PREWAPHARM

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).

Innovation

The project’s innovation lies in deploying and validating, at large demonstration scale and year-round continuous operation, an integrated on-site treatment system combining an anoxic moving bed biofilm reactor, aerobic membrane biological reactor (MBR), and advanced oxidation process to achieve high-efficiency removal of contaminants of emerging concern (CECs) such as pharmaceuticals and ARB/ARGs directly from hospital wastewater before it reaches municipal sewage systems.

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 three pilots utilizing advanced techniques at high-risk sites, including healthcare units and hospitals to remove pharmaceuticals at their source. 

LIST will play a pivotal role of the success of the project as the leader of the work package on communication and dissemination. In this WP, a 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. LIST will also coordinate a wastewater treatment pilot at the Dudelange site of the Centre Hospitalier Emile Mayrisch, evaluating the effectiveness of innovative and sustainable technologies for degrading pharmaceuticals and their metabolites.

Impact

The PREWAPHARM project tackles the growing problem of pharmaceutical residues polluting water systems in Northwest Europe, which pose serious risks to aquatic ecosystems and human health, exacerbated by ageing populations and climate change. By combining behavioral change with technological innovation, PREWAPHARM develops and tests solutions aimed at reducing pharmaceutical emissions at the source, such as promoting greener prescribing, proper medication disposal, and patient adherence, alongside advanced wastewater treatment technologies implemented at hospitals and other high-risk sites. 
The project fosters cross-border collaboration among healthcare, water management sectors, and policymakers across seven countries, creating harmonized regional action plans and a knowledge-sharing network to ensure sustainable, scalable impact. Real-world pilots and installations demonstrate practical approaches that significantly reduce pharmaceuticals in surface and drinking water, while awareness programs and capacity building engage a broad range of stakeholders. 

Through this integrated approach, PREWAPHARM advances water quality, protects biodiversity, improves public health, and supports sustainable healthcare and water management across Northwest Europe.