At CleanMed Europe 2025, the session “Is Europe ready to produce cheap and green medicines?” explored the complex challenges and opportunities involved in reshoring pharmaceutical production to Europe. With growing concerns about pharmaceutical pollution, fragile supply chains and the climate impact of drug manufacturing, the conversation focused on how relocating production could contribute to sustainability, equity and resilience. The discussion gathered perspectives from Europe and India to evaluate whether shifting the pharmaceutical industry’s centre of gravity can also shift its environmental footprint.
Sustainability at the Core of Reshoring
Luna Dayekh, Safer Pharma Project Officer at Health Care Without Harm Europe, opened the session by explaining what reshoring means in the pharmaceutical context: relocating the production of critical medicines, particularly active pharmaceutical ingredients (APIs), back to Europe. Currently, around 80% of APIs used in Europe are manufactured outside the continent, largely in countries like India and China. This dependency creates supply vulnerabilities, as revealed during the COVID-19 pandemic, but also carries environmental and social consequences.
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Dayekh noted that reshoring is typically framed around strategic autonomy and economic resilience, but it also presents an opportunity for systemic change—if properly managed. She argued that relocating production could enable enforcement of higher environmental and labour standards, potentially supporting greener, more circular manufacturing systems. However, she warned that without structural reform, reshoring could merely reproduce “the same extractive and transparent polluting models… under a more greener banner.”
The environmental and health impacts of current global production systems remain largely invisible in Europe, she explained, because they are externalised to producing regions. Weakly enforced regulations have allowed the discharge of untreated or poorly treated pharmaceutical wastewater containing antibiotics, hormones and heavy metals. These pollutants disrupt aquatic ecosystems, enter the food chain and drive antimicrobial resistance (AMR). “Pharmaceutical production is a highly energy intensive sector, sometimes equal to or higher than the automotive industry,” she added, urging for stronger enforcement mechanisms and sustainability training for procurement professionals. Dayekh concluded by highlighting the opportunity to embed transparency, equity and resilience into a reshaped supply chain—provided the political will exists to go beyond cost-driven procurement.
The Indian Experience: Regulation and Responsibility
Joining from Bhopal, India—a city historically affected by industrial disaster—Chandan Khanna, India Programmes Manager at Health Care Without Harm Global, provided insight into the Indian regulatory landscape. India, as a global pharmaceutical manufacturing hub, has recently introduced a series of measures to address pollution from the sector. These include zero liquid discharge mandates, location requirements for new plants, regulations on air and water pollution, and a focus on phasing out harmful plastic packaging. The government is also promoting cleaner, more circular production through its clean chemistry initiative.
Khanna described India’s role as “the pharmacy of the world,” particularly during the COVID-19 crisis when it supplied vaccines to underserved nations. He noted that economies of scale make Indian pharmaceutical production highly cost-efficient, and that even countries seeking autonomy in manufacturing would still rely on Indian or Chinese raw materials. “India… can do it in a much cleaner way and at a much lower cost than if each country or each region would like to have its own manufacturing facility,” he said. For this reason, Khanna stressed the need for globally applicable environmental, social and governance criteria to drive responsible practices across the supply chain.
Policy Alignment and Procurement Reform
Stefan Berggren, Director of Sustainability at the Swedish Medical Products Agency, brought a regulatory perspective to the discussion. He acknowledged that production within Europe generally benefits from stricter controls, but environmental criteria are still absent from the vast majority of pharmaceutical procurement decisions. “For 90% of the procurement of the pharmaceuticals, environmental aspects are not included,” he said, making the case for harmonised sustainability requirements across countries. This would create predictable conditions for manufacturers and reduce barriers to market entry for environmentally responsible producers.
Berggren also commented on the role of the EU’s revised Urban Wastewater Treatment Directive, which incorporates the polluter pays principle. While supportive of the intent, he warned of practical challenges in its implementation and the need for harmonised application across member states. He emphasised the importance of addressing the entire pharmaceutical lifecycle—from development to disposal—and pointed to the role of small pharmaceutical startups in early innovation. These actors, he noted, should be involved in the push for greener practices from the outset.
The session also raised the issue of persistent toxic substances such as PFAS, commonly used in pharmaceutical production. Berggren and Dayekh both expressed support for including environmental risk assessments in market authorisation procedures. Khanna added that even if full phase-outs are not immediately feasible, conscious efforts and clear regulations could gradually shift production practices. “If regulation is the way to get these chemicals out, then maybe that's the [right] way,” he stated.
The session concluded with a shared recognition that reshoring pharmaceutical production to Europe is not inherently sustainable—it depends on the decisions made now. Without structural reforms to procurement, regulation and transparency, the environmental burden may simply be relocated rather than resolved. Yet, if approached strategically, reshoring could act as a catalyst for global improvement in the pharmaceutical supply chain. It offers a chance to create measurable environmental criteria, foster cooperation across borders and promote equitable access to cleaner, more affordable medicines. With climate pressures and AMR risks intensifying, the question is not only whether Europe is ready to produce cheap and green medicines, but whether it is prepared to lead by example.
Source: CleanMed Europe 2025
Image Credit: iStock
