Finally, WHO, UNICEF and partners are working to strengthen safe and sustainable health care waste practices through wider efforts focused on WASH, waste and electricity in health care facilities.

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The guide addresses the regulatory framework, planning, waste minimization and recycling, handling, storage and transportation, treatment and disposal options, and training. The document is aimed at healthcare facility managers, policy makers, public health professionals and waste experts. In addition, as part of monitoring Sustainable Development Goal 6 on safely managed water and sanitation, the WHO/UNICEF Joint Monitoring Programme regularly publishes data and reports on safe management of health care waste in health care facilities.

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(1) Pépin J, Abou Chakra CN, Pépin E, Nault V, Valiquette L. Evolution of the global burden of viral infections from unsafe medical injections, 2000-2010.PLoSOne. 2014 Jun 9;9(6):e99677. (2) WHO/UNICEF, 2024. Data update on WASH in health care facilities for 2023. World Health Organization, Geneva. https://washdata.org/reports

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High-income countries generate on average up to 0.5 kg of hazardous waste per hospital bed per day, while low-income countries generate on average 0.2 kg. However, healthcare waste is often not separated into hazardous or non-hazardous wastes in low-income countries making the real quantity of hazardous waste much higher.

Healthcare waste contains potentially harmful microorganisms that can infect hospital patients, health workers and the public. Other potential hazards may include drug-resistant microorganisms which spread from health facilities into the environment.

WHO developed the first global and comprehensive guidance document, Safe management of wastes from healthcare activities, now in its second edition and more recently a short guide that summarizes the key elements as well as guidance on selecting technologies

A person who experiences one needle stick injury from a needle used on an infected source patient has risks of 30%, 1.8%, and 0.3% respectively of becoming infected with HBV, HCV and HIV.

The management of healthcare waste requires increased attention and diligence to avoid adverse health outcomes associated with poor practice, including exposure to infectious agents and toxic substances.

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Several reasons exist for inadequate health care waste services. These include limited legal frameworks (e.g. policies, regulation, guidelines), lack of awareness about the health hazards related to healthcare waste, inadequate training in proper waste management, absence of waste management and disposal systems, insufficient financial and human resources and the low priority. Many countries either do not have appropriate regulations, or do not monitor and enforce them.

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Worldwide, an estimated 16 billion injections are administered every year. Not all needles and syringes are disposed of safely, creating a risk of injury and infection and opportunities for reuse.

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Healthcare activities protect and restore health and save lives. But what about the waste and by-products they generate?

According to WHO/UNICEF, in 2021, only 61% of hospitals had basic health-care waste services. The situation is far worse in fragile contexts, where based on 2023 data, only 25% of health facilities had basic health care waste management services (2).

Additional hazards occur from scavenging at waste disposal sites and during the handling and manual sorting of hazardous waste from healthcare facilities. These practices are common in many regions of the world, especially in low- and middle-income countries. The waste handlers are at immediate risk of needle-stick injuries and exposure to toxic or infectious materials.

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Injections with contaminated needles and syringes in low- and middle-income countries have reduced substantially in recent years, partly due to efforts to reduce reuse of injection devices. Despite this progress, in 2010, unsafe injections were still responsible for as many as 33 800 new HIV infections, 1.7 million hepatitis B infections and 315 000 hepatitis C infections (1).

Measures to ensure the safe and environmentally sound management of health care wastes can prevent adverse health and environmental impacts from such waste including the unintended release of chemical or biological hazards.

This work is closely linked to the work on climate resilient and environmentally sustainable health systems for which health care waste is a critical element. In particular WHO guidance on climate resilient and environmentally sustainable health care facilities provides technical recommendations on how to improve the environmentally sustainability of waste management systems while safeguarding human health.

Treatment and disposal of healthcare waste may pose health risks indirectly through the release of pathogens and toxic pollutants into the environment.

Government commitment and support is needed for universal, long-term improvement, although immediate action can be taken locally.

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Of the total amount of waste generated by healthcare activities, about 85% is general, non-hazardous waste comparable to domestic waste. The remaining 15% is considered hazardous material that may be infectious, chemical or radioactive.