Introduction

In most LEDCs (Less Economically Developed Countries), resources spent on HCWM are extremely limited. The activity is rarely included in the public health budget and HCFs are often not allocated any or insufficient funds to ensure the safe management and disposal of healthcare waste (HCW).

Allocating insufficient financial resources to manage HCW properly has an even greater financial cost on the medium-long run in terms of morbidity and mortality as well as environmental damage, that will, in the end, impact negatively on peoples’ health.

For equity reasons, measures should be taken in all areas/ regions and not only urban centres.

This costing/ financial section has three aims:

1. Provide a rational for investing in HCWM;
2. Help set priorities/ identify the most cost-effective measures that can be taken and list the steps that should be taken;
3. Provide a set of tools to help estimate/ calculate the financial resources that will be necessary to set up an effective and sustainable HCWM system.

Rational for investing in HCWM

The reasons to invest in HCWM are ethical, legal and financial.

On an ethical level, knowing that over 23 million infections of hepatitis B, C and HIV occur yearly due to the use of contaminated syringes, managing and disposing infectious HCW and sharps in particular in a safe and environmentally-friendly manner becomes a moral obligation.

On a legal level, International agreements and principles, in particular the “Polluter Pays Principle” provide clear incentives for sound HCWM. At national level, Constitutions, environmental and health laws and regulations normally provide the necessary framework that obliges both public and private health actors to manage HCW in a safe way. Investing in HCWM is therefore a legal obligation.

On a financial level, the consequential costs to rectify the effects of poor HCWM are also often not recognised. As with most pollution/ public health related issues, “preventive” measures usually cost less than “curative” expenditures…

Financial aspects related to HCWM should be analysed not only in terms of cost-effectiveness but also cost-benefits: investing in HCWM is an investment for improved public health.