Experts have warned that Bangladesh’s current healthcare waste management system falls significantly short of sustainable waste management principles, with 55% of solid waste in urban areas remaining uncollected, exacerbating pollution, public health risks and climate change.
Despite the severe consequences of inadequate legislation and the absence of a comprehensive waste management plan, Bangladesh lacks a dedicated authority to oversee this critical issue.
The country’s medical waste generation is increasing at an estimated rate of 3% per year, with overall waste production standing at approximately 25,000 tonnes per day. Dhaka alone manages nearly 6,500 tonnes daily, a figure projected to rise to 8,500 tonnes by 2032.
Meanwhile, South Asia generates over 1.5 million tonnes of solid waste daily, with only 40% being collected and less than 10% recycled, according to the World Bank.
A study titled Healthcare Waste in Bangladesh: Current Status, the Impact of Covid-19, and Sustainable Management with Life Cycle and Circular Economy Framework predicts that, excluding surges due to Covid-19 and other medical emergencies, Bangladesh will generate approximately 50,000 tonnes of medical waste (1.25 kg per bed per day) in 2025, of which 12,435 tonnes will be hazardous.
Research published in 2022 found that medical waste generation in Dhaka ranges between 1.63 kg and 1.99 kg per bed per day, a figure that significantly increased after the Covid-19 pandemic.
Persistent Challenges Despite Some Progress
The International Committee of the Red Cross (ICRC) established five medical waste management facilities in Cox’s Bazar district between 2015 and 2021. Despite such initiatives, medical waste management challenges persist, particularly in areas with vulnerable populations.
The United Nations Office for Project Services (UNOPS) Bangladesh hosted the 12th episode of SDG Café, a monthly roundtable discussion series focusing on sustainable development goals (SDGs).
The event, held on 3 October 2024, explored Solid Waste Management – Challenges and Solutions for Bangladesh and highlighted SDGs 11, 12, and 13, which aim to reduce waste generation through prevention, reduction, recycling, and reuse by 2030.
Expert Insights on Sustainable Solutions
Keynote speaker Dr Rowshan Mamtaz, Professor of Environmental Engineering at Buet, outlined the stark realities of Bangladesh’s waste management crisis.
She stressed the need for a comprehensive household waste segregation system, pointing out that the volume of waste is expected to double every 15 years. The country’s inadequate infrastructure, lack of segregation, and poorly managed landfills are worsening environmental issues.
Dr Mamtaz called for an urgent shift towards the 3R approach—Reduce, Reuse, and Recycle—and emphasised that Extended Producer Responsibility (EPR) must be implemented and enforced to develop a sustainable waste management framework.
UNOPS Bangladesh Country Manager Sudhir Muralidharan echoed these sentiments, stating, “Solid waste management is not just about disposal; it is about reshaping our consumption patterns and prioritising sustainability.”
Although medical waste comprises only about 1% of total solid waste in Bangladesh, its improper handling leads to contamination of the entire waste stream, making it hazardous.
Regulatory Framework and Its Limitations
The Bangladeshi government introduced the Solid Waste Management Rules 2021 and the National 3R Strategy to enhance waste management practices. City corporations and municipalities have incorporated these strategies to improve their waste management activities. The Solid Waste Management Rules 2021 also introduced Extended Producer Responsibility (EPR) for the first time.
Despite these regulations, Bangladesh has yet to establish a dedicated authority to manage medical waste. Instead, organisations such as PRISM Bangladesh, Waste Concern, the Centre for Sustainable Development (CSD), the Environment and Social Development Organisation (ESDO), and ICDDR,B take the lead in medical waste management, particularly in Dhaka.
Medical Waste Mismanagement and Corruption
Transparency International Bangladesh (TIB) has revealed that certain hospital staff members sell reusable medical waste—such as glass bottles, syringes, saline bags, and blood bags—to unscrupulous recyclable waste collectors instead of ensuring proper disposal. A syndicate reportedly cleans and repackages these materials without adequate sterilisation before selling them to drug stores, hospitals, and clinics.
Under the Medical Waste (Management and Treatment) Rules 2008, hospitals are required to cut or puncture plastic tubes and other waste items to prevent reuse. However, TIB research found that 31% of hospitals fail to comply with this rule, and 49% lack needle destroyers.
A study titled Governance Challenges in Medical Waste Management and Way Forward, conducted between June 2021 and November 2022, surveyed 93 medical waste workers and 231 institutions, including hospitals, city corporations, and municipal authorities across 45 districts. The study found widespread non-compliance with regulations and a lack of oversight.
Although the 2008 regulations mandated the formation of an Authority within three months of publication, this has yet to materialise. Instead, city corporations and hospitals have outsourced waste management to unlicensed contractors.
Lack of Transparency and Coordination
UNB investigations at various public and private hospitals in Dhaka found that most institutions were reluctant to discuss their waste management practices. Many hospitals still dispose of waste as general refuse, citing high sorting costs and a lack of enforcement mechanisms.
Moreover, there is no central database tracking medical waste. The study also uncovered irregularities in the recruitment process for waste management workers, with bribes of Tk 1-2 lakh reportedly exchanged for employment at government hospitals.
The absence of coordination among key ministries and agencies—including the Directorate General of Health Services (DGHS), the Department of Environment (DoE), and the Office of the Divisional Commissioner—has further hindered progress. National advisory committees and waste management committees at various administrative levels remain largely ineffective due to bureaucratic inefficiencies.
Calls for Urgent Reform
TIB Executive Director Dr Iftekharuzzaman highlighted the systemic governance failures and corruption that exacerbate medical waste mismanagement. “The lack of accountability in this critical sector increases disease transmission risks and contributes to environmental degradation at every stage,” he said.
Officials from the DGHS hospital and clinic section stressed that effective medical waste management in both public and private hospitals is crucial for improving healthcare environments and service quality. They emphasised the need for greater awareness, better logistical support, and enhanced coordination with local government agencies and the Department of Environment.
To achieve sustainable medical waste management, authorities are advocating for stricter enforcement of existing regulations, increased public-private partnerships (PPP), and better monitoring systems to ensure compliance in private healthcare facilities.
Without immediate reforms and the establishment of a dedicated waste management authority, Bangladesh risks severe environmental and public health consequences.
