As indicated in the GCO II, Pharmaceuticals are indispensable for human and animal health. However, certain pharmaceuticals may cause undesired adverse effects, including endangerment of certain species of vultures, endocrine disruption such as reproductive failures in fish, and the development of antimicrobial resistance due to the wide use of antibacterial agents in human and veterinary medicine. Pharmaceuticals designed to be slowly degradable or even nondegradable present a special risk when they enter, persist or disseminate in the environment. Such substances are referred to environmentally persistent pharmaceutical pollutants (EPPPs). There are also so called “pseudo-persistent pharmaceutical pollutants”, which are degradable although continuous emissions to the environment can lead to their constant environmental presence.
The GCO II further highlights that dozens of new pharmaceuticals are placed on the market every year, with more than 7,000 compounds currently under development. Due to their increasing use and following increasing attention in both the scientific community and public media, policymakers have initiated various actions to address pharmaceuticals in the environment. The WHO has described antimicrobial resistance as a growing public health threat and warned about a post-antibiotic era in which common infections and minor injuries may be fatal.
Finally, the GCOII notes that Pharmaceuticals, including antibiotics, and their metabolites can enter the environment through a variety of pathways, including manufacturing sites, untreated wastewater from households and hospitals, wastewater treatment plants, and municipal waste streams, animal husbandry, sewage sludge and aquafarming.
In 2015, the SAICM Fourth International Conference of Chemicals Management (ICCM4) adopted environmentally persistent pharmaceutical pollutants as an emerging policy issue in the SAICM context, while recognizing that pharmaceuticals have major benefits for human health and animal welfare. In adopting the issue, ICCM4 agreed international cooperation is crucial to build awareness and promote action on the issue. Additionally, ICCM4 considered that information dissemination and awareness-raising on EPPPs are particularly relevant and that improving the availability of and access to information on such chemicals is a priority as well as implement cooperative actions with the overall objective of increasing awareness and understanding among policymakers and other stakeholders.