In the western world (highly developed. densely populated) people are used to consume and inevitably also dispose medicines or pharmaceuticals in private households or hospitals that are connected to public sewer systems (see Annex to chapter 1). Purification is normally designed as an end-of-pipe solution in treatment plants for mixed waste water. focussing on defined parameters. The wide range of pharmaceutical substances or residues is hereby usually not considered. But some negative effects (e.g. of hormones on the reproduction of fish) have already been proven and the potential risks of pharmaceuticals on aquatic ecosystems is giving reason to growing concerns. The PILLS partnership aims to find out. whether the separation and treatment of concentrated. pharmaceutically burdened waste water from highly concentrated waste water point sources (such as hospitals. old peoples homes) can be regarded as a sustainable. cost-effective step in the reduction of overall discharge of such substances into the aquatic system. The projects' results will be disseminated to the public in order to raise the awareness for this problem (e.g. to protect waste water from contamination with pharmaceuticals also in households). Since measures at treatment plants are end-of-pipe approaches and probably very cost intensive. they should be regarded as last technical step to take. after avoidance. Therefore communication measures leading to avoid water pollution are also important. The aim of the project is a) to gain comparable (scientific and practical) solutions to treat different types of point sources that can also be transferred to other locations and b) to take the problem to a broad discussion about protective measures as well as about the responsibility of individuals. water boards. suppliers. hospitals or health service providers to avoid the pollution of water resources. Achievements: The concentrations of pharmaceutical residues, which are detected in the water, are very low and according to the current state of knowledge are not harmful to humans. However, for many substances it is unclear what effects these residues have on the water habitat – for example on micro organisms. Other micropollutants are already known as harmful for the environment. In these cases politics are asked to react.How a reduction shall be realised is currently an open question – it may happen by waste water treatment, prohibition of substances or other options. Regarding the PILLS project, one approach to deal with pharmaceutical micropollutants was the investigation of point source treatment:Which impact may point source treatment have on the load of specific substances that are mainly consumed in hospitals?Which techniques are appropriate to reduce the concentrated discharge at hospitals?What is the effect of this cocktail of pharmaceuticals on the bacteria population in the waste water treatment plants, in terms of the spread of multi-resistant bacteria?The projects full name "Pharmaceutical Input and Elimination from Local Sources" encompasses the idea of investigating waste water quality and researching and testing elimination methods to achieve better waste water treatment at the source. In this sense the work of the cooperation can be stated to be extremely successful. The increase in understanding of the issue, both in scientific terms and amongst the various communities (political, operational, public) has been dramatic during the last five years and the PILLS project has contributed to this in no small way with around 50 papers, more than 130 articles published reporting about the project and 150.000 visits to the website. We know now that it is possible to eliminate pharmaceuticals at one important points of use, the hospitals, and that it makes sense to do so from an ecotoxicological and multi-resistant bacteria point of view. However, doing so will be expensive and it is not certain this is warranted from a purely environmental or life cycle analysis point of view. Alternative approaches should be investigated and therefore the consortium has proposed a follow up project to study the impact of avoidance and optimisation of biological removal processes. The follow-up Interreg IV B project "noPILLS" was approved in 2012 and runs until 2015. The homepages of both projects www.pills-project.eu and www.no-pills.eu are linked to each other and provide latest findings, downloads and information about the topic.Four of the six PILLS partners worked together with local partner hospitals on the development of treatment facilities that were designed especially for the treatment of the hospital waste water. The hospitals cooperated voluntarily and the PILLS partners are grateful for their support and assistance – without the commitment of the partner hospitals PILLS would not have been possible. The experts meetings and exchange were funded as well as practical development of treatment facilities with associated research, dissemination and publicity actions and the organization of the partnerships activities.