Teaching the true cost of medicines: white paper for a green and sustainable pharmacology curriculum.

The drug lifecycle imposes a growing environmental burden, evident in pharmaceutical pollution, escalating consumption of finite resources (energy, water, and raw materials) and a substantial carbon footprint. Meeting these challenges requires more than technological fixes; it demands a workforce trained to recognise, evaluate, and reduce the environmental impacts of medicines while safeguarding patient outcomes. However, recent scoping and systematic reviews consistently note a gap in health professions education: few curricula provide structured, evidence-informed approaches for integrating environmental sustainability and planetary health into pharmacology and related training. The discipline of pharmacology is uniquely suited for integrating green and sustainability principles because it sits at the decision-point where molecular mechanisms become real-world medicine use and environmental impact. This paper presents a white paper proposing a Green and Sustainable Pharmacology Curriculum and an actionable strategy for embedding sustainability principles within core pharmacology teaching. Targeted at biomedical scientists, pharmacists, and prescribers, the curriculum is designed to strengthen decision-making across the medicine lifecycle, including greener selection, rational use, and responsible disposal. We outline a curriculum development framework that applies Understanding by Design and outcome-based evaluation through four streamlined steps: (1) needs analysis, (2) curation of priority content topics, (3) constructive alignment of learning activities with intended competencies, and (4) assessment aligned to learning outcomes. By offering an adaptable blueprint for local implementation, this white paper aims to accelerate adoption by pharmacology departments worldwide. Ultimately, the curriculum seeks to shift learners from concerned global citizens to empowered pharmacologists with personal agency implement workplace changes that mitigate environmental harms and to serve as thought leaders advancing sustainable healthcare.