The presence of pharmaceutical residues in Northwest European water bodies is a growing concern,

exacerbated by an ageing population and climate change. Up to 90% of orally administered

pharmaceuticals, including antibiotics and hormones, enter water systems as active ecotoxic

pollutants. Exposure to these residues is linked to abnormalities in aquatic life, the development of

antibiotic resistance, and significant threats to human health.

PREWAPHARM aims to address the issue of medicine residues through a strong collaboration of

NWE experts from the healthcare and water sectors. A transnational strategy will be developed,

aligning with the relevant policies of seven NWE countries and providing a framework for future joint

efforts. Strategic guidelines will be translated into four comprehensive regional action plans (NL, BE,

DE, LU) and three guiding documents (IE, CH, FR).

Two solutions - one focusing on medicine use and the other on wastewater treatment - will be jointly

designed and developed to reduce pharmaceutical residues in water. These solutions will be

integrated into regional action plans to enhance implementation and impact. The medicine use

solution is a result of three transnational pilots aimed at promoting sustainable practices, such as

greener prescriptions, appropriate drug delivery and disposal, and patient adherence. Meanwhile the

wastewater treatment solution will be developed through four pilots utilizing advanced techniques at

high-risk sites, including healthcare units and hospitals to remove pharmaceuticals at their source.

An NWE-wide knowledge centre with regional communities of practice will be established to ensure

long-term impact through a collaborative ecosystem. Capacity-building and awareness-raising

activities will engage key stakeholders across the healthcare and water sectors, including

policymakers, health institutes, water technology companies, water boards, patient organizations,

and citizens.