The issue of pharmaceutical waste, ranging from expired or unused medications to effluents from pharmaceutical production, has increasingly drawn serious attention in Indonesia over the past few years. Numerous studies point to a rising accumulation of pharmaceutical residues in line with the growth of national drug consumption and production. Unfortunately, household disposal practices in Indonesia remain largely inappropriate; in many cases, expired drugs are casually thrown into drains or household trash. This pattern, common in developing countries, stems from a lack of public awareness about the risks of improper medication disposal on human health and the environment.
The environmental consequences of pharmaceutical waste are far from negligible. Residual active pharmaceutical ingredients (APIs) have the potential to contaminate both aquatic and terrestrial ecosystems. Recent research has identified traces of pharmaceuticals in Indonesia’s environment; for instance, significant concentrations of paracetamol were detected in Jakarta Bay, particularly in Muara Angke and Ancol. Even more concerning, water quality surveys found antibiotics in drinking water sources accompanied by bacteria exhibiting resistance to those antibiotics. This indicates that improperly discarded pharmaceuticals are contributing to the rise of antibiotic-resistant bacteria in the environment, a direct threat to public health and ecological balance. Although the concentrations of these compounds are often low (nanograms per liter), they can still bypass conventional water treatment systems and accumulate over time.
A startling case emerged from one of Indonesia’s most critical watersheds. A 2024 study by the National Research and Innovation Agency (BRIN) revealed the presence of up to 460 tons of paracetamol and 336 tons of amoxicillin annually in the Citarum River basin, believed to originate primarily from daily household activities. The surge in household drug use, particularly in the wake of the COVID-19 pandemic, has not been matched by adequate waste management systems, posing a serious threat to aquatic ecosystems. The sources of pharmaceutical pollution are diverse: from livestock farming (antibiotics and hormones) and household disposal to pharmaceutical industry waste and medical facility leakage that escapes proper treatment.
These findings confirm that pharmaceutical waste in Indonesia is an increasingly urgent issue. Data from the past five years show a clear upward trend in medical waste generation, including pharmaceuticals. During the pandemic, the Ministry of Environment and Forestry recorded a 30% spike in daily medical waste. If left unaddressed, pharmaceutical pollution may exacerbate already critical river pollution crises, such as that in the Citarum, which is already overloaded with household and industrial waste. The resulting environmental risks include degraded water quality, destruction of aquatic habitats, threats to biodiversity, and potential bioaccumulation effects in the food chain. From a public health standpoint, pharmaceutical residues in groundwater or drinking water pose chronic chemical exposure risks and may accelerate the emergence of drug-resistant pathogens.
Sustainable Development Goals (SDGs) Relevant to the Pharmaceutical Industry
The United Nations 2030 Agenda for Sustainable Development provides a global framework that links development, health, and environmental concerns. Of the 17 Sustainable Development Goals (SDGs), several are directly relevant to the pharmaceutical sector and its waste management practices. At least four SDGs are particularly crucial:
SDG 3: Good Health and Well-being
This goal emphasizes ensuring healthy lives and promoting well-being for all at all ages. One of its specific targets calls for a substantial reduction in deaths and illnesses caused by hazardous chemicals and pollution of air, water, and soil by 2030. For the pharmaceutical industry, whose core mission is to promote health, this implies a responsibility to ensure that its products do not pose additional environmental health risks. Proper management of toxic pharmaceutical waste is therefore an integral part of protecting public health, in alignment with SDG 3.
SDG 6: Clean Water and Sanitation
SDG 6 targets universal access to safe water and effective wastewater treatment. Target 6.3 explicitly states that by 2030, the world must improve water quality by reducing pollution, eliminating dumping, minimizing the release of hazardous chemicals and waste, and substantially increasing recycling and safe reuse globally. Improper disposal of pharmaceuticals into waterways clearly undermines this goal. The pharmaceutical industry thus plays a critical role in ensuring that its operations do not pollute water sources. This includes adopting compliant wastewater treatment systems and developing take-back programs for expired or unused medications to prevent improper household disposal.
SDG 12: Responsible Consumption and Production
This goal encourages sustainable practices across the production, distribution, and consumption chain. One of SDG 12’s key indicators emphasizes the sound management of chemicals and waste throughout their life cycle. For the pharmaceutical industry, this means managing waste from manufacturing through post-consumption in a safe and environmentally responsible manner. SDG 12 also promotes the reduction of waste generation and the development of circular economy models, such as recycling packaging or repurposing production waste into valuable products. In this context, programs like medication take-back initiatives align with the 3R approach (reduce, reuse, recycle), which some pharmaceutical companies have started to adopt in their waste management systems.
SDG 13: Climate Action
While not directly addressing pharmaceutical waste, SDG 13 is still relevant because industrial activities, including pharmaceutical manufacturing, contribute to greenhouse gas emissions and climate change. Energy-efficient pharmaceutical production, the use of cleaner fuels in drug distribution, and waste treatment processes that avoid high-emission methods (such as open burning) all support climate goals. The industry can further reduce its carbon footprint through green manufacturing technologies and low-carbon supply chains. Moreover, climate change can worsen the spread of pollutants (for instance, via flooding that disperses medical waste), making proper pharmaceutical waste management an essential part of climate resilience. Integrating SDG 13 into pharmaceutical business strategies also means aligning with national emissions reduction targets through initiatives like factory energy efficiency programs and carbon offsetting.
The Role of Indonesia’s Pharmaceutical Industry in Advancing the SDGs
As part of the country’s health and manufacturing ecosystem, Indonesia’s pharmaceutical industry holds a strategic position in promoting sustainable practices. Over the past five years, signs of increased awareness and engagement with the Sustainable Development Goals (SDGs) have become more visible—manifested through internal company policies, CSR initiatives, and collaborative efforts with government bodies.
Several major pharmaceutical companies have taken progressive steps by explicitly aligning their sustainability reports with SDG 3 (Good Health and Well-being), SDG 12 (Responsible Consumption and Production), and SDG 13 (Climate Action). Many have implemented wastewater treatment systems at production facilities and entrusted hazardous waste (B3) management to certified third-party handlers. Others have gone further by turning herbal essential oil waste into community-produced soap, an inspiring example of creating shared value that merges environmental responsibility with local empowerment.
On a broader level, the Indonesian Pharmaceutical Companies Association (GP Farmasi) actively participates in policy dialogues on sustainability. The sector has also fostered international partnerships to enhance capacity building. Several companies have joined global platforms such as the UN Global Compact and the SDG Innovation Accelerator, where they share best practices on energy efficiency, emission reduction, and waste management. Even the traditional herbal medicine sector, which intersects with the pharmaceutical space, has begun to embrace ESG standards, with some firms achieving respectable ESG ratings, evidence that investors are also driving SDG-aligned practices within the health industry.
Yet despite these promising developments, commitment across the industry remains uneven. Many small- and medium-sized pharmaceutical manufacturers still lack adequate waste treatment systems. Even the national take-back program for expired medicines, launched in 2019, has reached only a fraction of the population. This is particularly concerning given that most improperly discarded medicines originate from households, not factories.
Furthermore, many sustainability reports fall short of meaningful impact measurement. ESG disclosures often focus on outputs, how many tons of waste are managed, how many trees are planted, but rarely reflect on outcomes. Are these efforts reducing contamination in rivers? Are they measurably contributing to climate mitigation? Are they curbing the risk of antimicrobial resistance?
Until these questions are addressed transparently and systematically, the industry’s SDG engagement will remain partial at best. A deeper cultural shift is needed from compliance-driven ESG checklists to evidence-based sustainability strategies that are rooted in accountability, equity, and long-term planetary health.
ESG Commitments in the Pharmaceutical Industry: Between Reporting and Reality
While SDG commitments are becoming increasingly mainstream, a critical evaluation is needed to assess how effectively they have been implemented in Indonesia’s pharmaceutical sector over the past five years. Several key indicators should be examined: compliance with environmental regulations, corporate ESG performance, sustainability report transparency, and the tangible outcomes of corporate sustainability programs.
In general, major pharmaceutical companies have shown high compliance with environmental regulations. Indonesia has strict standards for hazardous waste (B3), including Government Regulation No. 101/2014, which mandates proper handling of such waste. Oversight mechanisms like the Ministry of Environment’s PROPER rating system have assessed pharmaceutical manufacturing facilities, with several receiving a Green rating, indicating performance that exceeds basic compliance. However, not all companies have achieved this level, with many remaining at the Blue (compliant) level. Reports of illegal medical waste dumping, such as along the Citarum River, reveal persistent weaknesses in end-of-line waste management monitoring. National regulations are largely adequate, but consistent enforcement and field monitoring remain critical to ensure compliance.
Since the Financial Services Authority (OJK) issued Regulation POJK No. 51/2017, requiring public companies to produce sustainability reports starting in 2020, ESG transparency in the pharmaceutical industry has improved. Companies now routinely publish annual sustainability reports that outline their environmental and social initiatives and link them to SDG targets.
However, content analysis of these reports reveals a common trend: many still focus heavily on positive achievements and often avoid discussing challenges or negative impacts. While some reports are comprehensive and align with Global Reporting Initiative (GRI) standards, others appear to serve only minimum compliance. These reports must evolve into genuine tools for accountability and strategic improvement, not mere formalities.
Implementation should also be evaluated through the effectiveness of sustainability programs. The take-back scheme for expired medicines, launched in 2019 by BPOM and industry partners, has seen limited uptake—only a small portion of the public returns expired drugs to pharmacies. This points to a lack of continuity and public awareness. At the corporate level, initiatives like Kimia Farma’s OLIS Center, which turns essential oil waste into soap, need to be assessed for real impact, such as how much waste has been recycled and how much community income has increased.
Similarly, greener manufacturing programs, such as reducing harmful solvents and switching to eco-friendlier raw materials, should be evaluated for outcomes, not just implementation. Most large pharmaceutical firms have adopted ISO 14001 (environmental management standards) and have initiated continuous improvements in emissions, energy use, and waste management. However, small and medium-sized pharmaceutical companies often lack the resources to meet such standards. From the outside, ESG awareness among investors and consumers is rising. Several pharmaceutical companies have been listed in ESG indexes on the Indonesia Stock Exchange (IDX), pushing them to maintain and improve their sustainability efforts.
In the past five years, collaboration between the pharmaceutical sector, government, and international bodies has also increased. The Ministry of Health and the Ministry of Environment and Forestry, with UNDP support, launched a digital waste tracking system (SIMB3/WMIS), piloted at Sardjito General Hospital in Yogyakarta. Though originally designed for hospital waste, this system is relevant for pharmaceutical plants to ensure that B3 waste is monitored and traceable in real time. Early evaluations suggest that digital approaches help identify waste flows and prevent illegal dumping. Other collaborations include national guidelines currently being drafted by BPOM, pharmacists’ associations, and the industry to manage household drug disposal, enabling the safe return of unused medicines to public health centers or designated pharmacies.
Evaluating SDG implementation in the pharmaceutical sector also depends on policy support. The government has incorporated SDG-related indicators into the National Action Plan, while the private sector receives reputational incentives through awards such as PROPER and the Indonesian SDG Awards. Yet, several weaknesses persist, particularly the capacity gap between large and small firms, a lack of integrated national data on pharmaceutical waste, and limited waste processing infrastructure in remote regions.
One critical issue often overlooked in ESG discussions is the concept of materiality. According to Consolandi et al. (2020), most companies focus only on issues deemed “financially material,” those that affect profit or public image. Unfortunately, pharmaceutical waste does not yet fall within that scope.
As a result, despite growing evidence that pharmaceutical pollution harms water systems and accelerates antimicrobial resistance, the industry continues to prioritize operational efficiency and market innovation. Without financial pressure or market incentives, there is little urgency to change.
This is precisely why pharmaceutical waste has not become an industry priority, not because it lacks importance, but because it hasn’t yet hit the industry’s financial nerve. External intervention from governments, regulators, and civil society is essential to reshape the incentive structure and drive meaningful environmental responsibility.
What Can Be Done?
For the pharmaceutical industry to truly become a key player in achieving the SDGs, strong policy interventions and governance reforms are essential. The following are concrete steps that can be taken:
- Household pharmaceutical waste collection regulation.
The government should mandate that all pharmacies serve as official take-back points, with logistical support from pharmaceutical companies. Waste tracking systems such as the digital SIMB3 platform should be expanded to include household medicines.
- Fiscal incentives for green industry.
Companies that lower emissions, reduce hazardous waste (B3) intensity, or adopt circular economy models should receive tax breaks or investment incentives. Conversely, companies that neglect environmental standards should face environmental fines.
- Capacity-building for the pharmaceutical sector.
Many medium-sized companies cannot afford to build their own wastewater treatment facilities. The government can provide shared facilities or incentive schemes to ensure that all industry players meet minimum environmental standards.
- ESG reporting aligned with SDG targets.
Companies should be required to produce sustainability reports that quantitatively reflect their progress toward specific SDG targets, not just narrative highlights. This would significantly enhance corporate accountability.
- Research and innovation in pharmaceutical waste management.
Both the public and private sectors should invest in research to develop pharmaceutical residue filtration technologies, eco-friendly drug formulations, and biodegradable packaging materials.
- Public literacy on pharmaceutical waste.
Without a shift in public behavior, improper medicine disposal will persist. Sustainable, collaborative, and community-based education campaigns must be scaled up nationwide.
If Indonesia is serious about using the SDGs as a framework for national development, the pharmaceutical sector must not be left behind. ESG commitments must be brought to life, not just showcased. Sustainability reports should evolve from performative checklists to dynamic tools for evaluation and course correction. Social responsibility programs should no longer be judged by the size of donations but by the depth of their impact on people and the environment.
A good medicine is not only one that heals the body but also one that doesn’t poison our rivers, soil, or air. Reassessing the pharmaceutical industry’s ESG commitment is about demanding both moral and ecological responsibility from businesses we entrust with public health.
Because in the end, sustainable development is not only about curing the sick; it’s about ensuring the cure itself doesn’t harm the planet.
