Tanzania: The Technology Development Component

The technology development component of the project is managed from Tanzania, but its objective is to address a need identified by experts on persistent organic pollutants (POPs) from a number of sub-Saharan African countries.

Proper treatment and disinfection of healthcare waste is a high priority concern for most sub-Saharan African countries, in response to the high incidence of HIV, Hepatitis and other infectious diseases that can be spread by infectious wastes. The main approach now promoted by health experts and others for most healthcare facilities in sub-Saharan Africa is to encourage treatment of infectious wastes by combustion in small, locally-built incinerators lacking effective pollution controls, and in many cases, to treat healthcare waste by open burning or barrel burning.

As a long-term strategy, the World Health Organization, in a policy paper dated August 2004, calls for: "[e]ffective, scaled-up promotion of non-incineration technologies for the final disposal of health-care waste to prevent the disease burden from: (a) unsafe health-care waste management; and (b) exposure to dioxins and furans." In the short term, however, effective non-incineration technologies for health-care waste treatment that are affordable in the African context are not available, especially technologies that can operate in locales where electricity and other utility services are not reliable or are simply unavailable.

This need to identify or develop appropriate technology was raised by experts from several African countries attending the Third session of the Stockholm Convention Expert Group on Best Available Techniques and Best Environmental Practices, held in Tokyo, Japan, 11-16 October 2004. Their concerns are reflected in Annex II of the meeting report, entitled: Developing Country Concerns Relating to Meeting BAT-BEP Requirements, in Particular, in the Area of Medical Waste, While Contending with other High Priority Socio-Economic Issues. The Annex states:

The developing country parties expressed with concern, the difficulties that may be confronting some of their member[s] to meet the BAT-BEP [Best Available Techniques and Best Environmental Practices] standards for persistent organic pollutants in medical waste management due to lack of or inadequacy of capacity and technology while contending with other high priority socio-economic issues. However, we recognize that medical waste may have to be disposed of in a manner that will prevent the spread of infectious diseases arising from the present practice of co-disposal of hazardous medical wastes with other domestic type wastes in the open dump. Therefore, in the absence of sufficient, timely and appropriate international technical and financial assistance, developing country parties may have to be allowed in the short-term the use of the other options which are better than open dumping, including small scale hospital incinerators, even if they are not BAT, even though many aspects of BAT and BEP guidance would still apply and still be useful, especially waste management measures including segregation, and minimization. In this regard, there is need for early provision of financial resources for capacity building and institutional strengthening to enable compliance with BAT-BEP guidelines for POPs management by developing country parties. We note with interest the Global Environment Facility (GEF)/United Nations Development Programme/World Health Organization Medical Waste Management demonstration project under development, and we encourage the GEF, its implementing agencies and others to support and rapidly initiate much more work in this area. This would be greatly facilitated by developing countries making the related BAT/BEP issues an important part of their National Sustainable Development Strategies.

The need for special assistance in meeting BAT and BEP requirements for medical waste management is indicative of broader concerns relative to implementation of BAT and BEP for many developing countries. Implementation of BAT and BEP must be made broadly compatible with sustainable development goals in order to encourage development and poverty reduction while, at the same time, taking needed measures to protect public health and the environment from persistent organic pollutants.

The decision to add a technology development component to this project was made in response to concerns raised by these and other POPs experts from African countries. In short, Parties to the Stockholm Convention have an obligation to promote BAT (Best Available Techniques) for Medical Waste Incinerators (MWIs), and have an obligation to require BAT for new MWIs within four years of Stockholm Convention entry into force. However, the costs and operational requirements of what is generally considered to be BAT MWIs puts BAT incinerators out of reach for virtually all healthcare institutions in sub-Saharan Africa. This project component has been undertaken to address this problem.