Planetary health

Defining sustainability

Sustainability is a key concept in environmental management and policy making, and increasingly the motivation behind many of our everyday decisions. The term itself stems from the word sustinere, which is Latin for 'to sustain'. It refers to the capacity to maintain something over a long period of time. When applied within the context of environmental management, it refers to the potential of humanity to co-exist peacefully and long-term on a healthy planet. The first use of the sustainability concept dates back to the 17th century, when the German tax accountant and mining administrator Hans Carl von Carlowitz (1645–1714) coined the German word Nachhaltigkeit to refer to the responsible use of natural resources, notably wood from forestry. 

In 1972, the Club of Rome report 'Limits to growth' warned of the impossibility of endless growth and production on a planet with finite resources (Meadows et al., 1972). The sustainability concept was later popularised by the UN World Commission on Environment and Development (also called the Brundtland Report) that introduced the term Sustainable Development in 1987: 

This early concept of sustainability takes into account factors like societal structures, technology, environmental resources, and the planet's capacity to absorb human impacts. Within this framework, societal and technological advancements aim to enhance economic growth for overall well-being and better quality of life. However, linking sustainability to development has been criticised by several scholars (e.g., Brown, 2015; Williams and Millington, 2004) because it puts too much emphasis on consumption and economic growth which has the potential to threaten environmental sustainability. Nonetheless, this definition is widely accepted and often used policy making. The 1987 Brundtland Report did emphasise that widespread poverty is no longer inevitable and that development should focus on the basic needs of all and provide opportunities for improved quality of life (Barbosa et al., 2014). 

Following the Brundtland Report, the Sri Lankan physicist Munasinghe (2009) introduced the sustainable development triangle at the 1992 Earth Summit in Rio de Janeiro, Brazil. This triangle splits sustainable development in three major perspectives: economic, social and environment (Barbosa et al., 2014). This delineation of sustainability into three pillars is a recognised approach to better understand appropriate actions in business and policy making (Elkington, 1998, Correia 2019). Economic sustainability seeks balance between economic growth, resource efficiency, social equity and financial stability. Social sustainability creates inclusive societies, reduces inequality, and ensures long-term well-being for all people while preserving social cohesion and justice. Environmental sustainability is the ability to maintain an ecological balance in our planet's natural environment and conserve natural resources to support the wellbeing of current and future generations. 

With the sustainable development triangle in mind, it is clear that sustainability extends beyond just environmental concerns, encompassing social stability and economic factors. This holistic approach to sustainability is pivotal in guiding decision-makers in both the business and government sectors. 

Sustainability for the 21st century

A precise and universally accepted interpretation of sustainability is essential. Clarity in this matter is needed to facilitate effective decision-making with sustainability as a guiding principle. To ensure that any interpretation of sustainability is robust and widely accepted, it should align with the perspectives of various stakeholders, thereby minimising the risk of misunderstandings and fostering a more sustainable future (Valdivia et al., 2021). From this, it is clear that any useful definition of sustainability will be complex and multi-faceted.

In 2000, the United Nations established the Millennium Development Goals (MDGs), a set of eight objectives with a 15-year timeline. These goals addressed critical global challenges such as poverty, hunger, disease, and gender inequality. Subsequently, in 2015, UN member states adopted the 17 Sustainable Development Goals (SDGs) together with 169 concrete targets (United Nations, 2015). The SDGs aim to improve lives, protect the planet, and enable a prosperous future through the advancement of physical, social, human, and natural capital. Among the SDGs, SDG6 (clean water and sanitation), SDG7 (affordable and clean energy), SDG12 (responsible consumption and production), SDG13 (climate action), SDG14 (life below water) and SDG15 (life on land) directly relate to environmental sustainability, primarily addressing issues concerning the natural environment (Arora and Mishra, 2019). These goals underscore the necessity of addressing environmental impacts across various sectors, including the pharmaceutical industry.  

Ambitions to realise a sustainable world has far-reaching implications for the pharmaceutical sector. According to Belkhir and Elmeligi (2019), the greenhouse gas emission intensity of the global pharmaceutical industry is about 55% higher than that of the automotive industry. Other environmental impacts that should be considered include the ecological risks of pharmaceutical residues that reach the environment after medicinal use, and the use of non-renewable resources in the production of pharmaceutical products. These negative environmental impacts must be placed into context by the positive effect of pharmaceuticals on human health, as treated by SDG3 (good health and well-being). Sustainability in the pharmaceutical industry should be about taking a comprehensive approach to the entire product lifecycle, from drug development and manufacture to the end-of-life phase. Within this context, the following definition of sustainability by the EU Joint Research Centre is applicable to the Safe and Sustainable by Design policy for chemicals and materials (Caldeira et al., 2022):

By considering environmental impacts, resource consumption, and societal benefits at every stage, the pharmaceutical industry can strive towards achieving overall sustainability.