POLICY HIGHLIGHTSPharmaceutical Residues in FreshwaterHazards and Policy ResponsesPharmaceutical Residues in Freshwater Hazards and Policy ResponsesA combination of promoting hygiene practices to reduce the incidence of infection and disease, encouraging sustainable pharmaceutical design andproduction, spreading awareness of responsible pharmaceutical use anddisposal, and improving environmental monitoring and risk assessmentof pharmaceuticals, are critical steps to achieving the dual sustainabledevelopment goals of improving health and protecting the environment.Rodolfo LacyDirector of the Environment Directorate, OECDPO LICY H IGH LIGH TSOECD POLICY HIGHLIGHTS Pharmaceutical residues in freshwater: Hazards and policy responses . 1The OECD (2019) report Pharmaceutical Residues in Freshwater: Hazards and Policy Responses calls for a better understanding of the effects of pharmaceutical residues in the environment, greater international collaboration and accountability distribution, and policy actions to prevent and remedy emerging concerns. Laboratory and field tests show traces of oral contraceptives causing the feminisation of fish and amphibians, and residues of psychiatric drugs altering fish behaviour. Antimicrobial resistance, linked to the overuse of antibiotics, has rapidly escalated into a global health crisis.Unless adequate measures are taken to manage the risks, pharmaceutical residues will increasingly be released into the environment as ageing populations, advances in healthcare, and intensification of meat and fish production spur the demand for pharmaceuticals worldwide. The report outlines a collective, life-cycle approach to managing pharmaceuticals in the environment. A policy mix of source-directed, use-orientated and end-of-pipe measures, involving several policy sectors, can help to improve health and protect the environment.Pharmaceuticals are an important element of medical and veterinary practice, and their beneficial effects on human and animal health, food production and economic welfare are widely acknowledged. However, an area where we lack a common understanding is what happens when these pharmaceuticals are constantly discharged into the environment, through pharmaceutical manufacturing, consumption and excretion, and improper disposal of unused or expired products.