Medical Waste Management: Lessons from Research, Pathways to Hope
Zahid Hossain Firoz :
Every human being requires food, water, and medical care to survive. However, once these basic needs are met, the wastes they generate from these services are often ignored, receiving little attention despite posing significant risks to both health and the environment.
During and after COVID-19, some studies and research were carried out on medical waste in South Asia.
One of the related studies titled ‘Governance Challenges in Medical Waste Management and Way Out’ was conducted by Transparency International Bangladesh (TIB), and they released research findings in December 2022. Data were collected and verified from June 2021 to November 2022.
The research highlighted several key gaps in the Medical Waste Management Rules-2008.
Although the rules mandate the formation of an “Authority,” they do not specify who is responsible for establishing it, nor do they clarify to whom this Authority would be accountable.
Similarly, the roles and responsibilities of city corporations and municipalities in managing outhouse medical waste remain undefined.
As a result, these institutions have not developed any concrete action plans, and there is a noticeable tendency to avoid responsibility in this area.
TIB further observed that the Local Government Act 2009 does not provide clear directives on the responsibility of city corporations and municipalities regarding the management of hospital-generated waste within their jurisdictions.
Consequently, ensuring their effective participation and accountability in medical waste management has not been possible under the existing legal framework.
TIB’s research identified several challenges in medical waste management. These include limited institutional capacity, shortage of skilled human resources, and inadequate budget allocations.
Concerns also arise over weak protection of health and the environment, coupled with a lack of transparency and accountability.
Moreover, poor coordination among government bodies, as well as between public and private institutions, remains a major obstacle.
The illicit sale of medical waste through syndicates, along with irregularities and corruption involving waste workers, further compounds the problem.
Finally, to improve medical waste management, TIB put forward 13 key recommendations.
These include: ensuring effective coordination, monitoring, and supervision of all relevant institutions; forming the mandated ‘Authority’ and establishing coordination committees at both national and local levels; and amending the Medical Waste Management Rules, 2008 in line with international standards, with clearly defined roles and responsibilities of all stakeholders.
The harmful impact of medical waste should also be explicitly recognized in the Environment Protection Act, 1995. An action plan must be developed in collaboration with the Department of Environment, the Directorate General of Health Services, hospitals, city corporations, and municipalities.
The capacity and effectiveness of stakeholders should be strengthened, and medical waste management should be prioritized with increased budget allocations.
The use of modern technologies needs to be expanded, with ETPs installed in all public and private hospitals along with area-based central incinerators.
Waste should only be disposed of by trained personnel, while awareness of the risks of medical waste must be raised among hospital officials, health workers, handlers, and the general public.
In addition, dedicated and well-trained staff should be employed in city corporations/municipalities, and health insurance benefits must be provided for medical waste workers.
A central database should be created and regularly updated with waste generation data, and reports must be disclosed on the websites of relevant ministries and divisions. Finally, strong measures must be taken against corruption and irregularities to stop the illegal trade in reusable and recyclable medical waste.
Furthermore, other research and studies, conducted by Dr. Md. Monirul Islam (2023), Dihan (2023), and Alighardashi (2024), highlight critical challenges, such as gaps in policy development and implementation, weak regulatory enforcement, and inadequate financial mechanisms that continue to obstruct effective medical waste management.
Now, a drop of hope we are getting, while we see that with the support from the World Bank, the Local Government Division (LGD) launched the ‘Improvement of Urban Public Health Preventive Services Project’ on 16 March 2025, which is ongoing.
A key objective of this project is to strengthen out-house medical waste management in Dhaka South City Corporation (DSCC), Dhaka North City Corporation (DNCC), Chattogram City Corporation (CCC), Savar Municipality, and Tarabo Municipality.
As part of its activities, the project will engage a reputed university or research institute to assess the existing outhouse medical waste management practices, identify health hazards and environmental impacts caused by medical waste, and identify the cost-effective and sustainable management solutions for Bangladesh.
In addition, out-house medical waste treatment plants will be established in DSCC, DNCC, and CCC. Based on the research’s recommendation, the project will adopt sustainable approaches tailored to local contexts, ensuring effective and environmentally sustainable medical waste management.
The initiative aims not only to improve practices within the project areas but also to develop replicable models. Then thisprovenand sustainable approach will be proposed for scaling up across other city corporations and municipalities nationwide.
(The writer is a Medical Waste Management Specialist, IUPHPSP, Local Government Division; Email: [email protected])