South Africa’s Department of Water and Sanitation Responds to High Levels of ARVs in Rivers and Treated Water Supplies
ARV-Contaminated Water IN SA: South Africa’s water system is facing an unusual yet alarming challenge — the presence of anti-retroviral (ARV) drugs in both rivers and treated water supplies. In a recent study by North-West University, high concentrations of these pharmaceutical compounds were found in water sources across the country, prompting concern from health experts, researchers, and now the government itself.
What the Research Revealed: ARV-Contaminated Water
The North-West University study discovered dangerously elevated levels of ARVs in South Africa’s rivers and municipal water systems — levels that exceed global safe water standards. These drugs, primarily used to manage HIV/AIDS, are being excreted by the millions of South Africans on treatment, ultimately flowing into sewage systems and then into rivers and reservoirs.
But it’s not just the presence of ARVs that’s troubling — it’s the impact. The university warned that:
- Freshwater snails exposed to ARV-laced water showed abnormal embryonic development.
- Bacteriophages, which help regulate bacteria in wastewater treatment plants, were negatively affected, potentially leading to bacterial overgrowth and a decline in water quality.
- The long-term health impact on humans is still uncertain, but the risks are serious enough to warrant immediate intervention.
Government’s Response: A Plan in Motion
Speaking in Parliament on 15 July 2025, Department of Water and Sanitation Director-General Sean Phillips acknowledged the severity of the issue and committed to formulating a strategy.
“Most wastewater treatment works were designed some time ago and they weren’t built to handle this level of antiretroviral chemicals,” said Phillips.
The department is now collaborating with researchers from North-West University and the Water Research Commission to assess the health and environmental implications. Depending on the outcomes, the government will develop and implement updated treatment strategies specifically aimed at removing ARVs and similar bioactive compounds from the water supply.
This may include:
- Technological upgrades to wastewater treatment plants
- New filtration methods targeting pharmaceutical residues
- Increased monitoring and testing of water systems
- Educational campaigns to inform the public about safe medication disposal
Why This Matters for Public Health
ARVs are life-saving drugs, but when they find their way into our water systems in high concentrations, they can pose unintended consequences. While no immediate human illnesses have been reported, the ecosystem disruption and the uncertainty around long-term exposure have triggered concern.
The situation also raises broader questions about urban infrastructure, public health safeguards, and how developing countries like South Africa manage the interplay between healthcare and environmental sustainability.
Looking Ahead
As research continues and public concern rises, the Department of Water and Sanitation has assured South Africans that no stone will be left unturned in ensuring water safety. The government’s partnership with academic institutions and the Water Research Commission signals a proactive and scientific approach.
This emerging challenge is a wake-up call — not only to strengthen our water infrastructure but also to innovate in ways that match the country’s evolving healthcare landscape. With the right investments and oversight, South Africa can turn this crisis into a case study in resilience, research, and reform.
Also read: New HIV Prevention Drug Rolled Out in South Africa – A Game Changer for Public Health
