Over 60 participants, mostly of course from pharmeceutical companies gathered to listen to

- Hans Kullin from Eklips (the social media guru at the conference),

- Rikard Pellas from LIF, the association of the research based pharmaceutical industry in Sweden (the expert on how to apply the LIF’s ethical rules to social media),

- Elisabeth Eklund and Henrik Bengtsson from Delphi (lawyers who could explain at least what shouldn’t be done…),

- Myself, describing three different experiences Pfizer have had with social media (”can you feel my pain“, Dizza Tobak, and this blog), and

- Hanna Brodda, editor of Dinamediciner.se

As you can see, a fairly broad selection of speakers. But the conference would not have been as good if the audience would not have participated the way they did. Really good discussions!

Some reflections from my side include the very clear message that social media grows enormously fast, e.g. Facebook has over 800 million users today, only last year 100 billion pictures were uploaded on Facebook, and there were more than 1000 billion showings of videos on YouTube during 2011. It is difficult to really understand the huge possibilities and both positive and potentially negative consequences of this…

I have written blog posts on social media use before (see for instance the 2011 posts Oct 26 regarding Worldfavor, Oct 6 regarding some Pfizer experiences, Aug 24 on the use within health care, April 5 on stakeholder dialogue, and from 2010 Nov 24 also on stakeholder engagement). You know that my opinion is that Social media is not really something that dramatically changes what “we can and what we cannot do” when it comes to communication. The same rules apply to these communication channels as to the old ones. This was also clearly stated by both the lawyers from Delphi and by Rikard Pellas. The difference however is of course that everything is much faster: It reaches out to everyone, and everything once posted on the net seem to be there forever. So although the same rules apply our own culture and our internal guidelines for the use of social media have probably not been able to develop as fast as the social media platforms have. It was good to see LIF’s guiding document how the ethical rules should be understood in the social media world (see this link for details).

Potentially due to the lack of the internal guidance documents, the pharma industry have been very careful (some would say scared and slow) in starting to use social media platforms in their communications, marketing, and CSR strategies. Some companies have however slowly started to adapt to the changing media environment and I feel proud that Pfizer is one of the leaders in the industry. See for instance our Corporate Facebook page, and follow us on http://twitter.com/pfizer. And by all means, go to the Facebook page of our initiative Can You Feel My Pain, or view some of my favourite uploaded contributions from teenagers involved in the Dizza Tobak project (for instance “Love this way to die“).

So although we may feel unsecure in the new media environment, and especially how to manage issues such as reporting of adverse effects, it should be obvious for everyone that the development cannot be stopped… And if we had not understood that previosuly, I think Hanna Brodda’s presentation based on her personal experiences and experiences from running the site Dinamediciner.se made it clear. Our final and most important stakeholder, i.e. the patient, have dramatically changed his/her behaviour the last years. They are out their on the social media platforms and they discuss illnesses, medicines, individual doctors, alternative treatments etc. We may not like all those things and we may disagree on several issues, but we just have to understand that it happens and we need to manage that. And yes there are several reasons to be scared of the development, but on same time there are several positive things and great opportunties with the revolution as well!

 From MiljöRapporten Direkt:

“… Enligt Anders Wijkman som leder upphandlingsutredningen handlar problemet även om uppföljning.
– Det är helt centralt att tuffa miljökrav ställs. Lika viktigt är dock att följa upp kraven och kunna verifiera att man fått vad man efterfrågat. Där har det brustit mycket hittills. Jag är övertygad om att vi kommer med ett vasst betänkande när utredningen är klar till slutet av året…”

One thing that I also want to comment is that both on the front page of the NyTeknik newspaper that arrived in my mailbox this morning as well as on their website, another news article regarding pharmaceuticals is highlighted just next to the worrying news about presence of pharmaceutical residues in the environment. But this article is presented in a very “positive” way: “Take a pill - and skip your work-out training”. “The work-out pill is soon a reality“…

I do often find it somewhat disturbing that reports about pharmaceuticals are either “scary alarms” or “magical innovative news”. It has however rarely been as clearly shown as on the front page of today’s NyTeknik… I would prefer a more balanced discussion, both regarding the worrying reports as well as the promising innovations. Life is very rarely completely black or white!

Pretty much the same topics as were discussed on our meeting on November 14 were on the agenda now, and the final wording of the different proposals for objectives are being laborated upon. We will now all receive a final draft of the report including all proposed objectives allowing for our final comments. On February 1, the chairperson of the expert group, Christina Rudén, will give a presentation to the All-Party Committee. It will be very interesting to see what will remain unchanged, what will have been altered to some extent and what might even have been deleted completely when the All Party Committee publish its final report regarding the environmental objective “A Non-Toxic Environment” on June 15…

Stay tuned… This document, together with the outcome from ongoing environmental initiatives such as the ones in the National Pharmaceutical Strategy, will be very important to set the “Pharmaceuticals and the Environment” agenda for the coming years.

Their comments have helped me in my thought process regarding CSR platforms and programs. And as you know if you read my blog post from Jan 9, during 2012 I will both work on a further development of Pfizer’s CSR-programs and, within my part-time assignment at LIF, the development of a CSR-platform for LIF. Niclas’ and Susan’s comments are of course welcome in that work process!

The results show that 92 out of 101 APIs could be detected in incoming waste water, 85 APIs were found in treated effluent leaving the treatment plant. 23 APIs were also found in fishes investigated and 26 APIs were found in drinking water.

Jerker Fick, at Umeå University, says to Dagens Apotek that the identified concentrations in drinking water are extremely low compared to therapeutic doses. Hence, there is no known risk for humans consuming drinking water. The study however states that the concentrations of some of the APIs in surface water could potentially impact water living organisms such as fishes.

As has been discussed for several years now, the type of impact, the degree of that impact to water living organisms, and potential consequences (especially on an ecosystem level) are however not known. I hope that MistraPharma and similar research initiatives could help us to understand these matters better, and also help society to identify, and specify, any potential further investments in the waste water treatment facilities.

Jan Christiansson, at the Swedish EPA, states in the press release that in addition to upgraded waste water treatment plants there is also a need for industry to design the APIs in a more “environmentally adapted” way, hence for instance allowing for faster biodegradation of the substances. I have commented on this matter of “green design” previously and I couldn’t agree more in principle, however huge difficiulties exist… It is not an easy task for our scientists to both make substances with good therapeutic effects, without severe adverse health effects, and simultaneously perfectly control the degradability. The substance should not degrade until it has given it’s intended medical effect, but preferentially directly afterwards. Not easy, but something industry tries to accomplish…

So I agree with Jan Christiansson that upgrades of certain waste water treatment plants will most likely be necessary, but we should also never forget to strongly communicate to the public, to all users of pharmaceuticals, that un-used medicines should never be thrown into the toilet! Un-used medicines should be brought back to a pharmacy for controlled disposal.

My most important objective for the year, in my part-time role at LIF, is to deliver according to the project plan for action item 7.2 in the Swedish National Pharmaceutical Strategy (NLS):

7.2. Encourage voluntary control of emissions from pharmaceutical factories (Lead: LIF): Introduction of a voluntary environmental labeling of pharmaceutical products.

In order for LIF to be succesful in this work it is crucial that Sofia Wallström comes to a positive conclusion regarding green economic incentives in her review including action item 7.1. in the National Pharmaceutical Strategy:

7.1. Investigate if the environmental aspects should be considered when decisions on subsidy for a pharmaceutical are decided (Lead: Ministry of Health and Social Affairs): Review of possibilities to – within the context of the national reimbursement system - increasingly take environmental considerations.

Read more about the environmental action items in the National Pharmaceutical Strategy via this link. Below is my hand-written version of the project plan for item 7.2 that I update continuously as the project develops…

Project plan NLS 7.2

I know it is difficult to see the details of the project plan, but I can tell you that an additional crucial issue (in addition to positive conclusions in Sofia W’s work on NLS 7.1) is the development and finalization of green criteria for pharmaceuticals: Which pharmaceuticals are green? Below is a summary of criteria discussed in LIF’s round-table discussions during 2011:

My second most important objective for 2012 will be to develop a CSR platform for LIF, and to maintain and further develop the CSR-programs in Pfizer. When it comes to a CSR platform for LIF you will find some of parts on which I believe the platform should be based in my blog post from Oct 19, when I wrote about my part-time assignment at LIF. Regarding the CSR programs at Pfizer I recommend that you read about them on our Swedish web site and on our global web site. There are a lot of interesting projects, programs and initiatives running. It is a huge task only to maintain them, even more so to further develop them.

If you have followed me here at the blog you would probably know that one of the more interesting developments of our CSR program I strongly believe in is the “more-than-medication initiatives”. Please spend some time reviewing our Canadian colleagues’ initiative at morethanmedication.ca or our Australian colleagues’ program at morethanmedication.com.au. These kinds of initiatives are extremely important in what I refer to as Step 1, in our model called “4 steps to a sustainable use of pharmaceuticals“:

Sustainable use of pharmaceuticals

Let’s hope for a productive and successful 2012!

- The National Pharmaceutical Strategy was published and it did highlight some important issues around Pharmaceuticals and the Environment (e.g. the so called action items number 7.1 to 7.4). One very important action item in the Strategy is number 7.1: Sofia Wallström’s review on environmental considerations within the frame of the pricing and reimbursement system.

- In parallell with the work to develop the Strategy, LIF run a series of round-table discussions (and break-out work group sessions) to develop ideas around green criteria and green economic incentives. These discussions will both be important for action item number 7.1 in the Strategy (see above) and for 7.2: “Encourage voluntary control of emissions from pharmaceutical factories” (see for instance this link for more information)

- As a consequence of the discussions around the National Pharmaceutical Strategy and Sustainability, a work-group within LIF, consisting of among others members from the Environmental Committee, developed a strategy called “4 steps to a sustainable use of pharmaceuticals“.

- I started working part-time at LIF (the Swedish Association of the Research Based Pharmaceutical Industry). It is fun, interesting and challeging - exactly as I want it! I will be the project leader for action item 7.2 in the National Pharmaceutical Strategy, and also develop a CSR strategy or program for LIF.

- LIF has, in collaboration with all relevant stakeholders in the sector, planned for a campaign to be run during spring 2012 on the importance to bring back, to any pharmacy of your choice, any un-used medicines. This is regradless of where you have purchased them. More to come on this item during 2012.

- The All Party Committee on Environmental Objectives was initiated. One of the first priorities is the objective “A Non-toxic Environment”. See the blog post from the initial meeting of the work-group on Pharmaceuticals and the Environment, which is a prioritized issue in the review of the “Non-toxic Environment-objective”.

- One of the most discussed items within the field of pharmaceuticals and the environment was MPA’s report on how GMP can be amended with environmental requirements. An item that will be high on the agenda for several years to come, that’s for sure.

- When it comes to Public Procurement the most important thing that happened during 2011 was that County Councils finally started to follow-up their criteria, and company answers, on environmental and social responsibility issues. See this link for some more details.

- MistraPharma got funding for an additional 4 year period. If you would like to meet one of MistraPharma’s project managers “face-to-face” please have a look on the TEDx lecture given by Joakim Larsson on pharmaceutical substance releases from manufacturing.

- The end of the Dizza Tobak project. After three extremely fun and interesting years our collaboration with among others SAMBA and A Non Smoking Generation the project has come to an end. It will be interesting to see how we manage to build on the experiences we have gained and on the lessons we have learned when it comes to working with youth advocacy leaders and social media.

- The EU communication on CSR was published (see the communication, and also some of my comments on CSR and corporations, e.g. “an enterprise 2020 company“, and how a CSR program in a company can be communicated to colleagues). I will for sure come back to this issue several times during 2012 in my work on developing a CSR strategy/program for LIF.

- The political summit in Almedalen was as always stimulating as well as very interesting. See some of my reflections to seminars and meetings via this link.

- We saw a good participation in Earth Hour 2011, but few political achievements during the large UN Climate Conference in Durban. Cannot really say that I believe any real breakthrough to happen here during 2012…

- I received the award “Women’s Heart of the Year” (in Swedish: Årets Kvinnohjärta) from the Sollentuna Kvinnojour. I have to admit that I am very proud!

- My blogpost number 400 was written… It has become quite a few blog posts during these years… I am actually kind of proud of this as well! It presents a good opportunity for interactive communication, although I have to say that I would still welcome much more comments!

If you would like to read a summary of year 2010 and the ideas and expectations I had for 2011 roughly a year ago follow this link. As you see, some things hang around several years…

The project was initiated three years ago. It has been a collaboration between, among others, Pfizer Foundation, Pfizer AB, SAMBA, A Non Smoking Generation, and American Cancer Society (ACS). The project is a tobacco prevention initiative, where teenagers are creating e.g. videos to share the message that “tobacco is NOT cool” through their social media channels and through other communication channels. Their contributions have been uploaded on the Dizza Tobak web site. Have a look - there are so many good pieces there! If you want more details on the project please read any of my many blog posts on Dizza Tobak. You’ll find them in the “Dizza Tobak Category Archive“. 

Anders Lönegård, the project manager from SAMBA, is right now finalizing “Dizza Tobak - the Book” and “Dizza Tobak - the Movie” where stories, experiences, lessons learned etc will be told. I promise to come back to the topic as soon as there are more stuff to share. It has been a very successful project, and it is definitely worth sharing!

Gustav Andersson, with a political responsability for environmental matters in Stockholm County Council, says in a press release that (nota bene: it is my own translation here):

“We will work faster, at a high speed, in several environmental areas with our tough objectives. Moreover, we challenge others!”

Pharmaceuticals is among the areas for environmental objectives. SLL says that they will continue their work to reduce the environmental impact from the usage of pharmaceuticals. A tool for this work is of course SLL’s own pamphlet of environmentally classified active pharmaceutical ingriedients, which is based on data from LIF’s classification scheme avalable through Fass.se. That makes good sense of course. But what frightens me is when they say that (once again my translation and words, not their)

“we will phase out all environmentally hazardous pharmaceuticals and chemicals”.

There are several life saving pharmaceuticals, which according to the classification scheme may very well be rated “environmentally hazardous”. To phase them out, e.g. products for chemotherapy, should not in my opinion be an objective for a county council. A wise use of the products, with safety precautions of course implemented, is to me a clear responsibility for a county council. Patients that need the therapy should of course have access to the treatment. I do not think actually that anyone in the County Council would argue here. It rather shows the problems of setting, and communicating, environmental objectives. Even if the use of “hazardous substances” has increased (which may be warranted due to an increase in patients with certain forms of cancer for instance) the County Council may have done a magnificent work within the environmental program.

The “right use” of pharmaceuticals - from the unique patient’s perspective and from a more holistic perspective on public health and environment - is not always a very simple discussion to take…