PRESENTATION TO THE PORTFOLIO COMMITTEE

1. PRESENTATION TO THE PORTFOLIO COMMITTEE ON THE MANAGEMENT OF HEALTH CARE RISK WASTE IN SOUTH AFRICA DATE: 12 MAY 2010

2. PURPOSE • To brief the Parliamentary Committee on problems experienced with the management of health care risk waste in the country; • To outline the legislative requirements that govern the industry with specific emphasis on the Environmental Management: Waste Act and the Air quality Act; and • To discuss the plan to remedy the current problems being faced by the industry.

3. HEALTH CARE RISK WASTE MANAGEMENT IN THE COUNTRY - BACKGROUND • Pre 2001 Health Care Risk Waste (HCRW) management was in crisis & Gauteng Province (GP) embarked on projects that resulted in: • first data on HCRW generation rates & available HCRW treatment for GP; • HCRW regs which set emission standards for burn and non-burn HCRW treatment plants operating in the GP; • the development and piloting of a segregation systems for provincial hospital and clinics situated in urban areas • the development of a five day HCRW management training course and training an initial batch of provincial health staff members; and • provincial tender specifications to supply HCRW collection, transport, training & disposal services to the Gauteng Provincial Dept of Health.

4. HEALTH CARE RISK WASTE MANAGEMENT IN THE COUNTRY - BACKGROUND • 2005 Department of Environmental Affairs (DEA) under the National Waste Implementation projects built on the work done in the GP & produced among other the following outputs: • the first set of national data on HCRW generation; • the first set of national data on HCRW treatment potential; • a draft national policy on HCRW; • draft national HCRW regulations; and • the development and piloting of a segregation system for hospitals and clinics in rural areas • At the time of finalising the work the treatment capacity for HCRW in the country exceeded the generation rates.

5. HEALTH CARE RISK WASTE MANAGEMENT IN THE COUNTRY - BACKGROUND • 2008 a large incineration in GP closed down due to poor operations non-compliance with the conditions of the Environmental Authorisation. This was followed by illegal stockpiling of HCRW generated at public facilities • DEA did a study indicating that the generation of HCRW has increased from 31 000 tons in 2005 to 42 200 tons in 2007 with treatment capacity figures declining. In December 2007 it was estimated that there was a deficit of 6 000 tons of treatment capacity per year. • DEA requested permission from the Gauteng MEC to use landfill sites classified as H:H for disposing of this. • Option not widely used as the costs were prohibitive.

6. HEALTH CARE RISK WASTE MANAGEMENT IN THE COUNTRY - BACKGROUND • The deficit of treatment capacity directly contributes to the following management issues in the sector: • Poor maintenance – machines both burn and non-burn are not maintained on a regular basis as any down time creates backlogs • Overloading – machines are overloaded reducing the performance of the treatment and putting pressure on the technology • Manipulation of the industry – companies not being prepared to use particular treatment facilities or some facilities not being prepared to take the waste from others and in particular from their competitors. • Illegal storage • Illegal dumping

7. HEALTH CARE RISK WASTE MANAGEMENT IN THE COUNTRY - BACKGROUND • The DEA 2008 study identified that the HCRW management sector is extremely competitive, to the point where the competition is unhealthy and there is undercutting of rates to secure business. This leads to insufficient funds to provide an adequate service. This competition is making the management of HCRW uneconomical as waste is not treated at the nearest facility, but transported vast distances, increasing costs and risks. This has undermined the economic viability of the sector as a whole. • The industry is also plagued with management issues and many facilities have not complied to conditions of relevant authorisations with the resultant risks to health and safety and to the environment.

8. HEALTH CARE RISK WASTE MANAGEMENT IN THE COUNTRY - BACKGROUND • The unhealthy competition coupled with management issued resulted in the following: • 2004 Evertrade liquidation • The Ixopo incinerator closed down by the Dept - poor operations & maintenance. • Clinical Waste Management authorised in 2002 but never operated despite successfully trials until it burned down in 2007. • Aid Safe, using tried and tested technology meeting international stds closed down in 2007 - non-compliance to ECA & APPA authorisation & illegal dumping. • The Wasteman facility in North West was unable to meet its air quality guideline emission standards and was in non-compliance with their air quality permit. Also being investigated for illegal dumping & CEO imprisoned.

9. LEGAL FRAMEWORK GOVERNING HCRWM • Pre 2009, an incinerator operater needed three authorisations, namely: Environmental Impact Assessment (EIA) by province , Environment Conservation Act (ECA) waste permit & Atmospheric Pollution Prevention Act (APPA, air quality) by National. • Significant inconsistency hasexisted in the way in which the legislative framework governing HCRW treatment plants was implemented. • Absence of a national standard regarding non-burn technologies hence implementation of different provincial standards. • HOWEVER, The situation has improved in the last year. • Policy on the thermal treatment of waste which identifies emission standards and operating conditions for incinerators. • Promulgation of the National Environmental Management; Waste Act, as the requirement for a separate EIA authorisation has fallen away and the requirements are taken up in the Waste Licence process.

10. CAUSES OF THE CHALLENGES EXPERIENCED IN THE HCRW INDUSTRY • The inconsistence with respect to the implementation of emission and performance standards between provinces and between the EIA and APPA permits has adversely affected the performance of the sector. What is legal in one province is illegal in another. • Requiring new plants to meet very strict standards but allowing old plant to meet significantly reduced emission standards and monitoring requirements has meant that compliant facilities are not able to tender for contracts on the same footing as non-compliant technologies. • etc

11. CAUSES OF THE CHALLENGES EXPERIENCED IN THE HCRW INDUSTRY • The uneven playing fields with respect to the compliance requirements of treatment capacity for thermal treatment facilities has lead to: • The inability of compliant technology to compete on an equal footing with non-compliant technology when tendering • Reluctance in the industry to develop new capacity • Uncooperative behaviour within the industry players towards each other • Cutting corners with respect to applying environmentally protective management measures • Undercutting of prices to win tenders • Pressure on all aspects of the service, collection, transport, storage and disposal – need to do more for less • Enormous pressure from NGO’s when attempting to develop new capacity

12. PROPOSAL TO IMPROVE ON THE IMMEDIATE SITUATION Short term intervention – Additional HCRW treatment capacity in the Western Cape (WC) & a new facility will be licensed in GP by the end of May. Therefore no need for landfilling of HCRW. Medium Term interventions –Standards for the performance of incinerators have been set in the National Air Quality Emission standards process. DEA is finalising the HCRW Policy & Regulations for completion by February 2011. Long Term interventions –it is proposed that a study be undertaken to determine the feasibility of developing a regional facility owned by government or a Public/Private partnership and operated through a performance contract.

13. THANK YOU FOR YOUR ATTENTION