Climate and Environmental Sustainability Across Healthcare to Inform Updates to WHO/FIP Good Pharmacy Practice (GPP)

Background and rationale Healthcare systems significantly contribute to environmental degradation through energy consumption, pharmaceutical and medical waste, water use, pollution, and greenhouse gas emissions.1,2 Climate change and environmental decline now pose direct threats to global health systems, demanding that all health professions—including pharmacy—integrate sustainability principles into daily practice, service delivery, and regulatory frameworks.3,4 The current WHO/FIP Good Pharmacy Practice (GPP) guidelines (2011) provide comprehensive standards for quality, safety, and professionalism in pharmacy services.5 However, the document contains minimal explicit guidance on environmental sustainability, referencing only safe waste disposal, medicine storage conditions, and environmental risks related to disposal of expired or unwanted medicines. Since 2011, sustainability considerations have evolved dramatically, including • Climate mitigation expectations within pharmacy practice • Circular economy principles and resource efficient operations within pharmacy practice • Sustainable procurement, green pharmacy initiatives, and carbon reduction strategies • Expanded pharmacist roles in managing environmentally safe medication disposal, reducing unnecessary packaging, and improving supply chain sustainability This scoping review will systematically map global evidence on climate and environmental sustainability in pharmacy practice, with a focus on the roles, responsibilities, and opportunities for pharmacists. The results will directly inform an updated, sustainability aligned version of the WHO/FIP GPP guidelines.