Safeguarding People and the Environment Against Infectious Waste During Health Crises

GEF’s support to countries is critical in promoting and implementing environmentally sound practices for medical waste treatment during health crises. It not only promotes global environmental benefits through best management practices, but also builds capacities in countries to minimize the impact of infectious waste on people. Synergies between health care and environmental sustainability are demonstrated through GEF-financed interventions, leading to overall reduction in harm to human health and the environment.

Since the COVID-19 outbreak in December 2019,  globally, there have been more than 3.5 million confirmed cases reported to World Health Organization (WHO) when this blog was written. Treating affected patients during this pandemic generated an enormous amount of medical waste. Take Wuhan city for example, where the COVID-19 first identified, hospitals produced more than 240 tonnes of medical waste per day during the peak of the outbreak, versus 40 tonnes pre-pandemic time. Mountains of infectious waste overburdened the city’s medical waste treatment system, which only has a daily processing capacity of 50 tonnes.

Improper treatment of medical waste could cause secondary disease transmission among waste workers and health workers due to their exposures to infectious agents. The common approach to dispose of infectious waste is incineration. Without adequate pollution control, incineration of waste results in the release of pollutants into the air and in the generation of toxic ash residue that pose serious health and environmental hazards.

How to safely deal with the increasing amount of medical waste? In addition to the Chinese government’s emergency responses, two GEF Agencies jointly developed an emergency medical waste disposal project in China to help close the gap in processing capacity. By deploying environmentally sound non-incineration mobile facilities, this project aims to enhance the capacity and efficiency of medical waste treatment in the areas hit the hardest by the COVID-19 in China.

It is worth noting that this project was developed based on the achievements and experience of the previous GEF-financed project “Environmentally Sustainable Management of Medical Waste in China”, which helped the country to improve medical waste management practices after the outbreak of Severe Acute Respiratory Syndrome (SARS) epidemic in 2003. According to the project’s terminal evaluation, this GEF project assisted China in implementing its relevant obligations under the Stockholm Convention through minimizing the generation and emissions of unintentionally produced Persistent Organic Pollutants (POPs) from the medical waste treatment sector. It also provided massive training covered 50,000 people, resulting in an increased awareness of the medical waste treatment issues among the operators of the healthcare system.

Not only in China, GEF-financed environmentally sound sterilizing equipment (autoclave) has brought significant and positive change to Guinea, Liberia and Sierra Leone during the 2014-2016 Ebola outbreak to help those countries safely treat medical waste.

The autoclave was designed under a GEF-funded project on “Demonstrating and Promoting Best Techniques and Practices for Reducing Health-Care Waste to Avoid Environmental Releases of Dioxins and Mercury” , which was implemented United Nations Development Programme (UNDP) from 2007 to 2012. An important component of the project was to develop and disseminate affordable non-incineration healthcare waste treatment technologies that can be built and serviced in sub-Saharan African countries using locally available supplies and skills. After completion of pilot activities and testing of the prototype in Tanzania, the new autoclave system was produced in partnership with a South African autoclave manufacturer – Medi-Clave.

During the Ebola outbreak, the microbiological tests indicated that the Ebola virus would be effectively destroyed by the autoclave system developed under the project, therefore, another project was immediately launched by UNDP, which provided 20 autoclaves to the three Ebola-affected countries to help dispose of infectious waste generated in treating Ebola patients. The autoclave was the first of its kind in any of the Ebola-affected countries. Unlike burn barrels, burial pits, or low-tech incinerators that emits dangerous fumes and toxic ash, the autoclave uses high temperature and pressure steam to disinfect the waste, allowing for their safe disposal. These autoclaves are now used for treating hospital waste in the post-Ebola recovery period.

Lessons learned from this deployment of autoclaves during the Ebola outbreak have been incorporated into a new GEF funded project “Reducing UPOPs and Mercury Releases from the Health Sector in Africa”. In partnership with UNDP, WHO and Health Care Without Harm, this GEF project will introduce non-incineration healthcare waste treatment technologies and mercury-free medical devices in another four Sub-Saharan African countries (Ghana, Madagascar, Tanzania and Zambia) to reduce harmful releases from the health sector.

As the COVID-19 outbreak getting under control in China, Chinese lawmakers started to act on improving medical waste regulations based on the experience gained in the fight against COVID-19. Just about 10 days ago, on April. 26, a new draft law revision proposing strengthened medical waste management was submitted to the National People’s Congress (NPC) Standing Committee for review. By changing behaviors and the choices we make today, we create hope for a better future.

Read more about how the GEF response to the crisis, by clicking here.