Researchers at North-West University (NWU) have unveiled a study detailing the presence of antiretroviral drugs (ARVs) in South Africa’s water resources.
Entitled ‘Quantification, fate, and hazard assessment of HIV-ARVs in water resources,’ this report has been submitted to the Water Research Commission (WRC) and is heralded as the most extensive exploration of its kind in the region.
Led by NWU’s Unit for Environmental Sciences and Management and the Africa Unit for Transdisciplinary Health Research, the research team, including esteemed experts such as Prof Suranie Horn, Prof Rialet Pieters, Prof Henk Bouwman, and Prof Petra Bester, has effectively merged environmental, health, and social sciences to delve into the implications of ARVs in water systems.
The findings of the study are alarming. Substantial concentrations of ARVs, especially lopinavir and efavirenz, were discovered particularly downstream of wastewater treatment facilities, with some locations showing levels significantly above global norms.
This issue is closely tied to South Africa’s expansive HIV treatment programme, which is the largest of its kind worldwide.
The consequences for aquatic ecosystems are striking. For instance, tests revealed that freshwater snails exposed to ARVs displayed altered embryonic development.
More worryingly, bacteriophages essential viruses responsible for regulating bacteria within wastewater systems were adversely affected. Such disturbances raise concerns about the potential for increased bacterial blooms and deteriorating water quality.
The research makes a critical observation: ‘The consumption of any type of exogenous drug by any organism in sufficient quantities may intervene with the regulation of metabolic systems and bring about adverse effects,’
It further warns that the presence of ARVs in water constitutes a hidden or latent risk to ecosystems and human health.
Notably, the study cautions that humans may be exposed to these drugs through drinking water, as concentrations exceed calculated hazard quotients. Although the research did not detect them, the ingestion of ARVs and their by-products by aquatic organisms, particularly fish, poses additional risks.
Utilising advanced analytical techniques, including liquid chromatography/mass spectrometry, the team quantified ARV levels in water while conducting biological assays to assess the toxicological impact on non-target organisms. The study concludes that current wastewater treatment processes are insufficient for eliminating these bioactive compounds, prompting calls for technological advancements.
The comprehensive report presented to the WRC outlines several key recommendations, including the establishment of regulatory guidelines governing ARV concentrations in water, investment in improved wastewater treatment technologies, and further research to explore the long-term ecological and health impacts of these pharmaceuticals.
Furthermore, the team advocates for a multidisciplinary approach that intertwines public health and environmental sustainability.
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Pictures: Getty Images / Michel Lunanga
Source: North-West University
