When Going up in Smoke is a Good Thing

Enweruzo-Amaefule’s story illustrates just one of the many innovative means that GHSC-PSM staff utilize to achieve USAID’s goals and those of the project’s Environmental Compliance Unit and its Waste Management Plan to protect people and the environment. GHSC-PSM has been working with country governments around the globe to efficiently and safely dispose of unused pharmaceutical products that it procures and delivers for the past five years.

Pharmaceuticals can be unused because of overstock and expiry, some form of damage or improper storage, or replacement of medication regimen. When these products are improperly disposed of, people can scavenge them from landfills or small waste sites adjacent to health facilities and sell them on the black market, potentially threatening the health of consumers.

These items also carry USAID branding, which could prompt consumers to reject drugs procured by the Agency and distributed by GHSC-PSM if they thought they were unsafe or ineffective. This could further threaten the health of those who need treatment for HIV, malaria, or other illnesses or want contraceptives. If disposed of improperly, these products could also harm the environment and consequently communities.

“It’s very important that any waste coming out of health care facilities or warehouses is appropriately dealt with to prevent any harm,” said Janine Berger, Environmental Compliance Unit senior specialist. “We send it directly to an authorized incinerator or even aligned landfill instead of just sending it to any location and dumping. We want to make sure that it’s going to government-authorized locations. That is one of our requirements under the project.”

Different countries have varying degrees of success with waste management. Haiti, which struggles with ongoing sociopolitical turmoil, cannot currently manage its own waste, and pollution is a serious problem in urban areas. The 2010 earthquake produced tons of waste, including pharmaceutical products, because donors around the world sent more to the country than could be managed and used. About 40 tons of unused pharmaceutical products are generated in Haiti each year, and international donors procure at least 70 percent of them, said Emmanuel Le Perru, deputy country director for GHSC-PSM in Haiti. Of those, USAID and the Global Fund purchase more than two-thirds.

Since the earthquake, USAID had been collecting and storing the expired or unused products it had procured in a secure warehouse because the government said there was no means to incinerate them. But this was costly and unsustainable. Eventually, Haiti gave USAID permission to export the products through a private company to France, where they were incinerated and converted to energy.

GHSC-PSM then worked with the Ministry of Health to come up with a sustainable disposal plan. They were able to identify two hospital incinerators that burned at the necessary temperature of 850 degrees Celsius (1,562 degrees Fahrenheit). The ministry recently signed an operational plan and is developing a memorandum of understanding with the two facilities for destroying a specific amount of unused pharmaceutical products each year.

Sustainability, environmental protection and safeguarding health go hand in hand. GHSC-PSM has been working toward sustainability and waste reduction by exploring the environmental implications of changes to the secondary and tertiary packaging of key family planning products. The exploration of greener packaging configurations will take place as part of an ongoing GHSC-PSM activity focused on identifying opportunities to harmonize packaging offerings with UNFPA and optimize packaging to meet the needs of in-country supply chains.

This year, GHSC-PSM will engage a sustainable packaging expert to assess the environmental impacts of recommendations for harmonized and optimized packaging and explore other opportunities for decreasing environmental impact through packaging. This assessment will include an analysis of options to reduce carbon emissions and the use of single-use plastic and cardboard. GHSC-PSM expects results from the assessment toward the end of 2021, which will inform further recommendations for changes to the secondary and tertiary packaging of key family planning products.

Overall, whether through transport, incineration or packaging, GHSC-PSM continues to explore ways to minimize the impact of pharmaceutical products on the environment and further safeguard the health of those who consume them.