This guidance document aims to support United Nations Children’s Fund (UNICEF) Country Offices in defining their procurement requirements for healthcare waste treatment technologies. In the process of drafting Long Term Agreements (LTAs) for waste treatment plants and equipment, the East Asia and Pacific Regional Office (EAPRO) assessed manufacturers that met the highest standards in terms of reduction in carbon emissions, meeting green climate actions and ensuring the safety of their devices for health workers, the communities and the environment. 

In December 2023, the United Nations General Assembly adopted a resolution on water, sanitation and hygiene (WASH), waste and energy in healthcare facilities. This resolution marks the first time that waste has been recognized as a critical need for safe, quality care and encourages countries to take action to meet the goal of universal coverage of WASH, waste and energy services in healthcare facilities by 2030. Waste is also now included as one of the core considerations for climate-resilient and environmentally sustainable healthcare facilities.

This guidance document supports governments and their partners to determine their needs in terms of: 

• infectious and hazardous medical waste capacity that requires treatment, such as: sharps, expired or used vials, protective personal equipment, material with pathogens, body fluids, bandages, swabs, drapes, instruments and small anatomical organs; 

• requirements related to energy and civil resources: electricity, water and sewage. 

The guidance includes:

• a technology brief on each type of waste treatment technology included in the LTAs; and

• a decision tree model to guide on the most applicable technology(ies) according to the individual country context.