Environmental exposure to active pharmaceutical ingredients (APIs) can have negative effects on the health of ecosystems and humans. While numerous studies have monitored APIs in rivers, these employ different analytical methods, measure different APIs, and have ignored many of the countries of the world. This makes it difficult to quantify the scale of the problem from a global perspective. Furthermore, comparison of the existing data, generated for different studies/regions/continents, is challenging due to the vast differences between the analytical methodologies employed. Here, we present a global-scale study of API pollution in 258 of the world’s rivers, representing the environmental influence of 471.4 million people across 137 geographic regions. Samples were obtained from 1,052 locations in 104 countries (representing all continents and 36 countries not previously studied for API contamination) and analyzed for 61 APIs. Highest cumulative API concentrations were observed in sub-Saharan Africa, south Asia, and South America. The most contaminated sites were in low- to middle-income countries and were associated with areas with poor wastewater and waste management infrastructure and pharmaceutical manufacturing. The most frequently detected APIs were carbamazepine, metformin, and caffeine (a compound also arising from lifestyle use), which were detected at over half of the sites monitored. Concentrations of at least one API at 25.7% of the sampling sites were greater than concentrations considered safe for aquatic organisms, or which are of concern in terms of selection for antimicrobial resistance. Therefore, pharmaceutical pollution poses a global threat to environmental and human health, as well as to delivery of the United Nations Sustainable Development Goals.

This paper reviews the occurrence of antimicrobial resistance (AMR) in insects, rodents, and pets. Insects (e.g., houseflies, cockroaches), rodents (rats, mice), and pets (dogs, cats) act as reservoirs of AMR for first-line and last-resort antimicrobial agents. AMR proliferates in insects, rodents, and pets, and their skin and gut systems. Subsequently, insects, rodents, and pets act as vectors that disseminate AMR to humans via direct contact, human food contamination, and horizontal gene transfer. Thus, insects, rodents, and pets might act as sentinels or bioindicators of AMR. Human health risks are discussed, including those unique to low-income countries. Current evidence on human health risks is largely inferential and based on qualitative data, but comprehensive statistics based on quantitative microbial risk assessment (QMRA) are still lacking. Hence, tracing human health risks of AMR to insects, rodents, and pets, remains a challenge. To safeguard human health, mitigation measures are proposed, based on the one-health approach. Future research should include human health risk analysis using QMRA, and the application of in-silico techniques, genomics, network analysis, and ’big data’ analytical tools to understand the role of household insects, rodents, and pets in the persistence, circulation, and health risks of AMR.

Background. Developing countries such as Zimbabwe deal with challenges in solid waste management such as insufficient waste recycling, hazardous wastes that are not separated for safe disposal, and landfills that are not properly engineered to prevent groundwater pollution. For these reasons, landfills in developing countries pose serious environmental and public health hazards. Objectives. The objective of this study was to assess heavy metal release and groundwater pollution from an unlined landfill in Bulawayo, Zimbabwe. The purpose of the study was to explore environmental and public health risks posed by improperly managed landfills in developing countries. Methods. We assessed levels of metal release from Richmond landfill in the city of Bulawayo, Zimbabwe by measuring lead, cadmium, chromium and copper levels in landfill soil, leachate and plants. We also monitored metal levels in groundwater from boreholes located in a residential area in the vicinity and downgradient of the landfill within a rang...

Access to water, sanitation, and hygiene (WASH)—including drainage-services—is essential for public health and socio-economic development, but access remains inadequate and inequitable in low- to middle-income countries such as South Africa. In South Africa, rural areas and small towns generally depend on a limited and climate-sensitive economic base (e.g., farming), and they have a limited capacity and are located in areas where transport challenges can increase WASH access risks. Climate change shifts hydrological cycles, which can worsen WASH access and increase susceptibility to the interlinked impacts of droughts and flooding in already vulnerable regions. We adopted a transdisciplinary approach to explore the needs, barriers, and vulnerabilities with respect to WASH in rural areas and small towns in South Africa—using two case studies to explore climate risk and vulnerability assessment (CRVA) in one rural village in the northern Limpopo province and a small town in the Western Cape province. This holistic approach considered natural (environment and climate) and socio-economic (economic, social, governance, and political) factors and how they interplay in hampering access to WASH. Extreme weather events characterized by frequent and intense droughts or floods aggravate surface and groundwater availability and damage water infrastructure while threatening agriculture-dependent livelihoods. The lack of reliable transport infrastructure increases risks posed by flooding as roads to vital supplies are prone to damage. High inequality linked to rising unemployment and the Apartheid legacy of a segregated service delivery system result in inequitable access to WASH services. The intertwined ways in which natural elements and historical, social, economic, governance, and policy aspects are changing in South Africa increase WASH vulnerability in rural areas and small towns.

As apex predators, marine mammals play a key role in maintaining community structure and functioning in marine ecosystems. Hence, a decline in marine mammal populations may have negative effects on the ecosystem function and services. The discharge of anthropogenic chemicals and particles (micropollutants) into the marine environment threatens the health of marine mammals. Traditional approaches for assessing the impact of micropollutants on marine mammal populations are limited by the complexity of micropollutants (e.g., low concentrations, unknown contaminants, transformation products, and mixture effect) and marine mammals (e.g., complex physiology, life history, multiple stressors, and logistical challenges) in the environment. Recently developed (bio)analytical tools that can integrate chemical and biological assessment such as non-target and suspect screening, direct effect analysis, and multiomics (e.g., metabolomics, lipidomics, proteomics, and transcriptomics) can offer critical insights into (i) the health risks of ‘known’ and ‘unknown’ micropollutants in marine mammals, (ii) the link between exposure and population effects, and (iii) identification of priority micropollutants. This review highlights the challenges and current progress in assessing the health risk posed by micropollutants to marine mammals. A tired integrated chemical-ecological-biological framework developed from current research practices is offered for effective assessment of micropollutant risk in marine mammals. Graphical Abstract