Abstract

Pharmaceutical waste management presents significant challenges in low- and middle-income countries (LMICs) due to limited infrastructure, inadequate regulations, and weak enforcement mechanisms. Improper disposal of expired or unused medicines contributes to environmental contamination, antimicrobial resistance, and public health risks. This review synthesizes current literature to explore the sources, types, and impacts of pharmaceutical waste in LMICs. It highlights systemic barriers such as insufficient funding, lack of awareness among healthcare providers and the public, and inadequate integration of waste management into national health policies. Furthermore, the paper examines successful interventions, including take-back programs, regulatory reforms, green pharmacy practices, and public-private partnerships. By comparing case studies and emerging innovations, the review identifies sustainable solutions tailored to the socio-economic and infrastructural realities of LMICs. Ultimately, effective pharmaceutical waste management requires a multi-stakeholder approach combining policy frameworks, capacity building, and community engagement to mitigate environmental harm and safeguard public health.