School of Social and Political Science, University of Edinburgh, Edinburgh, UK.
Department of Microbiology, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
Global Health. 2022 Mar 12;18(1):30. doi: 10.1186/s12992-022-00823-7.
Waste management is notably absent from current discussions about efforts to improve access to diagnostics in low-and middle-income Countries (LMICs). Yet an increase in testing will inevitably lead to an increase in diagnostic waste, especially since many of the diagnostic tests designed for use in LMICs are single-use point-of-care tests. Diagnostic waste poses a threat to both human and environmental health. In this commentary we draw on our experience of diagnostic waste management in Sierra Leone and review current evidence on: the volume and impact of diagnostic waste in LMICs, existing health-care waste management capacity in LMICs, established national and international policies for improving health-care waste management, and opportunities for strengthening policy in this area. We argue that questions of safe disposal for diagnostics should not be an afterthought, only posed once questions of access have already been addressed. Moreover, responsibility for safe disposal of diagnostic waste should not fall solely on national health systems by default. Instead, consideration of the end-life of diagnostic products must be fully integrated into the diagnostic access agenda and greater pressure should be placed on manufacturers to take responsibility for the full life-cycle of their products.
废物管理在当前关于改善中低收入国家（LMICs）诊断获取的努力中明显缺失。然而，检测的增加必然会导致诊断废物的增加，特别是因为许多专为 LMICs 使用而设计的诊断测试都是一次性使用的即时护理测试。诊断废物对人类和环境健康都构成威胁。在这篇评论中，我们借鉴了我们在塞拉利昂的诊断废物管理经验，并回顾了当前关于以下方面的证据：LMICs 中诊断废物的数量和影响、LMICs 中现有的医疗废物管理能力、改善医疗废物管理的既定国家和国际政策，以及加强这一领域政策的机会。我们认为，对于诊断的安全处置问题不应该是事后才考虑的，而应该是在已经解决了获取问题之后才提出。此外，诊断废物的安全处置责任不应该默认仅由国家卫生系统承担。相反，必须将诊断产品的使用寿命末期问题充分纳入诊断获取议程，并对制造商施加更大压力，要求其对产品的整个生命周期负责。
