Sustainable and resilient health care waste management system in Maldives

In 2016, the Health Protection Agency of the Maldives, with technical support from WHO and the UNDP, launched a national initiative to strengthen healthcare waste management (HCWM) and reduce associated health and environmental risks. The project developed a national policy, strategic plan and implementation guidelines, alongside a pilot in 11 health facilities in Laamu Atoll. Infrastructure improvements included installing a 600L autoclave at L. Regional Hospital and smaller autoclaves in local health centres. Training and awareness programmes equipped healthcare workers to safely treat infectious waste before transport, establishing a foundation for more resilient, sustainable, and low-carbon waste management. 

The initiative’s success was driven by strong ministerial commitment to building a low-carbon, climate-resilient health system and aligning HCWM reforms with national regulations. Technical partnerships with WHO, the Ministry of Environment, and donor agencies enabled the adaptation of international best practices to the Maldivian context. National guidelines and standardised training modules were developed. After which, a cascade system of training-of-trainers built institutional capacity and awareness. These combined efforts fostered systemic change across multiple levels of healthcare, ensuring consistent implementation and sustainability of non-burn waste management technologies nationwide. 

Replication requires sustained political commitment, interagency collaboration and investment in low-carbon, environmentally friendly waste treatment technologies suited to small island contexts. Clear national guidelines and ongoing training programmes are essential to address gaps in technical capacity and high staff turnover. Integrating non-burn technologies such as autoclaves into national health strategies supports climate resilience and regulatory compliance. Establishing monitoring mechanisms and continuous capacity-building programmes ensures operational consistency. With coordinated leadership and partner engagement, island states can feasibly transition toward sustainable, climate-resilient healthcare waste management systems.