Europe’s Press & Communications Manager, Aidan Long, then spoke about HCWH’s Global Green and Healthy Hospitals (GGHH) network, presenting a number of the network’s campaigns, tools, and resources that are available to members, such as GGHH Connect and the Hippocrates data centre.

In the last of the afternoon’s presentations, Louise McGregor from Zero Waste Scotland spoke about the Circular Economy and the potential to work within in to ‘design out’ waste and pharmaceutical pollution.

Another group discussion followed whereby participants worked together in groups to discuss collaboration in reducing pharmaceutical pollution and working together to ‘do no harm’. 

 The day ended with an address from Dr. Hugo Van Woerden, Director of Public Health with NHS Highland, who summarised the day’s proceedings and reiterated NHS Highland’s commitment to working to reduce pharmaceuticals in the environment.

 After a successful workshop, HCWH Europe would like to thank all of those who participated, as well as Highlands and Islands Enterprise for collaborating on running the workshop with it’s network of local partners.

Further reading

• Read more about HCWH Europe’s work on pharmaceuticals in the environment here.
• View HCWH Europe’s infographic on Minimising Pharmaceuticals in the Environment here.
• Check out all of HCWH Europe’s resources on pharmaceuticals in the environment here.
• Read more about HCWH Europe’s Safer Pharma campaign here.