As India builds a future ready healthcare ecosystem, the silent burden of biomedical waste demands urgent, coordinated attention merging compliance with innovation, investment with infrastructure, and action with accountability.
While the Biomedical Waste Management Rules, 2016, provide a regulatory framework, gaps in execution, awareness, technology adoption, and equitable infrastructure development remain.
The current landscape
Recent statistics reveal a startling truth: improper disposal of medical waste, particularly needles, has resulted in count less deaths and infections worldwide. According to the World Health Organization (WHO), over 1.3 million people die each year due to infections caused by needlestick injuries, which occur when healthcare workers or waste handlers come into contact with improperly discarded needles, risking exposure to infectious diseases such as HIV, hepatitis B, and hepatitis C.
Apart from the immediate risk to human lives, improper needle disposal also poses significant threats to the environment. When needles are discarded inappropriately, they can end up in open dumps, landfills, or even water bodies, leading to soil and water pollution, thereby endangering the health of wildlife and compromising the overall health of our ecosystems. The presence of these hazardous materials in the environment creates a cycle of contamination that can have far-reaching consequences for generations to come.
“In India, biomedical waste management (BMWM) is governed by the Biomedical Waste Management Rules, 2016, is sued by the Ministry of Environment, Forest & Climate Change. As per these rules, Health Care Facilities (HCFs) including hospitals and diagnostic labs are directly responsible for segregation, collection, pre-treatment (where required), in-house transportation, and storage of bio-waste,” says Dr Ravneet Kaur, Laboratory Head-Microbiology and Serology, Agilus Diagnostics.
In response to a directive from the National Green Tribunal issued on January 12, 2024, the Central Pollution Control Board (CPCB) com piled data submitted by 36 state and union territory pollution control authorities. Ac cording to this consolidated re port, India has approximately 393,242 healthcare facilities (HCFs). Of these, about 67.8 per cent are non-bedded units, which include entities such as clinics, diagnostic laboratories, blood banks, veterinary centers, and dispensaries.
The remaining 32.2 per cent comprise bedded facilities—hospitals, nursing homes, and similar institutions with inpatient care capabilities. Out of the total, 156,540 facilities have received formal authorisation from the respective State Pollution Control Boards (SPCBs) or Pollution Control Committees (PCCs). The rest are still undergoing the approval process. Notably, Uttar Pradesh, Karnataka, and Bihar account for the highest number of facilities pending authorisation.
Burden beyond the big cities
The divide is sharper in semi urban and rural belts, where infrastructure and capacity are limited. “Semi-urban facilities often struggle with irregular waste pickups and insufficient on-site storage capacity, leading to heightened public health risks,” says Dr Kriti Ganguly, Consultant-Microbiology, Marengo Asia Hospitals.
Even more troubling is regulatory non-compliance. According to Dr Sunita Kapoor, Director & Laboratory Head, City X-Ray and Scan Clinic, “Nagpur alone saw 314 health care establishments fined Rs 74 lakh over five years for improper waste disposal. Furthermore, limited awareness and inadequate training among healthcare workers have been noted, contributing to improper handling and disposal of biomedical waste.”
Adding to this, Dr Aashish Chaudhry, Director & Head Orthopaedics & Joint Replacement, Aakash Healthcare explains, “Biowaste generation in hospitals and diagnostic labs has grown significantly in both urban and semi-urban regions due to increased healthcare access, patient load, and testing volumes. While Tier 1 cities typically have structured waste management protocols and third-party tie-ups for treatment and disposal, many Tier 2 and Tier 3 cities continue to struggle with inadequate segregation, limited awareness, and lack of compliance.”
“In semi-urban areas, bio medical waste is often mixed with general waste, leading to serious health and environ mental hazards. Moreover, many small clinics and diagnostic labs either remain un registered or do not follow mandated protocols due to lack of resources or monitoring.”
Emerging technologies and digital solutions
Despite the structural challenges, Indian healthcare facilities particularly in metro clusters are gradually adopting modern technologies to improve the quality and safety of biowaste handling.
From IoT-enabled smart bins and RFID-based tracking to decentralised microwave sterilisation, innovation is stepping up to solve legacy challenges.
“Emerging technologies like plasma pyrolysis and gasification are gaining attention in biomedical waste management for their high waste destruction efficiency, volume re duction, and minimised harmful emissions,” shares Dr Kaur.
“Plasma pyrolysis operates at very high temperatures, making it suitable even for moist or hazardous waste types, and produces by-products like syngas which can be used as fuel. Gasification, similarly, takes place in an oxygen deficient environment and offers clean energy recovery options.
These technologies present a compelling solution for environmentally responsible disposal, especially in high-density healthcare clusters. However, their adoption comes with challenges such as high initial capital expenditure, specialised equipment requirements, and intensive operational planning and maintenance”, added Dr Kaur.
Several hospitals are embracing compact, decentralised treatment systems.“Decentralised waste treatment units, such as compact autoclaves and microwave dis infection systems, are making inroads, especially in smaller hospitals. These allow in-house treatment, reducing dependency on external vendors and lowering transportation risks and costs. Some facilities are now exploring AI-based dash boards to track waste generation trends and improve segregation compliance.” notes Dr Chandermani, Unit Head-Clinical Services, Jupiter Hospital, Pune.
Adding a diagnostics sector perspective, Dr Ganguly says, “Several hospital in India have already adopted to the latest technologies like real time monitoring apps, barcode based waste tracking system, and onsite autoclaving units that are directly integrated with the State Pollution Control Board System. Such innovations and technology not only helps in enhancing the compliance but also curbs down the reliance on manual handling, and thus enhancing worker safety and reduces any risk of infection.”
Dhrubaa Ghosh, Partner Healthcare, BDO India highlights, “Autoclaving together with microwave disinfection and plasma pyrolysis treatment methods generate reduced hazardous emissions and lower operational costs in the long term… Smart bins integrated with IoT systems and RFID tracking systems improve waste segregation accuracy while enabling real-time waste monitoring from collection to disposal.”
Further elaborating on safety innovations, she adds, “Automated handling systems and robotic arms perform dangerous material management to protect workers from infectious waste and sharp objects… Mobile waste treatment units operate in limited-resource environments to per form on-site processing which eliminates transportation risks and expenses.”
Dr Bilal Thangal TM, Medical Lead, NURA AI Health Screening Center, India also adds, “Emerging technologies such as AI-led screening, automation, and digital workflows are reshaping healthcare delivery by enhancing efficiency, safety, and cost-effectiveness. In diagnostic and preventive care set tings, especially those focused on non-invasive procedures, the generation of biomedical waste is inherently low. How ever, the real impact of digitaisation lies in reducing indirect waste such as excess consumables, redundant paperwork, and unnecessary manual interventions.”
“This shift is especially valuable in urban and semi-urban India, where infrastructure gaps and cost pressures persist. Technology-enabled models offer scalable, re source-efficient solutions that improve traceability, support compliance, and elevate patient safety. As the healthcare sector evolves, integrating such innovations will be crucial in building more resilient, efficient, and environmentally conscious care ecosystems.”
Investment and partnership trends in the bio waste management sector
With ESG becoming a board room priority and sustainability indices gaining prominence, the biomedical waste sector is attracting interest from government, private players, and institutional investors alike.
“The biomedical waste management sector is witnessing a steady increase in investments and strategic partner ships, driven by tighter regulatory oversight and the growing emphasis on environ mental sustainability and ESG compliance within healthcare,” says Dr Kaur.
This shift is evident in investment flows. “In 2024, the sector was valued at approximately USD 286.98 million and is projected to grow to USD 486.09 million by 2033 at a CAGR of 6 per cent,” shares Dr Kapoor.
“Investments are being directed towards the development of new treatment facilities, adoption of advanced waste treatment technologies like autoclaving and chemical disinfection, and integration of IoT-based monitoring systems to improve operational efficiency.”
Dr Ganguly echoes this trend, “The Bio Medical Waste Management sector in India is now witnessing a rising momentum pertaining to increased Public Private Partnerships (PPP), Investment by private sector, and the tech driven innovations.”
“Large hospital networks are exploring partnerships with certified waste management firms to set up centralised treatment facilities or integrated waste management systems. Startups offering tech-driven solutions for waste segregation and monitoring are also attracting seed funding”, added Dr Chaudhry.
From the hospital operator’s view, Dr Chandermani adds, “There is growing interest from private players and startups in the biomedical waste sector. With increasing regulatory enforcement and demand for professional waste management services, several companies are offering turnkey solutions to hospitals, including collection, treatment, data reporting, and training.”
Public-private partnerships (PPPs) are also picking up. Some large hospital chains have partnered with waste management firms to co-develop treatment facilities or digital tracking systems. The National Clean Air Programme and Swachh Bharat Mission have brought some focus and funding toward improving hospital waste infra structure.
Bridging the gaps: What still needs urgent attention
Despite the progress, glaring disparities and inefficiencies persist particularly in the policy-practice gap.
“Despite the establishment of a clear regulatory frame work through the Biomedical Waste Management Rules, 2016, gaps in infrastructure and policy implementation re main a major concern, especially in semi-urban and rural areas,” says Dr Kaur.
“A key concern is the inadequate number of treatment facilities, particularly in rural and semi-urban regions, where improper disposal methods like open dumping and uncontrolled incineration are still prevalent. The uneven distribution of infrastructure has resulted in urban centres being better equipped, while less developed regions remain under served”, Dr Kapoor added.
Ghosh underscores systemic issues, “The operational challenges of India’s health care waste management system become evident through observations which demonstrate ongoing deficiencies in rural and urban healthcare facilities… The personnel responsible for waste handling in these areas perform their du ties without wearing appropriate protective equipment or receiving proper training.”
Dr Ganguly adds, “Many districts are still lacking Com mon Bio-medical Waste Treatment and Disposal Facility (CBWTF) coverage, which leads to accumulation of waste beyond the saturation limit, or improper disposal. On the contrary, in the rural sector, the enforcement is quite limited due to lack of awareness, training and monitoring. Further more, some of the home-made diagnostic or telemedicine kits, a segment which has seen a sharp rise in the recent times post COVID, are not covered under the current policy frameworks.”
From the enforcement perspective, Dr Chandermani ex plains: “Training and aware ness among healthcare workers, especially support staff, remain limited. Waste segregation at the source is of ten poor… While the law is clear, enforcement is uneven. Fines and closures are rare, even in cases of gross violations.”
The way forward
Addressing the biomedical waste challenge requires a multi-pronged strategy spanning regulation, infrastructure, digitalisation, and behavioural change.
To begin with, India must increase the number and geo graphic distribution of CB WTFs, especially in semi-urban and rural areas. The inclusion of mobile or modular treatment units would provide flexibility and last-mile access.
Digital tracking tools must be made mandatory and seamlessly integrated with State Pollution Control Board dash boards. Uniform reporting systems would aid compliance and data-led policymaking.
Capacity building should also be institutionalised. “Mobile-based gamified applications function as essential educational tools to deliver continuous training for health care service providers,” says Ghosh
With robust laws, increasing awareness, scalable innovations, and investor interest, the country stands on the cusp of a breakthrough in sustain able waste management. Healthcare stakeholders must think beyond the bin towards circular solutions.
Kalyani.sharma@expressindia.com
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