One Health Breakthrough Partnership celebrates World Water Day

The pioneering Scotland-based initiative, the One Health Breakthrough Partnership (OHBP), will showcase its work on pharmaceutical pollution as part of World Water Day 2023 on 22nd March.

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The research team together in Inverness at a recent event.

The pioneering Scotland-based initiative, the One Health Breakthrough Partnership (OHBP), showcased its work on pharmaceutical pollution as part of World Water Day 2023 on 22nd March. The Scottish national event 'Accelerating Change through Partnerships and Cooperation' hosted the OHBP alongside other experts in exploring emerging trends and opportunities for water to act as a catalyst for accelerating change through intersectoral interactions, policy, research, and innovation to safeguard water sustainability and resilience worldwide.

Pharmaceutical pollution is a well-recognised global public health and environmental issue. This can negatively impact the environment through water pollution and large carbon emissions, with medicines representing 25% of the NHS carbon footprint. It can also exacerbate the spread of antimicrobial resistance (AMR) through the environment. Access to safe water and sanitation remains a basic human right out of reach for billions of people around the world.

The OHBP is a unique collaboration between Scottish Environment Protection Agency (SEPA), NHS Highland, Scottish Water, Centre of Expertise for Waters (CREW), and the Environmental Research Institute (UHI North Highland). At the conference, Professor Sharon Pfleger, Consultant in Pharmaceutical Public Health at NHS Highland, and co-founder of the OHBP, presented, “Working together to protect the health of Scotland's population and water environment.”

The presentation showcased how partnership working and cooperation is accelerating changes to protect our water environment. It focussed on the collaborative path and outputs that have led to eco-directed policies in Scotland and report how environmental data on medicines will be modelled alongside clinical and cost-effectiveness data for the first time in Scotland and the UK, in a step towards improving medicine prescribing to reduce pharmaceutical pollution.

OHBP members, including NHS Highland and UHI North Highland’s Environmental Research Institute (ERI), together with the University of Nottingham, have recently been awarded a £100,000 Medical Research Council grant to develop a framework for an eco-directed formulary that incorporates environmental data on medicines into the prescribing process. This ground-breaking initiative is the first of its kind in the UK. It will help decision-makers take into account the environmental impact of medicine, along with environmental monitoring data, excretion profiles, and wastewater information.

Pharmaceuticals enter the water environment when people taking medicines go to the toilet and when partially used or expired medicines are inappropriately flushed down toilets/sinks instead of being returned to a pharmacy for proper disposal. Wastewater treatment facilities were not designed to remove such pollutants from wastewater, and medicines like antibiotics, anti-inflammatories and anti-depressants have been detected in rivers and lochs in Scotland. Medicines have biological effects on our bodies and may have similar effects on aquatic life.

Each health board has a list of preferred prescribing choices for clinicians called a formulary. Currently, these formularies consider patient safety, clinical effectiveness, and cost-effectiveness, but they do not consider the environmental impact of medicine. With this funding, the research team and partners will adopt a novel, trans-disciplinary approach integrating public health, prescribing, environmental science, and social science methods and data to develop a framework that enables better-informed and more sustainable prescribing choices, ensuring the chosen medicines result in the desired clinical outcomes.

Professor Stuart Gibb, Director of the Environmental Research Institute at UHI North Highland, “Pharmaceutical pollution of waters has become a globally recognised environmental issue. We have been monitoring pharmaceuticals in natural and waste waters in Scotland for many years now, and have demonstrated their undesirable presence in some rural, as well as urban, water environments. This innovative tool, developed with our OHBP partners, will allow a better understanding of the relationships between the prescription of pharmaceuticals and their presence in natural waters. It should also therefore aid our ability to focus on where and how interventions should be made to reduce pollution and protect the integrity of our water resources.”


For more information, please visit the project page:

For media enquiries, see contact details below:

Stuart Gibb:

Lydia Niemi:

Neil James:

Sharon Pfleger:

Addition information:

OHBP is aligned with the UN Sustainable Development Goal to achieve water and sanitation for all by 2030, and has launched several outputs and ongoing projects that align with World Water Day.

Bringing together key regional and national stakeholders across the water, environment, and healthcare sectors who are committed to addressing the issue of pharmaceutical pollution, the OHBP partnership is designed to stimulate innovation and impact to help achieve optimal health for people, animals and our environment.

SEPA, on behalf of the OHBP, has launched a new data visualisation tool to help Scotland reduce the impact of pharmaceuticals (medicines) on the water environment. ‘Pharmaceuticals in the Water Environment’ is the first open-access interactive tool in the UK to combine environmental and prescribing data. With data for 60 medicines detected in river water, raw wastewater, and treated wastewater, it is designed to help researchers, academics, health professionals and environmental scientists develop a better understanding of the link between medicine use and the presence of pharmaceuticals in the environment. The tool will be used by the OHBP, research partners and others to explore and develop appropriate and sustainable solutions to reduce the discharge of pharmaceuticals to the environment. It will also guide monitoring efforts as the group continues to improve its understanding of the environmental occurrence and impact of these pollutants.