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Ignacio Sanchez DiazGreening Health Systems SpecialistUNDP Istanbul Regional HHD Team UN informal Interagency Task Team onSustainableProcurement in the Health Sector (iIATT-SPHS)

International Healthcare Waste Conference, London April 14-15, 2016

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Healthcare Waste Management in the Context of Global Health Initiatives

Pathways of Environmental Footprint Related to Healthcare

Waste in Global Health Initiatives

WHO core principles (HCW)

Governments should:

Include adequate budgets for the management

of healthcare waste (HCW)

Request donors, partners and other sources of

external financing

Donors and partners should:

Include HCW management components in their

health programme assistance

Include budget for sound management of HCW

generated through their programmes

Include HCW management in health systems

strengthening components

Healthcare Waste Management Toolkit

Taking Responsibility:

UNDP is currently active to develop a practical

toolkit for healthcare waste management

Assessing the Impact of GF Grants

To assess the possible environmental

impact of GF grants, rapid assessments

on healthcare waste were carried out

Example: HIV / AIDS Grants

General waste

Infectious waste from HIV and STI testing

Sharps waste (including syringes from PWID)

Pharmaceutical waste (ARVs or medicines for the

treatment of opportunistic infections)

Waste Management Systems

Waste management systems do often not exist

Basic waste logistic equipment does not exist

Hazardous and non-hazardous waste is collected

together

Frequent accidents are reported (needle stick)

Responsibilities are unclear

Budgets for financing consumables and waste

services are missing

Available Infrastructure

Healthcare waste treatment and disposal infrastructure extreme weak

Simple incinerators exists which create environmental problems (Dioxin)

Example Ebola response

Support by UNDP, GEF, Government of Korea (USD 4 million)

Supporting health systems of Ebola-affected countries

Autoclaves as alternative to burning waste in open pits, barrels

or inexpensive incinerators

Close-up of the Ebola-infected waste in the red

zone. They pour kerosene and burn it at night.

Note syringes on the ground.

Example of situation in waste treatment in Ebola

area (photos from Jorge Emmanuel and Babacar

Ndoye)

Gonin, Etienne: “UNDP’s activities on Health Care Waste Management:

reducing human exposure to dioxins and furans”. April 2015. PowerPoint

Presentation

UPOPs and Mercury

Project: Reducing UPOPs and Mercury release in the Health Care Sector

Partners: UNDP, GEF, WHO and HCWM

Countries: Ghana, Madagascar, Tanzania and Zambia

Toxin or

Pathogen

Originates from Health Effects

Dioxins • Burning of medical waste in the open

• Burning of medical waste in low-technology

incinerators

• Cancer of soft tissues, lung, liver and

stomach

• Birth defects

• Reproductive disorders

Mercury • Broken Mercury containing thermometers and

sphygmomanometers, Hg containing laboratory

chemicals, etc.

• Damage to the brain, nervous system and

kidneys

• Developmental disorders;

• Lower IQ

HIV,

Hep. B & C and

other pathogens

• Inadequate disposal, handling and

reuse/recycling of contaminated syringes and

other waste items

• 240 million Hep. B infected people

• 130 million Hep. C infected people

• 35 million HIV/AIDS infected people

(2015)

Gonin, Etienne: “Reducing UPOPs and Mercury release in the Health Care Sector”. February 2014. PowerPoint Presentation

Project Components

1. Disseminate technical guidelines, establish mid-term evaluation criteria and technology allocation formula, and build teams of national experts on BAT/BEP (Regional component)

2. Develop Health Care Waste National plans, implementation strategies, and national policies in each recipient country (National component)

3. a. Make available in the region affordable non-incineration HCWM systems and mercury-free devices that conform to BAT and international standards (Regional Component)

3. b. Demonstrate HCWM systems, recycling, mercury waste management and mercury reduction at the model facilities, and establish national training infrastructures (National component)

4. Evaluate the capacities of each recipient country to absorb additional non-incineration HCWM systems and mercury-free devices and distribute technologies based on the evaluation results and allocation formula. (Regional Component)

5. Expand HCWM systems and the phase-out of mercury in the recipient countries and disseminate results in the Africa region (National and regional component)

6. Monitoring, learning, adaptive feedback, outreach, and evaluation.

Gonin, Etienne: “Reducing UPOPs and Mercury release in the Health Care Sector”. February 2014. PowerPoint Presentation

International Environmental

Conventions on Chemicals

This novel and unique tool will allow

procurement practitioners to measure and

monitor the status and progress of healthcare

procurement related to the compliance with

International environmental Conventions

The indicators proposed as part of this guide are

intended to serve as a building block of the

GPIH and the compliance with International

environmental Conventions might be considered

as one of the pillars for the development of the

Index

INTRODUCTION

Checklist, Indicators and Guidance

Automated Report Dashboard

INTRODUCTION

SPHS Task Team is, through a transparent and inclusive

engagement process, and by leveraging its normative and

market power, lowering the environmental impact of its

procurement, with a final aim of improving human health

and well-being.

INTRO with UNDP LOGO 7 UN agencies and

3 multilateral health financing institutions

SPHS Task Team

Engagement with the key stakeholders

from the global health aid market

CTION

SPHS Task Team is, through a transparent and inclusive

engagement process, and by leveraging its normative and

market power, lowering the environmental impact of its

procurement, with a final aim of improving human health

and well-being.

3,500 institutions/experts in

our global network and 92

countries

SPHS Task Team

INTRODUCTION

Key objectives

savinglivesustainably.org

THANK YOU FOR YOUR

ATTENTION.

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IGNACIO SANCHEZ DIAZGreening Health Systems Specialist

UNDP Istanbul Regional HHD Team

UN informal Interagency Task Team on Sustainable

Procurement in the Health Sector (SPHS)

ignacio.sanchez.diaz@undp.org

twitter: @SanchezDIgnacio

MIRJANA MILICSPHS Associate Coordinator

UN informal Interagency Task Team on Sustainable

Procurement in the Health Sector (SPHS)

mirjana.milic@undp.org

Twitter: @milic_mirjana

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