Dutch contribution to pharmaceutical pollution reduction in Europe
Across North-West Europe, pharmaceutical residues are increasingly detected in rivers and drinking water sources. PREWAPHARM, launched in May 2025 under Interreg North-West Europe, brings together 18 partners from seven countries to reduce emissions at their source. Dutch partners play a leading role, coordinating the project and combining healthcare interventions with decentralised wastewater treatment pilots to deliver scalable solutions for cleaner European waters.
Driven by ageing populations, rising medicine consumption and the pressures of climate change, pharmaceutical pollution presents a complex and growing challenge. A large share of medicines taken by patients passes through the human body without being fully broken down and ends up in wastewater systems. Conventional treatment plants are not always designed to fully remove these micropollutants. This allows trace concentrations of antibiotics, hormones and other active substances to reach surface waters. The environmental implications are significant. Pharmaceutical residues can disrupt aquatic ecosystems, affect fish reproduction and contribute to antimicrobial resistance. At the same time, drinking water producers face increasing technical and financial pressure to safeguard water quality.
A transnational and cross-sector response
PREWAPHARM – Preventing Water Pollution by Pharmaceuticals – was launched in May 2025 as an Interreg North-West Europe project running until the end of 2028. The project brings together 18 partners and around 30 associated organisations from seven countries, including a strong Dutch consortium. Together, the partners aim to structurally reduce pharmaceutical residues in water through prevention and technological innovation. With a total budget of approximately €9.8 million, co-financed by the European Regional Development Fund, the project represents a coordinated response to a shared European challenge.
What distinguishes the project is its integrated, source-oriented approach. Instead of focusing solely on large municipal wastewater treatment plants, PREWAPHARM concentrates more closely on the source of the pollution. It operates along two interconnected tracks: influencing how medicines are prescribed and used, and piloting decentralised treatment solutions at identified hotspots.
From behaviour change to wastewater treatment
On the healthcare side, PREWAPHARM develops and tests interventions aimed at reducing unnecessary pharmaceutical emissions and places strong emphasis on behavioural change as part of prevention. These measures include promoting greener prescribing practices, improving dispensing systems and strengthening medicine take-back schemes. By supporting better therapy adherence and increasing patient awareness, the project seeks to prevent surplus medication from entering wastewater streams in the first place. Pharmacists, general practitioners, hospital staff and patients are actively involved throughout this process.
In parallel, PREWAPHARM is running several pilot projects that test different wastewater treatment options. These pilots help the partners understand which methods are most effective, affordable and suitable for large-scale use. They also show how technologies behave in day-to-day conditions, instead of only in laboratory settings. The pilots cover a range of techniques, from membrane filtration and advanced oxidation to nature-based solutions, such as reed beds, which are tested to remove medicines in a low-energy and low-maintenance way.
Pilot locations differ depending on local needs, but include hospital departments, where concentrated wastewater streams occur, as well as entire hospital sites, to test centralised treatment. They also include decentralised facilities, such as small-scale treatment plants, and sewer overflow points, which were simple, low-tech measures that may partially reduce emissions during storms.
The Dutch role: coordination, science and implementation
Within this international consortium, the Netherlands plays a multifaceted role. The Dutch contribution spans coordination, research, public health expertise and societal engagement.
Dutch partners TCNN acts as the lead partner of PREWAPHARM and is responsible for overall project coordination, strategic alignment and ensuring coherence between thematic work packages and participating countries. By connecting partners across healthcare and water sectors, TCNN facilitates collaboration and ensures that pilot outcomes feed into joint strategies and action plans.
Academic and medical expertise is provided by the University of Groningen and the University Medical Center Groningen (UMCG). These institutions contribute to the design and evaluation of pharmacy-driven and at-source pilots, linking prescribing behaviour and clinical practice to measurable environmental outcomes. The Dutch National Institute for Public Health and the Environment (RIVM) strengthens the scientific foundation of the project by analysing environmental risks and interpreting monitoring data within a broader public health context.
Societal engagement is reinforced by Zorgbelang Groningen, which represents patient interests and contributes to awareness-raising and behavioural interventions. Innovation partner Obseq supports pilot execution and practical implementation, and helps translate research findings into operational solutions.
Towards structural reduction of pharmaceutical pollution
By generating replicable models and practical guidance, PREWAPHARM provides EU regions with concrete tools to tackle pharmaceutical pollution in a coordinated way. In doing so, it strengthens not only technological innovation but also alignment between countries facing shared water quality challenges. This cross-disciplinary and cross-border collaboration between healthcare and water management allows the Dutch and other European partners to lay the foundation for a structural reduction of pharmaceutical pollution in Europe’s waters.
