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PREVENTING DISEASE THROUGH SAFE WASTE MANAGEMENT A Contribution to Public Health MENA Healthcare Infrastructure Investment & Finance Summit 2010 Cairo, 27-28.10.2010 Katharina Kummer Peiry, Executive Secretary Secretariat of the Basel Convention, UNEP SUB-TOPICS Introduction – Hazardous Waste and Health How Can We Promote ‘Green’ Health-Care? Basel Convention at a Glance Biomedical & Healthcare Wastes under BC BC Technical Guidelines on the ESM of Biomedical and Healthcare Wastes 2 INTRODUCTION Image: thehindubusinessline.com Healthcare facilities are among the common pollution sources, in addition to other activities/facilities. Some health-care waste types pose hazards to the public and environmental health due to their hazardous constituents (infectious, toxic, etc.) and potentially improper management Despite aiming at facilitating treatment for various diseases, health-cares facilities may also spread the disease agents carried in their waste materials. 3 Introduction (2) Health-care waste issue on newsmedia (1) “50% Mumbai hospitals cut corners; sell off bio-medical waste” … Over 50% of the hospitals sell off their bio-medical waste such as worn out disposable syringes, saline bottles, suction pipes used for blood transfusion and glucose, scissors and urine bags to scrap dealers. … “This is a white-collar crime. Indulging in it can put several lives at risk. Public awareness has to be generated to stop such a trade,” said Anup Nilawar, director SMS Envoclean. Published: Tuesday, Oct 12, 2010, 2:08 IST, By Priyanka Sharma (www.dnaindia.com) 4 Introduction (3) Health-care waste issue on newsmedia (2) “Waste accounts for $850B of healthcare costs annually” … The research firm found that unnecessary care, which it defines as overuse of antibiotics and diagnostic tests, accounts for 40 percent of healthcare waste; that administrative inefficiency contributes another 17 percent of costs; that provider errors account for 12 percent of waste; that preventable conditions generate 6 percent of healthcare waste; and that lack of care coordination generates 6 percent of waste. … (www.fiercehealthcare.com) 5 HOW TO PROMOTE ‘GREEN’ HEALTH-CARE? Your investment in health-care establishments certainly will support public health infrastructure. But, how would it ultimately turn out? Profit, reputation? Liability? Experience shows that with core expertise and safe & proper waste management, many health-care establishments can support public health: Curative (to patients) Preventive (to the environment) Public health & environmental problems from health-care waste can be prevented, a.o., with proper waste management (haz waste minimisation, safe disposal, etc.) 6 How To Promote ‘Green’ Health-Care? (2) Typical ratio of haz waste over non-haz waste in total waste from clinics & hospitals is about: 15:85 (USA, American Hospital Association) 20:80 (Europe, Health Care Without Harm) Treatment and disposal costs for haz waste are relatively higher than those for non-haz waste. It is important to segregate the originally non-haz waste from the haz waste in order to reduce volume and, eventually, costs. 7 How To Promote ‘Green’ Health-Care? (3) It is important for investors to ensure that the management take all Occupational Health & Safety and Environmental issues be addressed at all stages of activity. Planning Construction Operation Closure Make use of available standards, guidelines, best managemen practices such as those of the Basel Convention. 8 BASEL CONVENTION AT A GLANCE Basel Convention (BC) on the control of transboundary movement of hazardous wastes and their disposal The most comprehensive global environmental agreement on hazardous and other wastes Adopted on 22 March 1989 in Basel, Switzerland Entered into force on 5 May 1992, currently >170 Parties Governed by Conference of Parties (COP), the last COP theme was “Waste Management for Human Health and Livelihood” at which the “Bali Declaration” was launched (refer to brochures) Main Goal To protect, by strict control, human health and the environment against the adverse effects which may result from the generation and management of hazardous wastes and other wastes 9 Basel Convention at a Glance (2) Mechanism for Achieving the Goal The control of the transboundary movement of hazardous wastes and other wastes Environmentally Sound Management (ESM) of hazardous wastes and other wastes ESM means addressing the waste management issue through strict controls from the generation of a hazardous waste to its storage, transport, treatment, reuse, recycling, recovery and final disposal The Secretariat of the Basel Convention (SBC) facilitates Parties in the development of a range of projects, guidelines, mechanisms and strategies for minimizing wastes and ensuring their ESM, incl. the BM&HC waste 10 BIOMEDICAL & HEALTHCARE (BM&HC) WASTES UNDER THE BASEL CONVENTION BM& HC wastes are BC wastes as they are listed on some annexes to the text of the Convention Annex I • Y1 – Clinical wastes from medical care in hospitals, medical centres and clinics • Y3 – Waste pharmaceuticals, drugs and medicines Annex III (by characteristics, a.o.) • H6.2 – Infectious substances Annex VIII • A4010 – Wastes from the production, preparation and use of pharmaceutical products • A4020 – Clinical and related wastes 11 BC TECHNICAL GUIDELINES (TGs) FOR BM&HC WASTE MANAGEMENT One of the TGs provided to Parties as a tool for managing the BM&HC waste which is classified as hazardous wastes under the BC. Basis: National guidelines from developed and developing countries; Publication from WHO (World Health Organisation); Paper by CEN (European Committee for Standardisation) To be used with other considerations, esp.: TGs for Incineration on Land; TGs for Specially Engineered Landfill; Legal frameworks and responsibilities of relevant CAs. 12 BC TGs on the ESM of BM&HC Wastes Definition of “Health-Care” Medical activities such as diagnosis, monitoring, treatment, prevention of disease or allevation of handicap in humans or animals, including related research, performed under the supervision of a medical practitioner or veterinary surgeon or another person authorised by virtue of his or her professional qualifications. Image: life.com 13 BC TGs on the ESM of BM and HCW Contents (for details, please refer to http://www.basel.int/pub/techguid/tech-biomedical.pdf) Introduction Purpose and scope of the guidelines General definition of biomedical and health-care waste Hazards of biomedical and health-care waste Field of application/source identification Waste identification and classification/waste groups Applicable state-of-the-art management, treatment and disposal technologies Waste management auditing Capacity-building Annexes 14 THANK YOU For Further Information on Biomedical & Health-Care Waste Management Programme: SECRETARIAT OF THE BASEL CONVENTION International Environment House 15 Chemin des Anémones Chatelaine CH-1219 Geneva, Switzerland Website: www.basel.int E-mail: [email protected], [email protected]