The Issue

Health Care Without Harm (HCWH) has been working to make health-care sustainable since 1996.  Combatting the hazards of improper health-care waste management was one of the first issues the campaign faced and remains a priority to this day.  One the most important ways to reduce the environmental impact of healthcare waste management is to use non-incineration waste treatment technologies and HCWH is actively assisting members to make this transition.

HCWH, along with the World Health Organization, was a principal cooperating agency in the Global Healthcare Waste Project (, a seven-country initiative, which demonstrated and developed non-incineration technologies; and first published an inventory of alternative technology suppliers in 2007. 

This database has been developed to allow regular updates of the data, keeping it current and enhancing its usefulness.

The scale of the pollutant emissions from healthcare waste incineration were first recognised in the mid-1980s and legislation in the US, Europe and other developed countries was brought in to reduce the amount of toxic chemicals they release.   As a result, alternative treatment technologies were increasingly used and between 1988 and 2008, 99% of the health-care waste incinerators in the USA were closed down.  Those that remain in these countries are very highly engineered, costing millions of dollars to construct and operate. 

At the global level, governments came together to create the Stockholm Convention on Persistent Organic Pollutants (   Today, 179 of the world’s countries are parties to the convention, and have agreed to follow its guidelines.  The convention aims to minimize and, where feasible, eliminate over 20 of the most environmentally harmful chemicals and groups of chemicals known to science. 

Of these chemicals, the chlorinated dioxins and furans, PCBs, hexachlorobenzene and pentachlorobenzene are all unintentionally produced by incineration.  Indeed, incineration and open burning of municipal and medical waste probably rank amongst the two largest sources of these chemicals in most countries of the world.

In keeping with this, the Stockholm Convention states that priority should be given to technologies that prevent the formation and release of dioxins and furans, among others. Similarly, the World Health Organisation policy on safe and sustainable healthcare waste management calls for the effective, scaled-up promotion of non-incineration technologies.

To facilitate the switch to non-incineration technologies, this inventory contains a global listing of providers of technologies for the treatment of infectious waste. They all avoid the formation of dioxins, furans and other pollutants controlled by the Stockholm Convention.

These technologies comprise an essential part of a safe and sustainable health-care waste management system, but only a part.  Health care providers should have a written environmental policy that encompasses the spectrum from environmentally preferable purchasing to safe disposal of treated wastes.