his presentation was delivered at the Global Forum 2019 in Africa parallel session on Water Management Pharmaceuticals in the Environment (PiE) / Antimicrobial Resistance (AMR) by Iris Cherry Panorel, Programme Officer, SIWI.

1. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Water and
Pharmaceuticals
Shared responsibilities along the lifecycle
Iris Panorel, D.Sc.

2. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Water and
development
SIWI and
SwedishWater
House

3. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Environmental
-related risks
dominating
global risks
World Economic Forum,
Global Risks Report 2019
http://reports.weforum.org/global-
risks-2019/

4. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
What’s hiding
in our water
bodies?
(Natalie Renier,WHOI Creative Studio)

5. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Hakai Magazine

6. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Effects of
pharmaceuticals
in the
environment
➢ Development of antimicrobial resistance
➢ Multiple mechanisms of action of medicinal products
depending on considered species
➢ Multi-component mixture of different pharmaceuticals in
the environment
Source: Review onAntimicrobial Resistance.
Antimicrobial Resistance:Tackling a Crisis for
the Health andWealth of Nations. London 2014

7. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Water and
Pharmaceuticals?
➢ Shared responsibilities along the lifecycle
➢ Demand, supply, regulation
➢ Most urgent: antimicrobial resistance
➢ Need for sufficient tools, incentives,
ownership
➢ Efficiency: Going beyond mere effluent
management
➢ Procurement as a pilot area

8. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Water and
Pharmaceuticals:
Focal areas along
the life cycle
Consumption
Production
Wastewater
Procurement
(Market)
Env.
monitoring

9. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Breaking the
deadlock
between
mutual
dependencies
Use of
information.
Procurers/
Regulators
Demand for
sustainably
produced
pharmaceuticals.
Procurers, Public
and/or political
demand
Acces to
information.
Industry/
Regulators

10. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
SIWI and SPHS in dialogue with
the industry:
• Trust building and facilitation
of dialogue
• Increasing knowledge and
piloting a new methodology
• Procurement leverage
• Emissions from pharmaceutical
industry are a significant factor for
promoting AMR
• Water risks (access, quality)
• Suboptimal energy, water and
chemicals efficiency
GOAL
• Reducing Emissions from
Antibiotics Production
• Increased resource efficiency
• Reputational advantage
• Awareness of potential
solutions
BARRIER:
Lack of
experience,
integrated and
user friendly
tools, and
incentives
APPROACH
SIWI and UNDP in dialogue
with manufacturers:
• Trust building and
facilitation of dialogue
• Increasing knowledge and
piloting a new methodology
• Procurement leverage
PROBLEM
• Pollution: Industry emissions
are a significant factor for
promoting AMR
• Efficiency: Suboptimal energy,
water and chemicals usage
• Sourcing risks: access, quality
Project REAP:
Joint solutions

11. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Opportunities!
Efficient use
mitigates multiple
risks
• Cross sectoral learning
• Visibility of early movers
• Policy and Incentive
structures
• Proactive market
advantage

12. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Upstream
measures
➢ During manufacturing, process efficiency is the
key to minimize APIs from leaving the production
site.
➢ Point sources: additional treatment or avoidance
of liquid discharge
➢ Optimize and reduce total consumption
➢ Choose where there are choices without
compromising patients’ health
➢ Proper disposal of unused medicines
➢ Require prescription due to environmental impact

13. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Downstream
measures
Wastewater treatment between opposing
environmental objectives and economic constraints:
➢ Available at significant cost and additional energy
consumption
➢ Demand (and risk) is defined upstream
➢ Need for clear prioritization (high concentrations,
sensitive recipient)
Systematize monitoring!
➢ Need for definition of maximum concentrations in
wastewater recipients
➢ Look at biological effects, not just toxicity
➢ Take cocktail effects into account

14. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Efficient use
Transparency
Accountability
➢ Shared responsibilities along the antibiotics lifecycle
➢ Demand, supply, regulation
➢ Need for sufficient tools, incentives, ownership
➢ Alliance of pioneers: EU, India, Industry
➢ Acknowledging existing commitments
➢ Efficiency, going beyond mere effluent management
➢ Risk mitigation
➢ Proactive market advantage

15. Africa Forum 2019: 18-19 July 2019, Dar es Salaam,Tanzania I #AfricaForum2019
Thank you for your attention!
Iris Panorel, iris.panorel@siwi.org
www.siwi.org | www.swedishwaterhouse.se