ABSTRACT:
Pharmaceutical waste is fast becoming one of the most underestimated threats to global health and environmental sustainability, especially in Sub-Saharan Africa.1 As the region grapples with the growing burden of climate change, an invisible crisis is unfolding—one where expired drugs, industrial by-products, and improper disposal practices contaminate ecosystems, fuel antimicrobial resistance, and expose communities to preventable harm.2 This issue remains glaringly absent from climate-health policy and research across the continent.3 Pharmaceutical production and consumption generate substantial chemical waste, with the industry responsible for 4.4% of global greenhouse gas emissions—a figure projected to triple by 2050.4,5 Drawing on a comprehensive literature review, this research investigates the complex interplay among pharmaceutical waste mismanagement, climate stressors, and their combined impact on public health. The article highlights that over 100 Pharmaceutical compounds have been detected in South African water sources alone.6 These pollutants drive antimicrobial resistance (AMR)—a top-10 global health threat projected to cause 4.1 million deaths annually in the region by 2050.7 The population living near informal waste sites faces elevated risks of asthma, tuberculosis, diabetes, and depression. The analysis identifies systemic challenges, including weak regulatory frameworks, limited infrastructure, and insufficient public awareness, compounded by the climate crisis and historical legacies. For instance, 91.2% of Nigerian Pharmaceutical businesses poorly manage waste8, and 92.9% of Rwandese university students report improper disposal practices9—the region’s heavy reliance on imported medicines of over 70% further compounds waste-related vulnerabilities.10 In this research, we call for urgent policy attention to pharmaceutical waste as a climate and equity issue. We advocate for a holistic planetary Health approach that integrates waste management into national adaptation plans and health systems reforms, emphasising multi-sectoral interventions, green pharmaceutical practices and robust policy reforms to safeguard both environmental integrity and human well-being in Sub-Saharan Africa.