Alternative societal solutions to pharmaceuticals in the aquatic environment

Environmental contamination with pharmaceuticals is widespread, inducing risks to both human health and the environment. This paper explores potential societal solutions to human and veterinary pharmaceuticals in the aquatic environment. To this end, we adopt transition research's multi-level perspective framework, which allows us to understand the dynamics underlying pharmaceutical emissions and to recognize social and technical factors triggering change. Our qualitative analysis is based on data collected through literature research and interviews with actors from pharmaceutical industry, the health and agricultural sector. The research aims at identifying potential future solutions including requirements for as well as barriers to pathways leading to these solutions and describing the role of key actors involved. The three alternative societal solutions identified are: 1) accepting pharmaceuticals in the environment - substantial changes to the system are not required; 2) reconfiguring the current system by implementing various innovations that reduce pharmaceutical emissions; 3) fundamentally changing the current system to (largely) avoid pharmaceutical emissions. The paper further elicits societal, financial, organizational, regulatory and technological requirements that can facilitate implementation of these solutions. This work is novel as it constitutes a systemic view on all stages of the pharmaceutical lifecycle, comprehensively synthesizing options and measures along the entire lifecycle into societal solutions that are framed as transition pathways. Deriving societal solutions from key actor's perspectives is innovative and provides insights to reflect on choices societies are going to have to make regarding pharmaceuticals in the environment.