Workshop on Medical Waste Management and Public-Private Partnership in Bangladesh

Bangladesh has become a Party to the Stockholm Convention since 2007, and its National Implementation Plan submitted to the Convention articulates emissions of Persistent Organic Pollutants (POPs) in the country and prioritized action plans to address the POPs risks imposed on its citizens and workers in related sectors. Upon receiving a request from the Government of Bangladesh, UNIDO is developing a project proposal to be funded by the Global Environmental Facility (GEF) on environmentally sound management of POPs. The project has two components: i. PCB, and ii. medical waste management.

The objective of this project is to assist Bangladesh in fulfilling its obligations under the Stockholm convention by (1) reducing the release of PCBs to the environment, and (2) improving healthcare waste management in the country to reduce the emission of dioxin/furan from disposal activities.

UNIDO in association with the International Finance Corporation (IFC), the private sector arm of the World Bank Group organized a workshop on the medical waste management and public-private partnership in a local hotel on December 14, 2011. The main objective of this workshop is to share and discuss the project design on medical waste disposal with major stakeholders, including potential investors and operators, and explored modalities of public and private sectors partnership operations in the area of medical waste disposal in Bangladesh.

At the workshop, UNIDO and IFC brought together global specialists, representatives from the ministry of health, environment and local government, multilateral donors and the private sector to discuss how the challenge of medical waste can be addressed through public-private partnerships. The workshop highlighted the benefits of public-private partnership, which include institutional development, and covered how to design, structure and tender sustainable projects.

“Public-private partnership in medical waste management can bring greater efficiencies in the sector and improve quality of service," said health minister Professor RuhalHaque who inaugurated the workshop. In his speech, the minister reiterated that the issue is a priority for Bangladesh government; it requires simple and cost effective solutions for Bangladesh. It does not essentially need big budget project as basic works have already been done in the medical waste management sector. He emphasised on the coordination of different government wings working in medical waste management. He also expressed on the need for coordination among different government agenciesfor improving management of medical waste in Bangladesh. He also remarked on developing electronic system for monitoringof waste disposal activities. The minister informed that the government of Bangladesh is working to build support for greater private participation in the country's development through sustainable public-private partnership.

AyumiFujino, South Asian regional director for UNIDO, stressed the importance of public-private partnership, especially in infrastructure, in boosting economic growth and supporting development. Ms.Fujino in her keynote speech explained the background of the project and highlighted UNIDO’s expertise on POPs, especially in medical waste management for the reduction of dioxins and furans, and encouraged south-south cooperation with an on-going project on medical waste in India. "Partnerships in the sector can also help attract more local and foreign investment," she said.

 “We believe that the private sector has the potential to help address some of the country's most pressing development needs," said IndranilSarkar, senior investment officer for IFC South Asia Region, at the workshop.

Seven technical papers including, two from UNIDO, one each from IFC, Department of Environment, Dhaka City Corporation, Directorate of Health Services and   PRISM, a local NGO were presented in the workshop.  Participants of the workshop suggested the following key issues are important for successfully implementing the medical waste management issue in Bangladesh.

Ministry of Health and Family Welfare (MoHFW),  Ministry of Local Government, Rural Development and Cooperatives (MoLGRD&C) and Ministry of Environment and Forest (MoEF) are responsible for managing the medical waste management. A strong coordination is needed among these three ministries and concerned departments to establish proper medical waste management in every corner of the country. For this, the country may need to prepare by-laws for existing guidelines and policies already issued.

a)    A strong monitoring system should be developed:particpnats of the workshop emphasised on the development of strong supervision and monitoring system for implementing a successful PPP model in medical waste management. Otherwise, the project will suffer in future.
b)    Capacity Development for hospital staff and medical waste service providers:extensive capacity development campaign is needed for hospital staff, city corporation staff and medical waste service providers. Government, private sector and NGOs have requested for UNIDO’s assistance in this area.
c)    Strengthening the capacity of Department of Environment (DoE) for implementing existing laws regarding medical waste management in Bangladesh: There are a few laws regarding medical waste management existed in Bangladesh. Medical Waste (Management and Processing) Rules 2008 is the main legal instrument for regulating medical waste management in Bangladesh. But, lack of proper training and manpower prevents DoE from implementing these rules properly.DoE has requested UNIDO’s assistance in this area.
d)    Nurturing new/upcoming medical waste operators in Bangladesh:At least four NGOs are operating healthcare waste management service in seven cities of Bangladesh. Their service is adequate for covering the whole country. There is a need to encourage new and upcoming healthcare waste operators to serve un-met demands for this service in other areas in the country. Large private companies would play a vital role in this sector as a CSR (corporate social responsibility) activity.   

e)    Sustainability issue: sustainability issue is found as one of the most important issues regarding the healthcare waste management sector in Bangladesh. In the workshop, some of participants raised questions regarding the sustainability of PPP project on healthcare waste management. Dr. T. Hemanth of MS Ramaiah Medical College of India said that at least 10,000 beds are needed to make a Public Private Partnership (PPP) project sustainable in India. It is expected that the situation of Bangladesh should be similar to India, so there is a prospect for introducing PPP for medical waste management in Bangladesh.

As an immediate outcome of the workshop: considering the present problems of the medical waste management and fostering the sustainability of medical waste management activities in Bangladesh, present practitioners of medical waste management have formeda forum: Bangladesh  Medical Waste Management Forum (BMWMF) recently.

Seventy two  participants from the government and private sectors, NGOs, and hospitals  have attended the workshop.