healthcare waste management assessment and strategies for global fund projects
TRANSCRIPT
United Nations Development Programme
'Saving Lives Sustainably'
Healthcare Waste Management Assessment and Strategies for Global Fund Projects
Dr. Christoph Hamelmann, UNDPJan-Gerd Kühling, ETLog
Presentation at The Global Fund
Geneva, 15 April 2015
The Guiding Principles
Following Primum Non Nocere
Guarding Human Rights
Acceptance of Polluter Pays
Supporting Greening the Blue
Supporting UNDP Environmental and Social Standards
Assessing Practice and Potential Impact
To assess the possible environmental impact of GF grants, rapid assessments on healthcare waste were carried out
Pathways of Environmental FootprintRelated to Healthcare Waste
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)
Example: TB Grants
General waste
Infectious waste from testing including highly infectious waste (BSL 3 labs)
Chemical waste
Sharps waste
Pharmaceutical waste (first- and second-line anti-TB medicines)
Tanzania - medical waste. © 2013 by Global Environment Facility
Tanzania - medical waste inside. © 2013 by Global Environment Facility
Example: Malaria Grants
General waste
Infectious waste from testing and sharps waste
Pharmaceutical waste
Toxic chemical waste(indoor spraying, contaminated packing, disposal of used LLINs)
What are we talking about…
Hazard identification for ARVs and ACTs -Example: Efavirenz (based on MSDS)
Hazard identification for Efavirenz:o Hazard statement(s) : H400 Very toxic to aquatic life. o Precautionary statement(s): P273 Avoid release to the
environment.
Potential health effects of Efavirenz: o Inhalation: May be harmful if inhaled. o Ingestion: May be harmful if swallowed. o Skin: May be harmful if absorbed through skin. o Eyes: May cause eye irritation.
Overview – Waste Streams
International Agreements
Name of Convention Topic
Basel Convention Transboundary movement of hazardous waste
Stockholm Convention Persistent Organic Pollutions (POPS) e.g. Dioxins, PCB, DDT
Rotterdam Convention Consent Procedure for Certain Hazardous Chemicals and Pesticides
Vienna Convention/ Montreal Protocol
Protection of the Ozone Layer
ADR International Carriage of Dangerous Goods by Road
Minamata Convention Anthropogenic emissions and releases of mercury
Sample Impact for GF Grants
Name of Convention Examples of potential interventions
Basel Convention Tracing of to-be-returned pharmaceuticals / chemicals from countries to supplier
Stockholm Convention Usage of alternative treatment systems for infectious waste instead of incinerators; substitutions
Rotterdam Convention Selection of pesticides for spraying (malaria)
Vienna Convention/ Montreal Protocol
Refrigerator without CFC (chlorofluorocarbon) and HCFC (hydrochlorofluorocarbon)
ADR Requirements on transport and transport packing for hazardous goods and waste
Minamata Convention No supply of mercury containing medical devices (thermometer, sphygmomanometer)
Waste Management Systems Country Level
Waste management systems do oftennot exist
Basic waste logistic equipment is ofteninadequate
Hazardous and non-hazardous waste is collected together
Frequent accidents are reported (needle stick)
Responsibilities are unclear
Grant budgets dedicated for financingwaste management are largely missing
Tanzania - healthcare waste was improperly disposed. © 2013 by Global Environment Facility
Waste Management Systems Country Level
Healthcare waste treatment and disposal infrastructuregenerally weak
Simple incinerators exists which create environmental problems (dioxins)
Taking Responsibility
UNDP is developing a practical HCWM toolkit for Global Fund practitioners and policy makers
Target: Environmental Safeguarding Integrated in all GF NFM Grants
WHO Core Principles (HCW)
Sustainable Procurement in the Health Sector (SPHS)
Establishment of evidence-based standards
Implementation of environmental product specifications and procurement criteria
Engagement with suppliers / manufacturers and global health financing agencies
Sustainable Procurement in the Health Sector (SPHS)
Three dimensions:
Greenhouse gas emissions (GHG)
Resource depletion (water, energy and material consumption)
Chemical pollution
Sustainable Development Aid
USAID Sustainability Policy Statement DFID Corporate Social and Environmental Responsibility Statement
What the Others Do…
Environmental Safeguarding is today a standard in nearly
all international major health projects.
Multilateral Financing Institutions Environmental Policies
Gavi Environmental Statemento Commitment to minimize the
impact on the environment
UNITAID Green Procurement Policyo UNITAID supports the 4 R’s strategy
- Re-think the requirements to reduce environmental impact
- Reduce material consumption
- Recycle materials/waste
- Reduce energy consumption
United Nations Development Programme
TowardsSustainable Development Goals
Helen Clark
Keynote Address to Preparatory Session for the 3rd International Conference On
Financing for Development United Nations, New York, November 2014
‘The SDGs require major changes to be made in how public monies are
used to address international challenges.’
United Nations Development ProgrammeSaving Lives Sustainably
Protecting Millions of People Against Malaria in Chad © 2015 The Global Fund (Andrew Esiebo)
United Nations Development Programme
Twitter: @cahamelmann
Christoph HamelmannUNDP
Jan-Gerd KühlingETLog
Kristian SteeleARUP