Decision No. 170/QD-TTg dated February 08, 2012 of the Prime Minister approving the master plan on hazardous solid medical waste treatment systems through 2025

DECISION

APPROVING THE MASTER PLAN ON HAZARDOUS SOLID MEDICAL WASTE TREATMENT SYSTEMS THROUGH 2025

THE PRIME MINISTER

Pursuant to the December 25, 2001 Law on Organization of the Government;

Pursuant to the November 29. 2005 Law on Environmental Protection;

Pursuant to the November 26, 2003 Law on Construction;

Pursuant to the Government s Decree No. 59/2007/ND-CP of April 9, 2007. on the management of solid wastes:

Pursuant to the Prime Minister s Decision No. 2038/QD-TTg of November 15, 2011, approving the master plan on medical waste. treatment for the 2011-2015 period, with orientations toward 2020;

At the proposal of the Minister of Construction,

DECIDES:

Article 1.To approve the master plan on hazardous solid medical waste treatment systems through 2025 with the following principal contents:

1. Scope of the master plan

The master plan on hazardous solid medical waste treatment systems shall be implemented nationwide.

2. Subjects of the master plan

Hazardous solid medical wastes (excluding radioactive wastes and wastes from pharmaceutical plants).

3. Viewpoints of the master plan

- To conform with the national strategy for solid waste management through 2025, with a vision toward 2050, the socio-economic development master plan, the master plan for development of Vietnam s health system through 2010, with a vision toward 2020, and the master plan on the healthcare network through 2010, with a vision toward 2020;

- To associate with approved master plans on inter-provincial and provincial solid waste treatment centers;

- To focus on the collection, isolation and minimization of hazardous solid medical wastes at source and thoroughly treat them to ensure environmental sanitation and save land:

- To apply advanced and environment-friendly treatment technologies suitable to specific conditions of localities.

4. Objectives of the master plan

a/ General objectives:

- The master plan on hazardous solid medical waste treatment systems aims to raise the effectiveness of hazardous solid medical waste management, improve the environmental quality, protect community health and contribute to the sustainable development of the country;

- Hazardous solid medical waste treatment facilities must be associated with inter-provincial or provincial solid waste treatment centers or medical establishments to collect and thoroughly treat hazardous solid medical wastes by advanced and appropriate technologies.

b/ Specific objectives:

- The period to 2015: 100% hazardous solid medical wastes from medical establishments will be collected, sorted and transported to treatment facilities, of which 70% will be treated up to environmental standards;

- The period to 2025: 100% hazardous solid medical wastes from medical establishments will be collected, transported and treated up to environmental standards.

5. Contents of the master plan

a/ Forecasting the volume of hazardous solid medical wastes to be generated

 Based on the master plan for development of Vietnam s health system through 2010, with a vision to 2020, and the master plan on the healthcare network through 2010, with a vision toward 2020, annual statistics and Vietnamese and foreign researches, the volume of hazardous solid medical wastes to be generated nationwide is forecasted as follows: thoroughly eliminate germs capable of causing pollution and minimize the volume of wastes to be buried after treatment.

- Criteria for the selection of treatment technologies in order to thoroughly treat hazardous solid medical wastes in a way suitable to socio-economic conditions of localities.

b/ Hazardous solid medical waste treatment technologies

- Hazardous solid medical waste treatment technologies include incineration technology and non-incineration technology.

+ For incineration technology, hazardous solid medical wastes will be thoroughly treated at high temperature to eliminate germs in infectious wastes and minimize the volume of wastes to be buried. However, when temperature is not high enough under regulations, exhaust gas emission will cause air pollution; and construction investment and operation expenses are high.

+ For non-incineration technology, expenses for construction investment and operation are low. However, this technology can not

Treatment technologies (incineration or non-incineration) may be selected according to the following criteria:

+ Composition and characteristics of hazardous solid medical wastes;

+ Possibility to separate and isolate hazardous solid medical wastes at source;

+ Volume of hazardous solid medical wastes to be treated;

+ Locations of hazardous solid medical waste treatment facilities;

+ Financial and management capacity of localities.

c/ Hazardous solid medical waste treatment models

- Based on hazardous solid medical waste management, 3 models of hazardous solid medical waste treatment are suggested as follows:

+ Centralized treatment model: Hazardous solid medical wastes will be treated in hazardous medical waste treatment facilities located within inter-provincial or provincial solid waste treatment centers:

+ Hospital cluster-based treatment model: Hazardous solid medical wastes from hospitals located in places within reasonable distances will be treated in a hazardous solid medical waste treatment facility based at a hospital located in the center of the hospital cluster;

+ Model of treatment at medical establishments: Hazardous solid medical wastes will be treated right at medical establishments by appropriate technologies up to environmental standards.

- Criteria for the selection of models of hazardous solid medical waste treatment: In order to select appropriate models for localities, six criteria are suggested as follows:

+ Level of concentrated generation of hazardous solid medical wastes.

+ Volume of generated hazardous solid medical waste.

+ The actual state of the hazardous solid medical waste treatment facility.

+ Level of convenience in collection and transportation.

+ Orientations of the solid waste treatment planning.

+ Financial capacity.

d/ Planning on hazardous solid medical treatment facilities

- The Red River delta (covering the northern key economic region):

The Red River delta covers 11 provinces and centrally run cities: Hanoi, Vinh Phuc, Bac Ninh. Quang Ninh, Hai Duong, Hai Phong, Hung Yen, Thai Binh, Nam Dinh and Ninh Binh.

+ The period to 2015: Nine provinces and centrally run cities will apply the centralized treatment model. Ha Nam and Bac Ninh provinces will apply the hospital cluster-based treatment model;

+ The period to 2025: 11 provinces and centrally run cities will apply the centralized treatment model.

- The northern midland and mountainous region:

The northern midland and mountainous region covers 14 provinces: Ha Giang, Cao Bang, Bac Kan, Tuyen Quang, Lao Cai, Yen Bai, Thai Nguyen, Lang Son, Bac Giang, Phu Tho, Dien Bien, Lai Chau, Son La and Hoa Binh.

+ The period to 2015: 13 provinces will apply the hospital cluster-based treatment model. Lai Chau province will apply the on-site treatment model;

+ The period to 2025: 14 provinces will apply the centralized treatment model.

- Central Vietnam (covering the central key economic region, northern Central Vietnam and southern central coast):

Central Vietnam covers 13 provinces and one centrally run city: Thanh Hoa, Nghe An. Ha Tinh. Quang Binh, Quang Tri, Thua Thien Hue, Da Nang, Quang Nam, Quang Ngai, Binh Dinh, Phu Yen, Khanh Hoa, Ninh Thuan and Binh Thuan.

+ The period to 2015: Five provinces and 1 centrally run city (Thanh Hoa, Nghe An, Thua Thien Hue, Da Nang, Binh Dinh and Khanh Hoa) will apply the centralized treatment model: and 8 remaining provinces will apply the hospital cluster-based treatment model;

+ The period to 2025: 13 provinces and 1 centrally run city will apply the centralized treatment model.

- The Central Highlands:

The Central Highlands covers 5 provinces: Gia Lai, Dak Lak, Lam Dong, Kon Turn and Dak Nong.

+ The period to 2015: The on-site treatment model will be applied;

+ The period to 2025: Gia Lai, Dak Lak and Lam Dong provinces will apply the centralized treatment model; and Kon Turn and Dak Nong provinces will apply the hospital cluster-based treatment model.

- The eastern South Vietnam (covering the southern key economic region)

The eastern South Vietnam covers 5 provinces and 1 centrally run city: Binh Phuoc, Tay Ninh, Binh Duong, Dong Nai, Ba Ria-Vung Tau and Ho Chi Minh City.

+ The period to 2015: Binh Duong, Dong Nai, Ba Ria-Vung Tau provinces and Ho Chi Minh City will apply the centralized treatment model; and Binh Phuoc and Tay Ninh provinces will apply the hospital cluster-based treatment model;

+ The period to 2025: Five provinces and 1 centrally run city will apply the centralized treatment model.

- The Mekong River delta:

The Mekong River delta covers 12 provinces and 1 centrally run city: Long An, Tien Giang, Ben Tre, Tra Vinh, Vinh Long, Dong Thap, An Giang, Kien Giang, Can Tho, Hau Giang, Soc Trang, Bac Lieu and Ca Mau.

+ The period to 2015: Tien Giang, Ben Tre, Tra Vinh, Vinh Long, Dong Thap, An (Jiang, Kien Giang, Hau Giang, Soc Trang, Bac Lieu and Ca Mau provinces will apply the hospital cluster-based treatment model; and Long An province and Can Tho city will apply the centralized treatment model:

+ The period to 2025: 12 provinces and 1 centrally run city will apply the centralized treatment model.

6. Investment phasing

a/ Phase 1 (from 2011 to 2015):

- To implement projects on collecting, separating, minimizing and storing hazardous solid medical wastes in healthcare establishments under the Ministry of Health s regulations on hazardous solid medical waste management;

- To implement projects on renovating and upgrading existing solid medical waste incinerators;

- To implemenl projects on renovating existing incinerators based at provincial and district health establishments to meet environmental standards;

- To implemenl projects on building hazardous solid medical waste treatment facilities in inter-provincial solid waste treatment centers (Hanoi, Ho Chi Minh City, Thua Thien Hue and Binh Dinh) or provincial centers (Vinh Phuc, Quang Ninh, Hai Phong, etc.)

b/ Phase 2 (from 2016 to 2020):

- To implement projects on building hazardous solid medical waste treatment facilities in provincial solid waste treatment centers in phase 2 in Bac Ninh and Ha Nam, Thai Nguyen, Bac Giang, Phu Tho, Son La, Ha Tinh, Quang Nam, Quang Ngai, Phu Yen, Binh Thuan, Gia Lai, Dak Lak, Lam Dong, Tien Giang, Dong Thap, An Giang, Kien Giang, Ca Mau provinces and Can Tho city, etc.;

- To increase the capacity of hazardous solid medical waste treatment works built in phase 1 up to the designed capacity;

- To install hazardous solid medical waste treatment works in areas expected to apply the hospital cluster-based treatment model with non-polluting treatment technologies;

- To install hazardous solid medical waste treatment works in medical establishments applying the on-site treatment model with modern, easily operated and environment-friendly technologies;

- To implement projects on training human resources for hazardous solid medical waste management and treatment for medical establishments and units managing and treating hazardous solid medical wastes in localities in phase 1.

c/ Phase 3 (from 2021 to 2025):

- To implement projects on training human resources for hazardous solid medical waste management and treatment for medical establishments and units managing and treating hazardous solid medical wastes in localities in phase 2.

- To implement or complete construction investment projects and install hazardous solid medical waste treatment works in inter-provincial or provincial solid medical waste treatment centers;

- To install hazardous solid medical waste treatment works in areas expected to apply the hospital cluster-based treatment model with non-polluting treatment technologies;

- To install hazardous solid medical waste treatment works in medical establishments applying the on-site treatment model with modern, easily operated and environment-friendly technologies.

7. Investment capital sources

- State budget;

- ODA capital and foreign aid;

- Long-term loans;

- Capital of domestic and foreign investors;

- Other lawful capital sources.

8. Strategic environmental assessment

a/ Possible adverse impacts:

- Bacterial contamination: Microorganism, bacteria, fungi and viruses may cause hepatitis A, B, C, etc., acquired immunodeficiency syndrome (HIV/AIDS), meningitis, etc.;

- The toxicity of chemicals may cause poisoning through skin, mucous membranes, inhale or eating or cause injuries. When these chemicals are poorly managed and treated, they may cause indirect adverse impacts through underground water contamination;

- Genetic toxicity: Toxic substances may cause genetic mutation, DNA damage, birth defects or cancer;

- When temperature is not high enough under as required, exhaust gas can be emitted in the course of burning;

- Sharp objects: In addition to their physical danger, sharp objects, cultured samples full of germs and contaminated solid matters are hazardous wastes capable of adversely affect human health.

b/ Solutions to minimizing environmental impacts:

To minimize environmental pollution and prevent environmental incidents, the following solutions shall be implemented:

- General solutions:

+ Hazardous solid medical waste treatment facilities must ensure safe distance under technical regulations;

+ Works shall be arranged in treatment facilities to meet technical and scenery requirements, and assure quick response to incidents;

+ Greenery areas must comply with Vietnamese construction regulations.

- Technical solutions:

+ To popularize regulations on labor safety, prevention and control of fire and explosion, and machinery and equipment operating processes; and provide adequate labor protection devices for workers;

+ To install noise-preventing devices for highly noisy machinery;

+ Collection and transportation must comply with regulations on hazardous solid medical waste management;

+ To regularly control the local ecosystem so as to assess environmental impacts;

+ To take measures for preventing environmental incidents;

+ To take other support measures.

- Environmental management and supervision programs:

+ Air environment quality observation program;

+ Surface water and groundwater quality observation program;

+ Soil environment quality observation program.

Article 2.Organization of implementation

1. The Ministry of Construction shall assume the prime responsibility for, and coordinate with the Ministry of Health in, examining the implementation of projects on building hazardous solid medical waste treatment facilities under the master plan on hazardous solid medical waste treatment systems through 2025 approved by the Prime Minister.

2. The Ministry of Health shall assume the prime responsibility for, and coordinate with related ministries, sectors and provincial-level People s Committees in, organizing the implementation of the master plan; examining and supervising medical establishments in observing regulations on medical solid waste management nationwide under the approved master plan;

3. The Ministry of Finance shall assume the prime responsibility for, and coordinate with the Ministry of Planning and Investment in, balancing state budget investment capital; studying and formulating financial mechanisms and policies to encourage and attract domestic and foreign investment capital for development of hazardous solid medical waste treatment systems.

4. The Ministry of Natural Resources and Environment shall:

- Oversee, examine and assess the compliance with regulations on environmental standards in hazardous solid medical treatment facilities;

- Guide the environmental impact assessment of investment projects on building hazardous solid medical waste treatment facilities.

5. The Ministry of .Science and Technology shall:

- Appraise locally developed technologies of hazardous solid medical waste treatment according to its competence; and coordinate with the Ministry of Health in guiding the selection of technologies of hazardous solid medical waste treatment for application in the country;

- Encourage and support domestic production establishments in studying and making environment-friendly technologies of hazardous solid medical waste treatment.

6. Provincial-level People s Committees shall:

- Work out plans on implementation of the master plan on hazardous medical solid waste treatment;

- Organize the elaboration, approval and implementation of projects on building hazardous medical solid waste treatment facilities in their localities;

- Promulgate mechanisms and policies to encourage domestic and foreign organizations and individuals to invest in building hazardous medical solid waste treatment facilities in their localities;

- Periodically report on the implementation of the master plan to the Ministry of Construction and the Ministry of Health for summarization.

Article 3.This Decision takes effect on the date of its signing.

Article 4.Implementation responsibility

The Minister of Construction, related ministries, chairpersons of provincial-level People s Committees and heads of related agencies shall implement this Decision.-