The Challenges and Impacts of Pharmaceutical Waste Management in Low-Income Countries: A Systematic Review

Background: Pharmaceutical waste management is a critical environmental and public health concern, particularly in low-income countries (LICs). Inadequate disposal practices contribute to environmental contamination, antimicrobial resistance, and human health risks. Challenges such as weak regulatory frameworks, limited infrastructure, and lack of awareness exacerbate improper handling of pharmaceutical waste. Objectives This systematic review aims to evaluate the challenges associated with pharmaceutical waste management in LICs and assess its environmental and public health impacts. The study also seeks to identify best practices and policy recommendations for improving waste management systems. Study Eligibility Criteria: Studies published over the past above 20 years (1990–2025) that discuss pharmaceutical waste management challenges, environmental contamination, public health risks, and regulatory frameworks in LICs were included. The result of this review highlights major challenges, including inadequate waste segregation, poor infrastructure, weak regulatory enforcement, and financial constraints. Findings suggest significant environmental contamination, including pharmaceutical residues in water sources and soil, leading to ecological imbalances and antimicrobial resistance. The public health impacts include increased exposure to hazardous chemicals, poisoning risks, and the proliferation of drug-resistant pathogens. Conclusion: Pharmaceutical waste mismanagement in LICs poses severe environmental and public health risks. Strengthening regulatory frameworks, investing in sustainable disposal infrastructure, and enhancing public awareness are critical for mitigating these challenges. Further research and policy integration are needed to establish comprehensive waste management strategies.