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Cofinanced concession management of hospital waste in 356 health facilities in Metropolitan Lima administered by the Ministry of Health

Private initiative financed in concurrent evaluation process between PROINVERSION, Ministry of Health (MINSA) and the Ministry of Economy and Finance (MEF).

Vidal Abogados involved in the process from design project of private initiative and is currently in the procedure for the approval of studies prior to the declaration of interest pre-investment project.

Problematic

The "Environmental Performance Index" (EPI for short) measures the level of environmental policy performance of 178 countries. The measurement variables are divided into two main goals: environmental health (comprising air quality , solid waste management and its impact on health) and protection of ecosystems. According to the fifth and final report in 2015, Peru holds the 110th position very distant relative of their Latin American counterparts : Colombia (27), Chile (29), Ecuador (53), among others. This indicator shows the existing widespread problem in environmental management in the country.

In particular, deficiencies in the management of solid waste, especially for hazardous solid waste hospital have a number of very serious problems specific to both health and the environment, which in the case of Maharashtra are summarized below:


  • Direct health resulting from the disposal in landfills informal damage, marketing, recycling and reuse illegal medical waste

    Deficiencies in all phases of the management of hospital solid waste, comprising external transport, treatment and disposal of waste in landfills safety, have favored the existence of an informal market of medical waste in the capital for recycling and reuse waste plastic; as well as the proliferation of informal lifters where exposed residues and circulation of local fauna impact on the spread of pathogens.

  • Prevalence of diseases attributable to unsanitary environmental conditions

    According to reports from the World Health Organization (WHO), Lima has the highest air pollution in Latin America, representing the most polluted city in the region: in Lima Norte, the index reaches up to six times the healthy standard set by the organization. This largely explains the high rates of incidence attributable to air quality ranging from allergies, asthma, hormonal imbalances, even cancer, responsible for 32% of deaths in the city respiratory diseases, according to the directions of Lima Health of MINSA.

  • Dramatic increase in environmental pollution

    The lack of treatment of hazardous hospital waste and improper handling during transport and disposal in isolation cells (filled up) promotes the growth of greenhouse environmental release of methane and carbon dioxide; as well as by the increasing pollution of water sources due to the direct disposal in surface water sources and wet waste leaking underground sources.

  • Hospital pollution

    Deficiencies in waste management activities within health facilities generate serious risks to health workers and patients. Inadequate segregation and management causes hospital-acquired diseases in the population derived mainly from exposure to pathogens and transmission of infections accidents in handling sharps waste.

Solution strategy

Faced with this problem, the Project provides the implementation of a comprehensive solution comprising: (i) support and capacity building in the hospital phase of internal storage and (ii) the assumption of integrity management of outpatient phase, as follows:

  • Support and capacity building in the internal storage of hazardous and medical waste common.
  • Collection and transportation of hazardous waste common and segregated from the health center through(s) infrastructure(s) of treatment.
  • Design, construction, operation and maintenance of infrastructure for handling hazardous solid waste.
  • Transport and disposal of waste in landfills safety.

Project development is carried out under the framework of a concession contract, transferring the construction and operational risks to the private investor. The contract, whose term is 15 years, ensures the implementation of the project under the best conditions of quality, backed by the experience of PROACTIVA MEDIO AMBIENTA, member of GRUPO VEOLIA, the world leader in providing environmental services with presence in America, Europe, Asia and Africa.

Perspectives

Since its admission to proceeding the project has been supported by the Ministry of Health incorporated it in its project portfolio disseminated in roadshows and conferences promoted by the Governing Body. In that vein, the Ministry has issued a favorable opinion on the relevance and priority of the project.

To this date, the process of self concurrent evaluation of an admissible prior to the effective date of the new regulatory framework private initiative, is in its final phase, being next to the declaration of viability under the rules of the National System of Public Investment.

The conclusion of the contract award and represent the second experience in public private partnership projects co-financed public health service (outside the scope of EsSALUD) in our country and the first direct multi-sector impact: environment and health.