India has seen a significant increase in the number of healthcare facilities (HCFs) over the years, which signifies a positive shift in access to healthcare services. However, this growth comes with a major challenge: the proper management of biomedical waste (BMW). As the number of HCFs continues to rise, so does the volume of biomedical waste generated, which poses potential risks to public health and the environment. Without stringent adherence to the Biomedical Waste Management (BMWM) Rules, 2016, the gap between the generation and treatment of BMW will widen, leading to serious health hazards.
The COVID-19 pandemic further exacerbated this issue. According to the Central Pollution Control Board (CPCB), India generated 774 tonnes of biomedical waste per day in 2020, with 656 tonnes coming from non-COVID sources and 118 tonnes from COVID-related waste. This sharp rise in waste output put enormous pressure on both healthcare facilities and Common Biomedical Waste Treatment and Disposal Facilities (CBWTFs). During the pandemic, the inadequacies in existing waste management systems became evident, highlighting the need for urgent action to fill these gaps.
The BMWM Rules, 2016, require all healthcare facilities, including hospitals, clinics, blood banks, and veterinary institutions, to obtain authorization from the State Pollution Control Boards (SPCBs). This authorization serves as a means to track the amount and nature of biomedical waste produced by each facility. However, the CPCB's 2020 report reveals a worrying trend: approximately 48,154 out of 352,000 healthcare facilities nationwide were operating without mandatory authorization. This lack of authorization presents a significant risk, as it means the waste generated by these facilities may not be accounted for, potentially leading to illegal disposal practices.
In Assam, for example, nearly 66% of healthcare facilities (946 out of 1,444) were operating without authorization as of November 2021. This lack of proper documentation raises concerns about the disposal methods used by these facilities, making it difficult to ensure the safe treatment and disposal of biomedical waste.
In areas where CBWTFs are operational, healthcare facilities are prohibited from running their own treatment systems. The rules stipulate that all HCFs within a 75-kilometer radius of a CBWTF must have an agreement with the facility for the safe disposal of their biomedical waste. Currently, there are 208 CBWTFs operating in India, and 33 are under construction. However, several states, including Andaman and Nicobar, Arunachal Pradesh, Goa, Ladakh, Mizoram, Nagaland, Sikkim, and Tripura, lack CBWTFs, which severely limits the infrastructure available for safe waste disposal. Assam, with only one CBWTF, faces additional challenges in ensuring adequate coverage for waste treatment.
The CPCB guidelines also mention that there are 17,206 healthcare facilities nationwide that maintain their own captive treatment facilities for biomedical waste. While this might seem like a solution, it is only allowed in areas where no CBWTF is available. Where CBWTFs are present, the facilities must rely on these centralized treatment systems to handle their waste appropriately.
To address these challenges, the National Green Tribunal directed the CPCB to develop separate guidelines to improve the monitoring systems for CBWTFs. The aim is to ensure that these facilities are monitored effectively and that illegal disposal incidents are tracked and prevented. State Pollution Control Boards are also tasked with initiating special drives to monitor these facilities and ensure compliance with the rules.
For effective monitoring, the CPCB suggests that the State Pollution Control Boards update their websites with real-time data on the authorization status of healthcare facilities, the operational status of captive treatment systems, and the adequacy of infrastructure at CBWTFs. This transparency will help to keep the public informed about the state of biomedical waste management and ensure that all stakeholders are accountable.
Healthcare facilities play a crucial role in ensuring that biomedical waste is handled, segregated, and disposed of according to the prescribed rules. It is their responsibility to ensure that untreated biomedical waste, particularly high-risk categories such as human anatomical waste, animal anatomical waste, soiled waste, and biotechnology waste, is treated and disposed of within 48 hours.
In addition to complying with treatment protocols, healthcare facilities must ensure that their waste is collected promptly by authorized CBWTF operators. This collaboration between healthcare facilities and CBWTFs is essential for minimizing the environmental and health risks associated with improper waste disposal.
The management of biomedical waste is a growing concern that requires immediate attention. As the healthcare sector expands, so must the infrastructure and compliance mechanisms for biomedical waste management. Only through strict adherence to the BMWM Rules, 2016, and the establishment of robust monitoring and enforcement systems can India ensure the safe disposal of biomedical waste, protect public health, and prevent environmental contamination. The role of healthcare facilities, CBWTFs, and State Pollution Control Boards is critical in this endeavor, and a transparent, real-time monitoring system will play a pivotal role in ensuring that the rules are effectively implemented across the country.
ALSO READ:
ALSO WATCH: