Researchers from five European universities point to the global increase in the use of medicines and its long-term impact on the ecosystem and our health. They propose ten principles of sustainability to be applied in drug discovery. Sustainability should play an important role in the approval of new drugs, and universities should integrate sustainability into their (drug discovery) educational programmes, they say.
Due to the expanding and ageing world population, the importance and use of medicines is expected to increase. This will lead to a greater impact on the ecosystem and our health in the long term.
"Finding adequate treatments for unmet disease conditions, for everyone, everywhere, at a fair price, while respecting the environment and ecosystems is indeed an enormous challenge, and one that we must be better prepared for", says Ghent University professor Bart De Spiegeleer.
The concept of sustainability is rather slowly gaining traction and is currently still fragmented in the pharmaceutical field. The researchers therefore advocate a global, systematic approach and place the emphasis on sustainability already in early stages of drug development, i.e. drug discovery. According to the researchers, the competent authorities, universities, research institutions and industrial organisations all need to take sustainability more into account. They summarized the most important opportunities on the basis of ten sustainability principles.
The ten principles
- At present, the ecological-environmental impact is usually only taken into account in late stages of drug development. However, it is important to do so already in the first benefit-risk analysis of the research: active pharmaceutical ingredients damage the environment and may affect global biodiversity, which remains important in the development of new medicines.
- Moreover, it is necessary to critically prioritize medical needs (diseases for which there is no answer yet, such as life-threatening, incurable, therapy-resistant and neglected diseases). This could stimulate a worldwide equitable distribution of health care. “What to prioritize when” is obviously not a neutral choice. Therefore, it is also necessary to critically analyse who decides what, to what end and with what effect.
- Green chemistry in synthesis, production and analytics has been developing rapidly in recent decades and may aid in reducing the large quantities of organic waste and greenhouse gases generated in the pharmaceutical field; moreover, it can reduce the consumption of elements and resources that are increasingly scarce.
- Automation and the use of artificial intelligence (AI) and big data can increase the speed and effectiveness of drug discovery, as well as reduce the number of animals used in experiments and the burden on humans and the environment. Deep learning was recently already applied in the pharmaceutical field. Moreover, big health care databases as foundation of real world data are also essential tools to enhance personalised drug prescriptions, leading to a better benefit-risk balance for patients.
- Many existing drugs target disease symptoms rather than the underlying cause. Recent developments in biotechnology such as mRNA and CRISPR/Cas9 are very promising to address the root cause of illness, thereby improving the clinical outcome.
- The use of risk and decision models in drug research make it possible to take optimally sustainable decisions that consider the entire life cycle of the drug (from cradle to grave). Moreover, social considerations and the precautionary principle can also be taken into account.
- The use of biomarkers and bioinformatics supports precision medicine and thus helps to prevent ineffective drug use. They serve not only for accurate and rapid diagnosis and optimal therapy, but also to determine disease risks. Finally, adherence to treatment can also be monitored, which is important, for example in the fight against the world's most deadly diseases such as tuberculosis, corona and malaria.
- As medicines are a crucial part of the health system, social justice translates into equal access to medicines. This includes transparent discussions on cost-benefit and effectiveness.
- Implementation of ‘lean’ principles should aid in discovering the right medicine in a fast, efficient and value-creating way. The right questions must be answered in a logical order so that the drug selection process is as efficient and sustainable as possible.
- Finally, sustainability should also be pursued by responsible research and innovation in research institutions and universities, the results of which are industrially developed and commercialised. Public authorities are expected to support innovative and sustainable research while ensuring adequate and open access agreements to compensate for their investment.
According to the researchers, there is a need for the pharmaceutical industry and competent authorities to consider these sustainability issues and for universities to integrate them into their (drug discovery) programmes. The participating universities are currently preparing to include these principles into a new Erasmus Mundus Joint Master programme.