Health-care waste management
Purpose
Pharmaceutical waste management is regarded to be an integral part of supply chain management and the product life cycle, as a result of the use and/or expiry of health products. Inadequate and inappropriate handling of health-care waste can have serious public and global health consequences and a significant impact on the environment. Governments can better protect public and planetary health by reducing the volume and toxicity of the wastes produced and by implementing a range of environmentally and socially sound waste management and disposal options. Solutions exist to develop and popularise technologies, products and concepts that will help drive countries to a zero waste, low-carbon, toxics-free, circular economy.
Pharmaceutical waste includes expired, unused, spilt and contaminated pharmaceutical products, prescribed and proprietary drugs, vaccines and sera that are no longer required, and, due to their chemical or biological nature, need to be disposed of carefully. The category also includes discarded items heavily contaminated during the handling of pharmaceuticals, such as bottles, vials and boxes containing pharmaceutical residues, gloves, masks and connecting tubing.“
Source: World Health Organization, 2014. Safe Management of Wastes from Health-care Activities, 2nd edition.
UNDP’s approach
As part of support from the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), UNDP helped to conduct rapid assessments of national set-ups for managing health-care waste, with a view to understand the environmental impacts and safety concerns, in Belarus, Bosnia and Herzegovina, Kyrgyzstan, Tajikistan, Uzbekistan and Zimbabwe. These assessments resulted in the development of the Healthcare Waste Management Toolkit Package for practitioners and policy makers.
Upstream reduction of health product waste
UNDP undertakes two main axes of work to reduce waste production upstream. One is to strengthen areas of the procurement and supply chain cycle, such as quantification, inventory control, logistics management information systems, and procurement and distribution planning in supported countries. Building capacity in procurement and supply chain management helps reduce overstocking and product expiry, which result in the waste of financial resources and an increased need for pharmaceutical waste management.
UNDP also engages with antiretroviral manufacturers to optimize medicine packaging and reduce resulting waste. This practice, which has been piloted in a few countries, will be incrementally applied to other categories of medicines for which UNDP pools demand and procures on behalf of supported countries. The optimization of packaging to reduce upstream waste, requires coordination with manufacturers and national regulatory authorities to comply with international and national standards for medicine labelling. With increased experience and lessons learned, UNDP’s piloted approach for optimizing medicine packaging could be adapted and replicated by national procurement systems.
Tools and guidance
UNDP has developed the Health-care Waste Management Toolkit, based on several rapid country assessments of health-care waste management set-ups in 2015, to support the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), UNDP and other practitioners and policymakers. The toolkit consists of:
Part A – Rational for Environmental Safeguard Policies
Part B – Waste Stream Concept Development
The UNDP/SPHS Sustainable Procurement Guidance Note (2020) is a useful resource for integrating sustainability strategies in health procurement processes. It details steps of the sustainable health procurement approach, creation of an action plan and integration of the action plan into procurement planning, solicitation design, contract management and responsible supplier engagement.
UNDP’s partner Health Care Without Harm offers a range of health-care waste management resources, including guidelines and assessment tools, on its website. Additional guidance, including from the Global Fund and the World Health Organization (WHO), are available below.
Key Resources
Overview of Technologies for the Treatment of Infectious and Sharp Waste from Health Care Facilities
