Institutions generating Bio-Medical Waste has a major constraint for space. The fact that bio-medical waste management requires a combination of technology only compounds the problem. Health care institutions usually spring up in houses in residential colonies. An on-site integrated waste management system is not possible in most of these institutions because environmental concerns preclude the possibility of setting up incinerators or landfills, even if enough space is available.

Another factor affecting individual or on-site treatment and disposal facilities is the cost.

The minimum investment for an on-site integrated waste management system in an individual healthcare setting is approximately Rs 50 lakhs. In contrast, an integrated common treatment and disposal facility will cost a maximum of Rs 3-15/kg/day with the added benefit of no capital investment being required. The company/ private entrepreneur setting up such a centralized facility will stand to make a profit of about 30% making it a sustainable venture.

The other advantages of a centralized facility are a reduction in pollution and energy consumption, stream lined collection, and treatment of waste.

An onsite integrated waste management facility must meet certain statutory requirements of the State Pollution Control Board. The healthcare setting will have to maintain records, renew authorizations, submit reports and laison with the authorities. All these will be an additional burden to the healthcare setting. The workload associated with waste management will shift from the healthcare setting to the company maintaining the facility.  

The task of monitoring the performance of one common treatment centre will be far simpler for the concerned authorities and NGO's alike.

The approach and the policy to be adopted is setting up a common integrated bio-medical waste management system is as follows:

·         Determine the area covered and identify healthcare establishments also ensuring their participation in the programme.

·         Train the stakeholders in bio-medical waste management is important for the success and sustainability of the project.

·         Determine the quantity of waste generated in the hospital to help decide the capacity of the plant.

·         Inform all the stakeholders about the activities of the programme and work in coordination.

·         Set up an infection control committee consisting of all the stakeholders and authorities to monitor the activities. A technology evaluation committee also should be set up to review the technologies periodically.

·         Review the economics of the project periodically. This will allow the healthcare establishments to control the service charges.

·         Maintain an environment-friendly approach. Conduct a proper comprehensive environmental impact assessment should be conducted before siting the common facility.

·         Make waste tracking system mandatory. This will prevent unauthorized recycling or reuse and ensure treatment of all the waste.

·         Search for alternative technologies continuously.

·         Maintain a good database.