ARVs Water Impact: Examining the Environmental Consequences of Antiretroviral Drugs in South Africa’s Water Systems

By João L. Carapinha

July 29, 2025

A study by North-West University found high levels of HIV antiretrovirals (ARVs) in South African water systems. The ARVs lopinavir and efavirenz were detected downstream of wastewater plants, exceeding safety limits. These pose risks to aquatic life, such as altered snail development and disrupted bacteriophages. Authorities claim current standards protect human health.

Key Insights

Lopinavir and efavirenz were the most common ARVs found, at 38 μg/L and 24 μg/L. Wastewater systems cannot remove these drugs, and the resultant environmental effects include bacterial blooms and harm to non-target species. Long-term risks to ecosystems and humans are unclear.

South Africa’s HIV program uses about 159,000 kg of ARVs yearly. Around 30% enters water via sewage, and treatment plants are not designed to filter these drugs. Global research labels ARVs as contaminants of concern and current standards ignore such pollutants.

Implications

This crisis requires interdisciplinary solutions:

  1. Better wastewater tech (e.g., advanced oxidation) may help but could be costly.
  2. New regulations should set ARV discharge limits for environmental safety.
  3. Ongoing monitoring is needed to track risks like antimicrobial resistance.

The study highlights the balance between public health and environmental protection. Cross-sector collaboration is vital. For more, review the original findings on ARVs water impact.

Reference url

Recent Posts

2025 China Drug Catalog Boosts Access with 114 New Drugs and Innovative Solutions

By HEOR Staff Writer

December 9, 2025

Expansion of Coverage in the 2025 National Basic Medical Insurance Drug Catalog In this update we highlight updates and implications of the 2025 National Basic Medical Insurance Drug Catalog in China's ...
NICE Approves Seven Digital Cardiac Rehabilitation Technologies for Enhanced Patient Care

By HEOR Staff Writer

December 8, 2025

Digital cardiac rehabilitation is transforming how patients with cardiovascular disease access vital recovery support, and if you're wondering about the latest NICE recommendations for digital platforms in cardiac rehab, here's the key update. NICE has conditionally approved seven innovative tool...
Repurposing Off-Patent Medicines: Insights from the EU Pilot Initiative
EU Pilot Initiative for Repurposing Off-Patent Medicines: Core Outcomes and Regulatory Support Repurposing off-patent medicines offers a promising pathway to address unmet medical needs, p...