Call to action: Pharmaceutical residues in the environment: threats to ecosystems and human health

The increasing production and consumption [1] of pharmaceutical products by humans has led to measurable residues in the environment. They contaminate surface waters (fresh water and marine waters), soil, and groundwater, and traces may be present in treated drinking water. These residues originate from: • human excretion (urine and faeces) from households and hospitals • leaching from agricultural land and landfill sites • unsafe disposal of medicines • point source discharges from pharmaceutical manufacturing • point-of-use emissions of anaesthetic gases and pressurised metered-dose inhalers. Current water-treatment technology does not completely remove such residues, and untreated wastewater is discharged directly into the environment in many parts of the world [2, 3]. Evidence shows the potential for harm ful effects on aquatic life and ecosystems, posing direct and indirect risks to humans, other organisms, and ecological chains. These risks have been reported for up to three decades, and newly emerging evidence has been extensively documented, but little, if any, global coordinated effort has been made to address them adequately [4, 5]. The science con cerned with monitoring and mitigating the effects of pharmaceuticals on the environment is known as ecopharma covigilance. The growing body of evidence but absence of global initiatives to effectively tackle the problem indicates a pressing need for urgent, concerted, and global action.