PASIG Healthcare: Pharmaceutical Pollution Assessment to foster Systems Innovation and Governance

Healthcare remains inaccessible to many socio-economically deprived Filipinos, resulting in high levels of self-medication including inappropriate use of antibiotics, which can drive antimicrobial resistance (AMR), a threat to health and productivity. The nascent Universal Healthcare Act of the Philippine government will widen access to diagnosis, may increase appropriate prescription, and may decrease inappropriate use of antibiotics. Net consequences for pharmaceutical pollution and AMR risk are therefore unpredictable and baseline data lacking. Current behaviours and attitudes, which may be gender specific, towards disease management and pharmaceutical (antibiotic) use and disposal in the Philippines are also largely unknown, hindering evidence-based policy development.

Our proposal aims to investigate the complex social and behavioural factors that contribute to antimicrobial pollution along Pasig River in Metro Manila and co-design local systems-based solutions that will help mitigate this health and environmental issue. Using a transdisciplinary approach, we will: 1) conduct stakeholder mapping with social and behavioural key informant interviews on antibiotic use and disposal; 2) conduct the first-ever targeted monitoring campaign to identify hotspots of antibiotic pollution and AMR-related risks; and 3) conduct scenario-planning with key stakeholders to co-design an innovation roadmap for health and social wellbeing, a sustainable pharmaceutical industry, increased productivity, and strengthening of the blue economy through rehabilitated ecosystems.

With commitment from the Philippine and UK governments to the COP28 Health Declaration, and UK support to the full-scale implementation of the Philippine’s Universal Healthcare Act, this project envisages to support the Philippines towards its transition to a sustainable, resilient, and universal healthcare system.