A recent report has confirmed the presence of antiretroviral drugs (ARVs) in tap water and rivers across South Africa, prompting the Department of Health (DoH) to call for greater responsibility among wastewater treatment stakeholders.

DoH spokesperson Foster Mohale addressed the media, framing the detection of ARVs as a paradoxical success story. “The discovery of the drugs in the water is a net positive because it shows that people are taking the lifesaving medicine,” he stated. Despite the positive interpretation, Mohale emphasised the urgent need for accountability in how water is treated post-use.

The alarming findings stem from research conducted by the University of the North West, which identified significant concentrations of ARVs in water sources, particularly downstream from wastewater treatment facilities. Mohale pointed to a broader systemic issue, stating, “When water leaves our bathrooms, it doesn’t go to dams and rivers but treatment plants. The Department of Water and Sanitation is responsible for ensuring this.”

Further investigation revealed that exposure to these pharmaceuticals, particularly among aquatic life, is already having detrimental effects. Freshwater snails subjected to ARVs showed altered embryonic development, alerting researchers to the potential ecological ramifications of pharmaceutical contaminants. Additionally, critical bacteria-controlling viruses were found to be significantly impacted by the presence of these drugs.

The researchers went on to caution against the latent dangers posed by ARVs in water, warning that “the consumption of any type of exogenous drug by any organism in sufficient quantities may interfere with the regulation of metabolic systems and bring about adverse effects.” The report highlighted the risk to human health as well, stating that individuals may encounter these compounds through drinking water, with some sources exceeding acceptable thresholds.

Although ARVs were not directly identified in human samples during this study, there remains a considerable risk for those consuming aquatic organisms such as fish, which may absorb these contaminants.

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