www.ijbcp.com International Journal of Basic and Clinical Pharmacology | November-December 2016 | Vol 5 | Issue 6 Page 2290 IJBCP International Journal of Basic and Clinical Pharmacology Print ISSN: 2319-2003 | Online ISSN: 2279-0780 Review Article Global medication waste management practices: challenges and opportunities in developing countries Vipula R. Bataduwaarachchi*, Chamari L. Weeraratne INTRODUCTION Medication waste is defined as items intended to be used in the diagnosis, treatment or prevention of diseases among humans or other animals and it is synonymous with pharmaceutical waste, unused or expired medicines. 1 Improper disposal of medication waste leads to serious personal and environmental health hazards. 2 Medication waste management is not given enough priority in developing countries and this short communication explores the opportunities for medication waste management in this setting. Environmental pollution is a well-known consequence of improper medication waste management. The occurrence of pharmaceutically active compounds in the aquatic environment has been recognised as one of the serious and emerging problems in environmental chemistry. Most studies have given much emphasis on assessing the impact of ground water sources. In some investigations carried out in Europe and in the US, more than 80 pharmaceutical compounds and several drug metabolites have been detected in surface and ground water samples. The major concerns have been increased bacterial resistance to antibiotics and interference with growth and reproduction not only in human echo systems but also inside aquatic organisms such as fish and frogs. 3 In the surface water, medication derived chemicals are present in lower concentrations posing environmental risks. However, targeted ecotoxicological studies are lacking almost entirely even in developed countries. 4 It has been shown that impaired sexual development and increased feminisation of fish have occurred due to the presence of trace amount of oral contraceptive component, ethinyl oestradiol in rivers. 5 According to some sources, landfill disposal of unused medicines reduces surface water releases. 6,7 ABSTRACT Medication waste is synonymous with pharmaceutical waste, unused or expired medicines. Improper disposal of medication waste leads to serious personal and environmental health hazards. There were no established medication waste management programmes in most of the developing countries including Asia. Presence of unique socioeconomic problems in these counties makes the establishment of successful medication waste management programme a challenge. We reviewed the literature pertaining to the disposal of medication waste in different countries in order to understand the current status. We found that the medication waste disposal via normal sewage systems was the main method practiced in most of the countries and that the situation was much worse in developing countries. Return of unused medicines to pharmacies, which is considered to be the best method, was successfully practiced in some developed countries with established systems. Lack of proper mechanism to handle medication waste seems to be the main reason behind substandard medication waste management in developing countries. We propose a simple model for the disposal of medication waste taking into consideration the unique challenges and infra-structure issues in developing countries. International level policy and funding support, national level policy and unbiased financial allocations, institutional level comprehensive programmes according to the local requirements and most importantly the public support will make medication waste management programme a success. Furthermore, developing countries should join the on-going international forum on medication waste management. This short communication will be an eye opener for the academic key opinion leaders in developing countries to initiate medical waste management programmes in their countries. Keywords: Developing countries, Medication waste, Pharmaceutical waste DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20164081 Department of Pharmacology and Pharmacy, Faculty of Medicine University of Colombo, PO Box 271, Kynsey Road, Colombo 8, Sri Lanka Received: 06 October 2016 Accepted: 03 November 2016 *Correspondence to: Dr. Vipula R. Bataduwaarachchi, Email: vipbat7@yahoo.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open- access article distributed under the terms of the Creative Commons Attribution Non- Commercial License, which permits unrestricted non- commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.