Participants Q.1: Which of these categories describes your work best? 1.Work on sustainable development regarding pharmaceuticals mainly at national level 2.Work on sustainable development regarding pharmaceuticals mainly at EU level 3.Work on other aspects of sustainable development 4.Work on other aspects of pharmaceuticals

Pharmaceuticals and sustainable development 1.Harm to aquatic environment 2.Direct harm to public health (e.g. residues) 3.Indirect harm to public health (e.g. antibiotic resistance) 4.Increased cost of water purification 5.Increased cost for pharmaceutical companies (and consequently for patients) due to overregulation Q.2: In which area might the most potentially serious implications of pharmaceuticals in the environment lie?

Pharmaceuticals and sustainable development 1.Lack of data both on exposure and toxicity 2.Lack of test methods that are relevant and sufficiently sensitive 3.Laboratory insufficient as a model for a complex environment 4. ”No data” generally interpreted as meaning ”no danger” Q.3: What is the most significant problem related to assessing risks of pharmaceuticals in the environment?

Pharmaceuticals and sustainable development 1.Member States 2.European Commission, with European Medicines Agency 3.European Commission, with European Environment Agency 4.Industry Q.4: Who should have primary responsibility for safeguarding that pharmaceuticals are included in future work on sustainable development?

Pharmaceuticals and sustainable development Is there a need for action? If so, what should be done? Who should do it? Who should carry the burden? Group Task 1: How can we better include pharmaceuticals into the agenda on sustainable development?

The Swedish experience and industry perspective 1.Improving production processes (incl. control of third party production) 2.End-of-pipe technologies (waste water treatment) 3.Developing more targeted products with lower environmental impact 4.Environmental classification systems for active substances and related research Q.5: Where should efforts and investments to limit the environmental impacts of pharmaceuticals be targeted?

The Swedish experience and industry perspective 1.A very relevant example for developing EU wide approaches 2.A relevant approach that should be considered and further analysed for implications for possible EU wide approaches 3.Interesting, but not very relevant 4.Not relevant, other approaches better suited for the EU Q.6: How relevant is Sweden’s experience with the voluntary Environmental Classification System for Pharmaceuticals for the EU?

EU-perspective and Commission Communication 1.Participation of all/most Member States 2.Creation of a new forum suitable for this work (e.g. network of experts) 3.Strengthening existing structures for exchange of views 4.A coordination centre/lead agency at EU level Q.7: Communication: “Measures to reduce the potentially harmful impacts of pharmaceuticals on the European environment and public health should be proposed” – what is most important for developing measures?

EU-perspective and Commission Communication 1.Confident 2.Hopeful - but the devil lies in the detail 3.The issues are too complex & diverse to reach a solution in the near to mid-term 4.Reducing harmful impacts of pharmaceuticals is in the interest of industry - so this will happen anyway Q.8: How confident are you that measures at Community level will be agreed - in the near to mid-term?

EU-perspective and Commission Communication What should be the key task(s) of the forum? At which level should it be working, e.g. Council/EMEA/etc? How could competence regarding both environment and health be reached? What measures could potentially be discussed? Group Task 2: How should a suitable forum to develop measures that reduce the potentially harmful impacts of pharmaceuticals on the European environment and public health look like?