UNDP GEF Project on Global Healthcare Waste
INSTRUCTOR GUIDE
MODULE 3: INTERNATIONAL AND N ATIONAL HCWM LAWS
L EGISLATIVE , R EGULATORY , AND P OLICY A SPECTS
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UNDP GEF Project on Global Healthcare Waste
MODULE 3: INTERNATIONAL AND NATIONAL HCWM LAWS –
LEGISLATIVE, REGULATORY, AND POLICY ASPECTS
Estimated Time
Module Overview
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Learning Objectives
Target Audience
Instructor Preparation
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Lecture: 45 minutes
Activity: 1 hour
Introduce basic environmental principles
Define the guiding principles of waste management
Describe the World Health Organization’s policy and the core principles for
achieving safe and sustainable management of healthcare waste
Describe the country’s obligations under the Basel and Stockholm Conventions as
they relate to healthcare waste management (HCWM)
Describe national and local HCWM laws and regulations
Understand basic environmental principles
Understand five guiding principles of waste management
Understand purpose of Stockholm and Basel conventions
Know the WHO policy and core principles on HCWM
Understand the structure and provisions of national and local laws and regulations
specific to HCWM
Identify country/state specific HCWM laws and how they apply to your facility
Administrative personnel
HCWM coordinators
Facility managers
Other management staff
Make notes pages of PowerPoint slides to hand out to class
Read Chapter 4 in Blue Book, and other materials included in the References
Gather all relevant information/materials for national/local legislation related to
HCWM to fill in the corresponding slides in the PowerPoint; as noted in the
Teacher’s Notes, you may choose to begin the presentation with the final few slides
that discuss country-specific legislation
Make copies of any additional documents/readings that may be handed out to class,
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UNDP GEF Project on Global Healthcare Waste
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Materials Needed
Student Preparation
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Review Questions
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such as those included in the References
Copies of international and country specific laws, policy, and regulations for HCWM
to share with students. Highlight key pages you want students to focus on. You may
require this as reading for this session so students will be aware before the activity.
Prepare any additional notes to be discussed during the presentation
Prepare any additional discussion points or review questions
Projector
Student handouts: slides, exercise, homework
Flip chart and marker pens and/or board and chalk
Blue Book Chapter 4
International and country specific laws, policy, and regulations for HCWM to share
with students.
Think about and write your facility-specific guidelines and the local HCWM laws
and bring to class as part of class discussion.
Think about the five guiding principles of waste management. Do you know if your
country or region abides by one or another? Which of the principles do you think is
the most appropriate?
Does your facility incorporate some of the WHO core principles’ short-, medium-,
and long-term strategies?
What are some laws/policies on HCWM in your own country/region? What are
some of the elements that they include or provisions that they stipulate? How do
these compare with other countries or regions? If there is no legislation that you
are aware, what actions have been taken, if any, to establish national HCWM
programs and legislation?
How does your facility compare to the international/national requirements for a
HCWM program?
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UNDP GEF Project on Global Healthcare Waste
PRESENTATION
Slide
Number/Title
Slide 1: Title Slide
Slide 2: Module
Overview
Slide 3: Learning
Objectives
Slide 4: Basic
Environmental
Concepts
Slide 5: Basic
Environmental
Concepts
Slide 6: Basic
Environmental
Concepts
Slide 7: Basic
Environmental
Concepts
Slide 8: Basic
Environmental
Concepts
Slide 9: Basic
Environmental
Concepts
Teacher’s Notes
Introduce the outline and major points of the presentation
Describe what participants will learn at the end of this module.
Begin with an overview of basic environmental principles
Introduce the general definition of the environment
Give definitions for biosphere, atmosphere, hydrosphere, and lithosphere
Use the diagram to describe what an ecosystem is
There is a strong link between human health and the health of the surrounding environment.
Degradation to the air, water, soil, and/or biosphere can have adverse effects on human health (and on
the environment, in general)
Talk about the interrelationship between environmental and human health. Ask the class to come up
with some examples.
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UNDP GEF Project on Global Healthcare Waste
Slide 10:
International
Principles of Waste
Management
Slide 11: Polluter
Pays Principle
Slide 12:
Precautionary
Principle
Slide 13: Duty of Care
for Wastes
Slide 14: Proximity
Principle
Slide 15: Prior
Informed Consent
Slide 16: World
Health Organization
Definition of Health
Introduce the five guiding principles of waste management that will be individually discussed in the
next series of slides: polluter pays, precautionary, duty of care for wastes, proximity, and prior
informed consent.
It is important to understand the WHO principles/guidelines on HCWM and the global conventions.
Explore the WHO’s website on healthcare waste management at www.healthcarewaste.org
Look through the following documents:
United Nations Environmental Programme: The Hazardous and Chemical Wastes Conventions.
September, 2007.
http://www.healthcarewaste.org/fileadmin/user_upload/resources/UNEP-3Conventions-2007EN.pdf
WHO (2007). International Meeting on Health-Care Wastes.
http://www.healthcarewaste.org/fileadmin/user_upload/resources/HCWM_meeting_report_2007.pdf
WHO. Safe Health-care Waste Management: Policy Paper.
http://who.int/water_sanitation_health/medicalwaste/en/hcwmpolicye.pdf
WHO. Safe Health-care Waste Management: WHO Core Principles for Achieving Safe and Sustainable
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UNDP GEF Project on Global Healthcare Waste
Management of Health-care Waste.
http://www.who.int/water_sanitation_health/medicalwaste/hcwprinciples.pdf
WHO. National Steering Committees and National Working Groups for Health-Care Waste
Management Policy Development and Planning.
http://www.healthcarewaste.org/fileadmin/user_upload/resources/natsteercom.pdf
Slide 17: World
Health Organization
Guiding Principles on
HCWM
Slide 18: WHO Core
Principles on HCWM
Slide 19: WHO
Recommendations
Slide 20: WHO
Recommendations
Slide 21: WHO
Recommendations
Slide 22: World
Health Organization
Strategies on HCWM
Slide 23: World
Health Organization
Long-Term Strategy
on HCWM
Go through the bulleted WHO recommendations for how governments should deal with HCW
Describe the main WHO recommendations for donors/partners, non-governmental organizations, and
the private sector
Describe the major WHO recommendations for all concerned institutions and organizations
Describe the WHO core principle short and medium-term strategies
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UNDP GEF Project on Global Healthcare Waste
Slide 24:
International Laws
Stockholm Convention
A global treaty to protect human health and the environment from persistent organic pollutants
(POP)’s
POP’s are chemicals that remain intact in the environment for long periods, become widely distributed
geographically, accumulate in the fatty tissue of living organisms and are toxic to humans and wildlife.
Slide 25:
International Laws
178 parties have signed the convention
Enlisted parties are required to take measures (legal and/or administrative) to minimize the
unintentional production and release of POPs.
Instructor: Check the Stockholm Convention website to see if your country has ratified the Stockholm
Convention.
http://chm.pops.int/Countries/StatusofRatifications/tabid/252/Default.aspx
Slide 26: Dioxins and
Furans
Dioxins and furans are two of the major POPs that deserve extra attention because medical
incineration is a primary source. In the next few slides, go through the listed facts
g TEQ/kg/day = grams toxic equivalent per kilogram of body weight per day
Slide 27: Dioxins and
Furans
Slide 28: Dioxins and
Furans
Slide 29: Stockholm
Convention on POPs
Go over the five main goals of the Stockholm Convention
http://chm.pops.int/Implementation/BATBEP/Guidelines/tabid/187/Default.aspx
Slide 30: Stockholm
Convention on POPs
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UNDP GEF Project on Global Healthcare Waste
Slide 31:
International Laws
Introduce the basics of the Basel Convention
Visit the UNEP site for more information:
http://www.basel.int/
http://www.basel.int/TheConvention/Publications/TechnicalGuidelines/tabid/2362/Default.aspx
Slide 32: Basel
Convention
Slide 33: Umbrella
Graphic
Slide 34: National
Laws
Slide 35: Local Laws
Slide 36: Human
Rights and Medical
Waste
Slide 37: Discussion
References (in order
as they appear in
slides)
Resources about the Basel Convention
Use the graphic to describe HCW guidelines/plans at the global, national, and local levels
Prepare slides outlining the major laws dealing with healthcare waste management.
Discuss the national and local laws.
Ask questions on national and local laws that require participants to find the right sections in the law.
Provide relevant materials to familiarize participants with country-specific laws.
The report was prepared by the Special Rapporteur (Calin Georgescu) of the Human Rights Council of
the United Nations in light of the serious impact of medical waste on many individuals and the lack of
attention given to the problem. His report gave many examples of how people are affected and
concluded that improper management and disposal of medical waste is a threat to human rights.
Blue Book, Chapter 4
WHO: Healthcare Waste Management. http://www.healthcarewaste.org/
United Nations Environmental Programme: The Hazardous and Chemical Wastes Conventions.
September, 2007.
http://www.healthcarewaste.org/fileadmin/user_upload/resources/UNEP-3Conventions-2007EN.pdf
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UNDP GEF Project on Global Healthcare Waste
WHO (2007). International Meeting on Health-Care Wastes.
http://www.healthcarewaste.org/fileadmin/user_upload/resources/HCWM_meeting_report_2007.pdf
WHO. Safe Health-care Waste Management: Policy Paper.
http://who.int/water_sanitation_health/medicalwaste/en/hcwmpolicye.pdf
WHO. Safe Health-Care Waste Management: WHO Core Principles for Achieving Safe and Sustainable
Management of Health-Care Waste.
http://www.who.int/water_sanitation_health/medicalwaste/hcwprinciples.pdf
WHO. National Steering Committees and National Working Groups for Health-Care Waste
Management Policy Development and Planning.
http://www.healthcarewaste.org/fileadmin/user_upload/resources/natsteercom.pdf
UNEP, Stockholm Convention. Success Stories: Stockholm Convention 2001-2011.
Find link to document at:
http://chm.pops.int/chm.pops.int/Convention/Media/Publications/tabid/506/Default.aspx
Guidelines on Best Available Techniques and Provisional Guidance on Best Environmental Practices
Relevant to Article 5 and Annex C of the Stockholm Convention on Persistent Organic Pollutants, Geneva,
December 2006
http://chm.pops.int/Implementation/BATBEP/Guidelines/tabid/187/Default.aspx
UNDP GEF Project on Healthcare Waste. www.gefmedwaste.org
UNEP: Basel Convention. http://www.basel.int/
Technical Guidelines on the Environmentally Sound Management of Biomedical and Healthcare
Wastes (Y1; Y3), Secretariat of the Basel Convention, Châtelaine, Switzerland, September 2003.
http://www.basel.int/TheConvention/Publications/TechnicalGuidelines/tabid/2362/Default.aspx
United Nations General Assembly, Human Rights Council. Report of the Special Rapporteur on the
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UNDP GEF Project on Global Healthcare Waste
adverse effects of the movement and dumping of toxic and dangerous products and wastes on the
enjoyment of human rights, Calin Georgescu, July 2011.
http://daccess-dds-ny.un.org/doc/UNDOC/GEN/G11/144/22/PDF/G1114422.pdf?OpenElement
Available in other languages at: http://www.un.org/Docs/journal/asp/ws.asp?m=A/HRC/18/31
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UNDP GEF Project on Global Healthcare Waste
ACTIVITY: MODULE 3: EXERCISE (1 HOUR)
The purpose of this activity is for the participants to compare their facility specific guidelines for HCWM with the required
international, national, and local laws, regulations and guidelines.
Instructor: Break class into groups of three or more, and distribute exercise at beginning of class. You may group participants
by facility, department, or job type. Participants will complete the activity in groups and record their answers. Instructor
should record participant/group responses on a wipe board, flip chart, or transparency, categorize their responses.
Instructor will go over the responses, once again, during the de-brief.
Module 3 Exercise: International and National HCWM Laws – Legislative, Regulatory, and Policy Aspects
All participants must receive copies of all international and country specific laws and regulations preferably prior to the
session. This can be provided before the training/session begins. You may also share baseline assessment data and any
monitoring reports, if you have them.
Instructor will present the module and objectives and then ask participants to:
1. Compile written HCWM guidelines and procedures for their facility.
2. Compare their facility in relation to international, national, and local laws, regulations and guidelines
3. Identify the gaps and challenges
De-brief
Instructor will discuss how to possibly address these gaps or inconsistencies.
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