WHO Health Care Waste Management

1. WHO Health Care Waste Management Injection Safety Best Practices – Waste Management Richard M Carr Protection of the Human Environment (PHE)

2. WHO Health Care Waste Management Contents Health-care Waste Working Group Partners Strategy Products Action Items Conclusion Protection of the Human Environment (PHE)

3. WHO Health Care Waste Management Strategy : partners Regional activities • AFRO • AMRO • EMRO • EURO • SEARO • WPRO Internal partners • BCT Blood and Clinical Technology • VAB Vaccines and Biologicals • OSD Organization of Health Services Delivery • EDM Essential Drugs and Medicines Policies • PHE Protection of the Human Environment External partners • UNEP United Nations Environment Programme • SANDEC Water and Sanitation in Developing Countries • WEDC Water, Engineering and Development Centre • HCWH Health-care without harm • Initiated with others: PATH, CSIR etc. Protection of the Human Environment (PHE)

4. WHO HQ Health Care Waste Management HCWM strategy -progress in the last year • Evidence and information for policy Disease burden Risks related to HCW • Reference and guidance material Decision-making material Guides Case studies Web-site www.healthcarewaste.org • Safety and availability of options Description & contacts for HCWM options Framework to develop low-cost options • Country plans Aide-mémoire Networks National workshops Protection of the Human Environment (PHE)

5. WHO HQ Health Care Waste Management Framework for strategy Case studies Local level Guidance and information facility or campaign Case studies National level Government, ministries Guidance and information networks Evidence Country plans Protection of the Human Environment (PHE)

6. WHO HQ Health Care Waste Management HCWM strategy -What’s next • Gain experience - case studies • Outreach • Propagate information • Propagate awareness • Implementation in countries • Technologies for certain situations • Acceptance of responsibilities Protection of the Human Environment (PHE)

7. WHO HQ Health Care Waste Management HCWM strategy -What’s next • Many Products are available but better outreach is needed • Channels for outreach • Website • WHO Regional Offices • Mass mailings to country offices • Using established channels - e.g. UNICEF • Using established networks (SIGN, TECHNET, ISWA, HCWH…) • Conferences • Others? Protection of the Human Environment (PHE)

8. WHO HQ Health Care Waste Management Products • Aide-mémoire (3 languages) • Aide-mémoire immunization • Safe management of wastes from health-care activities • Teacher’s Guide to Management of wastes from health-care activities • Database (ongoing) Protection of the Human Environment (PHE)

9. WHO HQ Health Care Waste Management Products • Decision-making guide for PHC • Web site for information exchange • Rapid Assessment Tool (RAT) • Assessment + NAP Côte d’Ivoire • Evidence-based review of health impacts • Recommendations for GAVI Protection of the Human Environment (PHE)

10. WHO HQ Health Care Waste Management Products Planned • Treatment technology selection guide • Decision-making tree for treatment technologies • Country NAP for AfrR • Guidelines for developing HCWM NAPs • Guidelines for safe disposal of blood Protection of the Human Environment (PHE)

11. WHO HQ Health Care Waste Management Products Website WWW.HEALTHCAREWASTE.ORG • Documents online • Bibliography • Database • News • Country Information • Links • Contacts • Welcome your suggestions and news items Protection of the Human Environment (PHE)

12. WHO HQ Health Care Waste Management Products Database WWW.HEALTHCAREWASTE.ORG • Contains 27 technical HCWM options appropriate for developing countries • Options peer reviewed • Options should be relatively safe and environmentally friendly • Options should be sustainable • Options appropriate for the local situation should be selected • WHO has not independently verified information on the site and does not officially endorse any of the products Protection of the Human Environment (PHE)

13. WHO HQ Health Care Waste Management Products Database WWW.HEALTHCAREWASTE.ORG • Search by waste management step • Search by facility size • Search by cost • Search all • Recommendations for other categories? Protection of the Human Environment (PHE)

14. WHO HQ Health Care Waste Management Action Items Identify top 10 Scenarios for HCWM • Develop a list of 10 priority situations • Produce a short information sheet that briefly describes treatment options for those situations • Develop an easy reference decision-making tree to identify appropriate disposal options • Richard Carr, WHO to lead task Protection of the Human Environment (PHE)

15. WHO HQ Health Care Waste Management Action Items Add New Options to the Database • Identify appropriate management options for the database • Peer review options for the database –Health-care Working Group • Add new options to database • Periodically update SIGN and TECHNET of additions to database • Richard Carr, WHO to manage task, -SIGN members to identify, submit and review options Protection of the Human Environment (PHE)

16. WHO HQ Health Care Waste Management Action Items Advocate for non-PVC IV sets and blood bags • Research alternatives to PVC in IV sets and blood bags • Identify producers of these products • Conduct cost comparisons • Produce position paper? • Task leader? Protection of the Human Environment (PHE)

17. WHO HQ Health Care Waste Management Conclusion • WHO has many HCWM products available but needs to increase awareness and distribution • The website and database are helpful for raising awareness and distribution of products but may not reach most needy • There is a need to make a document that helps waste managers to select a treatment option based on the scenario • Updating (and de-bugging) the database is a priority • HCWM is an urgent issue in many areas Protection of the Human Environment (PHE)