Legal and Regulatory Framework

for management of Health Care

Waste in South Africa

Mmashela Kgole
Manager: Waste Assurance (National Health Laboratory Service)
ASLM2018 Conference Seminar: Waste Management Strategies for HIV Viral
Load and Early Infant Diagnosis
December 11, 2018
 Presentation Outline

- Waste management legal and regulatory framework

- “Best” health care risk waste management practices in SA
- “Best” health care risk waste management practices at NHLS
sites
- Challenges and Barriers
- Way Forward
 Waste management legal and regulatory framework

- Waste management in South Africa is governed by the National Environmental Management: Waste Act, 2008 (Act No. 59 of
2008)

- National Waste Management Strategy (NWMS) of 2011 developed to achieve the objects of the Waste Act

- NWMS supports the waste management hierarchy in its approach to waste management

- Waste management principles include duty of care, polluter pays principle and precautionary principle
 Waste management legal and regulatory framework

Other pieces of legislation in the governance of waste include

The Constitution of South Africa (Act 108 of 1996)
National Environmental Management Act (Act 107 of 1998)
National Health Act (Act 61 of 2003)
National Health and Safety Act (Act 85 of 1993)
Provincial Regulations
Municipal By-laws

Waste disposal is still the predominant option of managing waste in South Africa with about 297 waste disposal facilities which
handled about 57 million tons of waste in 2017 http://sawic.environment.gov.za)

66 waste treatment facilities which include chemical treatment, biological treatment, thermal treatment and physical
treatment which handled about 8 million tons of waste in 2017 (http://sawic.environment.gov.za)
 “Best” health care risk waste management practices in
SA
Legislation
- Integrated approach to waste management
- Legislation and guidelines govern management of health care risk waste (HCRW) from generation- to treatment- to
disposal
- Compliance monitoring and enforcement

Infrastructure, treatment capacity and technology

The South African Waste Information Centre registers all major hazardous waste generators, treatment and disposal
facilities
-17 authorised HCRW treatment facilities in 6 provinces with about 48000 tons treatment capacity
- 8 thermal treatment facilities (incinerators and pyrolysis) for all HCRW
- 9 non-burn treatment facilities (microwave, autoclaves, etc.) for infectious waste (non-anatomical) and sharps waste
- Compliance monitoring and enforcement
 “Best” health care risk waste management practices
at NHLS sites

- Waste management policy and procedures

- Waste management plans
- Appointment or delegation of staff
- Training of staff on management of HCRW waste and Occupational Health and Safety
- Waste information management system
- Compliance monitoring
 Challenges and Barriers

- No legislation specific to management of laboratory waste

- Implemented legislation not flexible
- Introduction of new technologies for analysis
- Volume and toxicity of waste generated
- Low priority given to HCRW management
- Cost of managing HCRW
- Lack of financial and human resources
- Inadequate training
 Way Forward

-HCRW regulations to be published for implementation

- National HCRW Forum established by the National Department of Health and National
Department of Environmental Affairs
- 16 additional HCRW treatment facilities licenced but not yet in operation
- Diversion of treated waste residue from landfill sites
- Risk based waste management approach
- Health technology assessments
- Assessment and registration of waste treatment technologies
 Thank You
Mr Thomas Stevens (Centres for Disease Control, USA)
Mr Brooks Wheeler (Defense Threat Reduction Agency,
USA)
Mr Perry Hlalele (National Health Laboratory Service, SA)
Mr David Jones (National Institute for Occupational
Health, SA)
Dr Shauna Costley (National Department of
Environmental Affairs, SA)