Antimicrobial resistance (AMR) arises when microorganisms resist the effects of pharmaceuticals, such as antibiotics, making these treatments ineffective and posing significant health risks. Healthcare facilities contribute heavily to AMR by releasing pharmaceutical residues and bacteria. This project seeks to address AMR by developing and implementing advanced, sustainable wastewater treatment solutions and monitoring methods specifically for healthcare settings. By collaborating with various stakeholders, the initiative aims to develop a process with cost-effective technologies that can remove pharmaceuticals and resistant organisms directly at their source. The goal is to mitigate AMR's spread, standardize evaluation methods for technology performance, and establish guidelines for early detection and removal of contaminants, thereby protecting public health and mitigating ecotoxicological impacts.

To improve water quality: this initiative focuses on reducing the influx of persistent pharmaceuticals into sewage systems, which otherwise risk being discharged untreated by conventional wastewater treatment plants into natural water bodies.

The healthcare sector is increasingly concerned about the environmental impact of pharmaceutical emissions and the rising antimicrobial resistance (AMR). This project is in line with the MMIP C4 objective of improving water quality by:
Developing integrated and sustainable strategies for decentralized removal of pollutants, i.e., pharmaceuticals, antibiotics, and AMR, from healthcare institution wastewater. The expected impact is to lessen the human footprint on water quality, thereby advancing toward achieving and maintaining the standards outlined in the Water Framework Directive.

Upon project completion, we aim to deliver
Analysis of the presence of pharmaceuticals and AMR, including types of compounds, concentrations, and spatial variations.
Chemical analysis of the wastewater of the hospitals and healthcare institutions part of the consortium is planned for 2023, and 2024.
In 2024, microbial analysis of the wastewater will be carried out, in two selected hospitals. Additionally, four antibiotic-resistant genes, commonly found in wastewater, will be screened.
Framework for technology evaluation (March 2024-July 2025)
Establish clear criteria for evaluating the effectiveness of wastewater treatment solutions in the removal of pharmaceuticals.
Evaluation of the synergistic combinations of physical and chemical treatment methods for water purification.
Precision monitoring techniques
Throughout the project we will focus on the development of i) detection and monitoring methods for specific pharmaceuticals and/or their metabolites, and ii) targeted techniques for identifying specific antibiotic-resistant microorganisms or resistance genes.
Validation of the treatment process (February 2025 – May 2025)
Test the efficacy of selected water treatment and monitoring technologies using actual wastewater. Two demonstration units are planned to start operation in February 2025.
Customized implementation strategies (January 2026)
Guidance for healthcare institutions on best practices and practical strategies to reduce pharmaceutical discharge into the sewage system.