Connecting Global Priorities Biodiversity and Human Health

SIMONE D. MCCOURTIE / WORLD BANK PHOTO COLLECTION / FLICKR
is required to understand the routes of exposure
of wild populations to APIs, and how these might
change under different scenarios of future climate
and population changes (Boxall et al. 2008; Kim
et al. 2010; Redshaw et al. 2013).
To date, much of the research into the
environmental occurrence, fate and effects of
APIs has been focused on high-income countries,
and more research effort is needed to understand
the situation in least-developed countries, and to
devise solutions to related environmental risks
(Kookana et al. 2014). Risk assessments also
need to be strengthened to better account for the
sublethal effects of APIs on wildlife populations
(e.g. in situations of low dose but long exposure),
particularly those that may have knock-on effects
on predator–prey relationships and wider food
chain impacts. The potential risks of synergistic
or additive impacts – through combinations of
APIs in the environment, or co-occurrence with
other pollutants (e.g. the added impacts of EE2
in populations also exposed to other endocrinedisrupting
compounds) – also need to be better
understood (Backhaus 2014).
One of the most pressing concerns involves
the manner in which antibiotic, antifungal
and antiparasitic APIs in the environment may
present selection pressures for drug resistance
in pathogenic organisms. The increasing threat
of antibiotic resistance, including the emergence
and rapid spread of multidrug resistance, means
that there is a demand for novel drug responses
as well as for a greater understanding of how the
use, abuse or overuse, and disposal of existing
antimicrobials might promote the emergence
and spread of drug resistance. Related to this is
the need for further research on how other forms
of pollution may enhance selection pressure
for the development of antibiotic resistance in
environmental microbes (Baker-Austin et al. 2006;
Finley et al. 2013), and on how drug-resistant
pathogens may be spread by wildlife.
Additional work is also required to prioritize
APIs for more detailed risk assessment. For
example, which types of drugs are likely to enter
the environment in ecologically significant
quantities? It is estimated that over 4000 different
pharmaceutical compounds are currently in
178 Connecting Global Priorities: Biodiversity and Human Health