Why medical waste is a circular economy challenge

From the newsletter

The government of Japan is funding a modern medical waste incinerator in Enugu State, southeastern Nigeria. Backed by a $66,309 grant, the project aims to reduce secondary infections and environmental hazards caused by improper disposal and open burning of medical waste, improving health and safety for the local community.

• According to the World Health Organization, medical waste is “waste generated by healthcare activities, ranging from used needles and syringes to soiled dressings, body parts, diagnostic samples, blood, chemicals, pharmaceuticals, medical devices and radioactive materials.”

• In Africa, while incineration remains the most common disposal method, it often generates hazardous emissions and toxic residues, posing additional risks to public health and the environment.

More details

• The medical incinerator, to be installed by the South Saharan Social Development Organisation (SSDO), will be located at Abakpa Primary Health Centre in Enugu State. It is also expected to serve additional public and private health facilities in the local community, offering a centralised means of disposing of medical waste and contributing to improved public health outcomes.

• “By providing a safe local option for hazardous waste, we are easing the long-standing burden of transporting medical waste over long distances to the state’s cold store. This intervention ensures that infection control is strengthened not just for one hospital but for an entire cluster of health facilities,” said Dr Stanley Ilechukwu, executive director of SSDO.

• Medical waste management remains a persistent blind spot across Africa, despite growing investments in healthcare infrastructure. While hospitals and clinics generate a relatively small fraction of waste, typically 10–15% by volume, this material is highly hazardous if mismanaged. It includes sharps, body fluids, chemicals, pharmaceuticals and other infectious or toxic materials. Poor handling can transmit disease, contaminate water and soil and release harmful emissions from open burning or low-quality incineration.

• While regulatory frameworks exist in several African countries, enforcement is often weak. Facilities frequently lack clear guidelines, technical expertise or funding to manage waste safely. Even when policies are in place, implementation is inconsistent, leaving frontline healthcare workers and surrounding communities vulnerable. For instance, residents of Masaka City in southern Uganda have raised concerns over the poor disposal of medical waste in a nearby landfill. According to WHO/UNICEF, only about 61% of hospitals have 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.

• Amid these overlapping challenges, incineration remains a common disposal method across the continent. While it can neutralise infectious waste, conventional incinerators often produce dioxins, furans and other pollutants if operated at low temperatures or without proper emission controls. Alternative approaches such as autoclaving, microwave disinfection or chemical sterilisation offer safer options but require investment and ongoing maintenance. Centralised or localised treatment hubs, such as the Enugu facility supported by Japan, provide a practical model by reducing transport risks, strengthening infection control across clusters of health facilities and ensuring safer operation.

• Beyond technology, medical waste management intersects with socio-economic factors. Informal waste pickers, healthcare staff and nearby communities face heightened health risks. Projects that provide safe disposal infrastructure can create opportunities for local training, capacity building and employment in facility operation and maintenance. They also help shift waste management from a reactive burden to a proactive, preventive system.

• Embedding circular economy principles offers further benefits. Effective segregation at source allows truly hazardous materials to be treated safely while recyclable or low-risk waste is recovered for reuse or recycling, reducing the volume of waste requiring high-risk treatment. Non-burn technologies and localised hubs reduce toxic emissions and align with international health and environmental standards. Public-private partnerships and pharmaceutical takeback programmes can also promote accountability across the supply chain while alleviating the waste burden on hospitals.

Our take

• If Africa is to keep pace with the growth of its healthcare systems and protect both human and environmental health, it must treat medical waste not as a side issue but as a core pillar of health system reform, environmental protection and circular economic development.

• With stronger regulation, targeted investment and clear political will, Africa can avoid a mounting health and environmental burden and position itself to lead in building cleaner, safer and more circular healthcare systems.

• Treating medical waste as a circular economy challenge, not just a health risk, could unlock new business models in waste recovery, treatment technologies and producer responsibility, turning a public burden into an economic opportunity.