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

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

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

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

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

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

7. WHO HQ Health Care Waste Management Protection of the Human Environment (PHE) HCWM strategy - What’s next l Many Products are available but better outreach is needed l 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?

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

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

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

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

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

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

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

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

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

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