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In Germany, as in almost all industrial countries, active pharmaceutical substances can now be found in virtually all water bodies and occasionally also in drinking water. Even though the concentrations in question tend to be very low, there are initial signs of their impact on aquatic life. There is no evidence as yet of any acute consequences for human health. It is, however, impossible to rule out long-term consequences from these minimal concentrations or unexpected effects from the interaction between various active ingredients (cocktail effect). At special risk here are sensitive segments of the population such as children and the chronically ill. There is thus a need for action on precautionary grounds.
The main actors in the health system are largely unaware of the problem posed by drug residues in water. Although knowledge cannot be equated with awareness – given the existence of the ‘not wanting to know' phenomenon – the first step is to generate a consolidated knowledge base. Only by creating awareness of the problem can further strategies be implemented to ultimately enlighten and bring about behavioural change. At stake here is the overall everyday handling of medications, including prescription, compliance, and drug-free disease prevention down to the doctor-patient relationship. The latter, namely, is often characterised by misunderstandings and a lack of communication about the – supposed – need to prescribe drugs.
The first part of the strategy for the general public involves using various channels and media to address three different target groups. These were identified by ISOE in an empirical survey as reacting differently to the problem under review:
· ‘The Deniers/Relativists'
· ‘The Truth-Seekers'
· ‘The Hypersensitives'
The intention is to address each target group in the right tone and using the most suitable line of reasoning via specific media and with the proper degree of differentiation. The ‘Truth-Seekers' play an opinion-leading role here. They can be provided with highly differentiated information through sophisticated media which they then pass on to their dialogue partners in an appropriate form.
The second part of the strategy for the general public relates to the communication of proper disposal routes for expired drugs. The goal is to confine disposal to pharmacies so that on no account are they flushed down the sink or toilet. Based on an analysis of typical errors in existing communications media on this topic, ISOE prepared recommendations for drafting proper information materials.
In addressing pharmacists, the first priority is to convey hard facts: to this end we propose a PR campaign to place articles in the main specialist media. At the same time, the subject should feature in training and continuing education programmes. Another aim is to strengthen the advisory function of the pharmacies. The environmentally sensitive target group would indeed react positively to having their attention drawn to the issue of drug residues in water. For all other customers, the pharmacists can and should act as consultants: they emphasise how important it is to take medication as instructed (compliance) and use suitable pack sizes, and warn older customers in particular about the potential hazards of improper drug intake.
The first stage of the communications strategy for doctors likewise revolves around knowledge. Here, however, it is important to take into account their self-image as scientists while in fact having little grasp of this specific area. The line to take is that of ‘discursive selfenlightenment'. This means that the issue of drug residues in water cannot be conveyed to doctors by laymen but must be taken up and imparted via the major media of the medical profession and by medical association officials (top-down).
The second stage, namely that of raising doctors’ awareness of the problem, is likely to encounter strong resistance from some of the medical profession. They may fear a threat of interference in treatment plans from an environmental perspective and feel the need to emphasise that doctors are not responsible for environmental issues. As shown in empirical surveys by ISOE, such a defensive reaction is ultimately down to an underlying taboo: people are loath to discuss the over-prescription taking place in countless doctors' surgeries. And it is a fact that this problem cannot be tackled from the environmental perspective, although the goals of water protection are indeed consistent with the economic objectives of restraint in the deployment of drugs. Any communications measure for this target group has to bear in mind that doctors feel restricted by what they see as a ‘perpetual health reform' no matter which government is in power. On no account are they prepared to tolerate any new form of regulation, in this case for environmental reasons.
An entirely different view of the problem is taken by ‘critical doctors' such as specialists in environmental health and those with a naturopathic focus. They are interested in the problem because they see a connection between the quality of our environment and our health. What is more, they have patients keen to be prescribed as few drugs as possible and who are instead interested in ‘talking medicine'. So, any communication strategy intent on tackling the difficult problem of oversubscribing drugs needs to look carefully at the experiences of these medical professionals and also at a ‘bottom-up strategy'.
Implementation of strategic communications should be entrusted to an agency with experience in ‘issue management'. Knowledge of social marketing and the influencing of behaviour are further prerequisites. All important decisions should be taken by a consensus committee (‘MeriWa'1 round table), in which the medical profession, pharmacists and consumers are represented.
Research aimed at helping to solve pressing societal problems must meet specific quality requirements: The knowledge it produces must not only be sound but also useable. This is particularly true of research that aims at bringing specific knowledge to bear on policy issues relating to sustainable development. This guide provides detailed actor-specific requirements profiles for this type of “policy relevant sustainability research.”
This guide is aimed at research funding agencies and contracting entities, researchers themselves and policymakers1 who participate directly in the research process. It can be used both for cases where the research funding agency/contracting entity and the policymaker are different institutions or where they are identical. However, policy consulting by specialized agencies that do not perform original research is not addressed.
The requirements profiles serve two functions. First of all, they should function as a guide for the three stakeholder groups, aiding them in their efforts to increase and ensure the quality of research processes and research outcomes. And, secondly, they should improve the reflexive communication among stakeholders regarding the means and the goals of research...
The results presented here are part of a research and development project (Research Code Number: 3711 11 701) funded by the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety (BMU) and the German Federal Environment Agency (UBA). The project was carried out by the Institute for Social-Ecological Research (ISOE, project management), the Institute for Ecological Economy Research and the Environmental Policy Research Center for of the Freie Universität Berlin (FFU) (project duration: 09/2011-01/2013).
The aim of the project was to develop concepts that can be used to increase the relevance of sustainability research for the design of environmental policy in Germany. In addition to the requirements profiles for a policy relevant sustainability research presented in this guide, recommendations, based on empirical studies, have been developed regarding how the coordination between different government departments with respect to funding such research can be optimized. The project's final report will be available starting March 2013 from the UBA.
Forschung, die einen unmittelbaren Beitrag zur Lösung drängender gesellschaftlicher Probleme leisten will, muss sich besonderen Qualitätsanforderungen stellen: Sie soll nicht nur gesichertes, sondern auch anwendbares Wissen bereithalten. Dies gilt besonders für Forschung, die darauf zielt, Politik in Fragen nachhaltiger Entwicklung mit spezifischem Wissen zu unterstützen. Für diesen Typ einer „politik-relevanten Nachhaltigkeitsforschung“ präsentiert der vorliegende Wegweiser ein detailliertes Anforderungsprofil.
Der Wegweiser richtet sich an Förderer oder Auftraggeber einer solchen Forschung, an die Forschenden selbst und an Akteure aus der Politik, die sich direkt an Forschungsprozessen beteiligen. Er kann dabei sowohl für den Fall genutzt werden, dass Forschungsförderer oder Auftraggeber und politische Praxispartner verschiedene Institutionen sind, als auch für den Fall, dass sie identisch sind. Politische Beratung durch spezialisierte Agenturen, die keine eigene Forschung leisten, wird dagegen nicht adressiert.
Die im Detail ausgearbeiteten Anforderungen haben zwei Funktionen. Sie sollen zum einen den drei genannten Akteursgruppen als Orientierung dienen, wie sie dazu beitragen können, die Qualität von Forschungsprozessen und Forschungsergebnissen zu erhöhen und zu sichern. Zum anderen sollen sie die reflexive Kommunikation zwischen den Akteuren über Mittel und Zwecke der Forschung verbessern. ...