Sustainable Pharmacy‒a guiding principle

All of us, as individuals and society, are responsible for ensuring that the needs of current and future generations are fully met. In the field of pharmaceuticals, however, due to system constraints, mostly individuals of the current generation benefit from progress. Within a Sustainable Pharmacy framework, the fundamental medical and pharmaceutical philosophy of “first, do no harm” and the prevention of illnesses and possibility of disease treatment of current and future generations should be addressed. The concept of Sustainable Pharmacy developed here integrates sustainable development into pharmaceutical sciences and provides a work-in-progress definition. It requires a strict distinction from (primarily) ecologically oriented approaches such as Green Pharmacy to reduce the risk of (un)intentional greenwashing, moral licensing, and misunderstandings. Sustainable Pharmacy focuses on the connection and interaction of the development, treatment, and perception of disease with the underlying causes that are embedded in social systems in which people live. Systems thinking is required to address the complexity of health, disease, sustainability, and pharmacy. We propose education, environment, society, economy, pharmacology, and culture as key areas to be integrated in terms of wholes (from a systems perspective), and call for increased communication about the values and ethics that underpin pharmacy and healthcare systems. To move towards enabling the opportunities for disease treatment for present and future generations through effective prevention and medical and non-medical treatment of diseases, high-leverage actions that address the underlying causes of diseases and barriers to health services are needed. With this paper, we provide a basis for further development of the concept of Sustainable Pharmacy at (inter)national, (inter)disciplinary, and (trans)disciplinary levels. • Sustainable Pharmacy as a framework serves to prevent and enable the treatment of diseases in the present and future generations. • Sustainable Pharmacy partly includes but should be distinguished from and goes beyond the ecological concept of Green Pharmacy. • Systems thinking is essential to address the complex interactions of disease treatment, sustainability, and pharmacy. • Achieving the goals of Sustainable Pharmacy requires high-leverage measures that address the underlying causes of diseases and barriers to health services. • Education, environment, society, economy, pharmacology, and culture are key domains that result in an added value when integrated as a whole. • Health, self-determination, justice, equity, and diversity are core values of Sustainable Pharmacy that have to be discussed. • Further elaboration of the concept is expected at (inter)national, (inter)disciplinary, (inter)professional, and transdisciplinary levels.