-
CENTRES
Progammes & Centres
Location
India’s growing biomedical plastic waste stream remains largely excluded from circular economy planning, particularly in healthcare systems beyond hospitals
 (1).jpg)
Image Source: Getty
Biomedical plastic waste is an escalating concern in India, driven by the widespread use of single-use medical devices. From intravenous (IV) bags and syringes to gloves and diagnostic kit packaging, plastics have pervaded the healthcare sector for being cheap, convenient, and sterile. Post-COVID-19, plastic waste has only continued to rise—but the end-of-life for these materials is seldom addressed using circular economy (CE) principles. A systematic review published in 2025 highlights that healthcare plastics (HCPs) remain significantly underrepresented in CE strategies, primarily due to security issues and the complexities of handling contaminated materials. As a result, India continues to treat biomedical waste linearly—used once and then disposed of through landfilling or incineration—losing the opportunities for reduction, reuse, and recycling.
World Health Organisation (WHO) estimates that roughly 15 percent of healthcare waste is ‘hazardous’, while the remaining 85 percent is comparable to regular household trash if properly segregated.
India generates an enormous quantity of biomedical waste—about 743 tonnes per day as of 2023, with plastics forming a significant share of this waste. (In the United States, an estimated 20-25 percent of hospital waste by weight is plastic. Indian hospitals likewise also rely heavily on plastics in devices and disposables.)
Crucially, only a small fraction of biomedical waste is truly hazardous or infectious. The World Health Organisation (WHO) estimates that roughly 15 percent of healthcare waste is ‘hazardous’, while the remaining 85 percent is comparable to regular household trash if properly segregated. However, due to poor segregation practices, many non-infectious plastics are treated as biomedical risk waste and incinerated or dumped—foregoing the chance for material recovery.
Moreover, biomedical plastic waste originates not just from large hospitals but also from a multitude of smaller sources such as clinics, doctors’ offices, diagnostic labs, blood banks, veterinary clinics, pharmacies, home healthcare, and even households.
India has nearly 4.35 lakh healthcare facilities (HCFs) generating bio-medical waste. Many of these—especially the tens of thousands of small clinics or non-bedded centres—remain difficult to monitor and integrate into the formal waste management. For instance, in Maharashtra alone, more than 43,000 non-bedded clinics collectively generate approximately 17.6 tonnes of biomedical waste daily. Home care (such as insulin injections or wound dressings by patients/caregivers) is another growing source outside the formal waste collection system. This decentralised generation presents challenges in capturing and safely processing all biomedical plastics.
Biomedical plastic waste originates not just from large hospitals but also from a multitude of smaller sources such as clinics, doctors’ offices, diagnostic labs, blood banks, veterinary clinics, pharmacies, home healthcare, and even households.
India's Bio-Medical Waste Management Rules, 2016 (BMW Rules 2016) serve as the central legislation for managing biomedical waste. They are mandatory for ‘all persons who generate, collect, receive, store, transport, treat, dispose, or handle biomedical waste in any form,’ and include explicitly all hospitals, nursing homes, clinics, dispensaries, laboratories, blood banks, veterinary clinics, research laboratories, and health camps. The 2016 regulations further tightened the rules by requiring the State Pollution Control Board to approve all health facilities, regardless of size (small or large), and by enforcing compliance with mandated waste management measures This plugged a giant loophole in previous regulations that failed to cover small clinics; previously, only the facilities that were of a certain size were to be licensed, allowing a majority of small generators to operate under the radar.
The subsequent 2018 and 2019 amendments to the BMW Rules introduced further provisions relevant to plastics and circularity. These reforms included—phasing out chlorinated plastic gloves and bags by March 2019 (which emit highly toxic dioxins when burned); mandating bar-code tagging and Global Positioning System (GPS) on waste transport vehicles and bags for accountability purposes. The rules also covered under its fold sectors previously overlooked, such as ayurvedic and homoeopathic dispensaries. Additionally, all vaccinators were specifically brought into the fold by 2019.
Although these rules have a holistic scheme on paper where they embrace even small waste generators, in theory, everything that is biomedical waste—be it from a multi-specialty hospital or a simple one-doctor clinic—has to be separated at the source, collected by a registered collector, and discarded at a Common Biomedical Waste Treatment Facility (CBWTF) by appropriate treatment (incineration, autoclaving, shredding). The rules also foresee some circular practices: duly disinfected plastic waste (red category) meant to be shredded and dispatched to licensed recyclers, and metallic sharp tools that may be sterilised and recycled as scraps. These are under the circular economy principles of material recovery.
Despite a strong legal framework, there are significant gaps between policy and practice. The gaps are still wide, especially for non-hospital and small-scale generators. Regulators face mounting pressure to monitor most small clinics and scattered health providers. While all clinics need to register and associate with a waste facility, most small clinics, laboratories, and pharmacies fall behind in compliance in practice. Others won't sort the waste or will have it taken out with regular municipal trash. Even in licensed health clinics, this is hard to comply with. Budget cuts result in smaller clinics cutting corners on disposing of the waste because it is an extra expense.
India's waste management is mostly linear - ‘make-use-dispose’ - with most plastics usually ending up in incinerators or dumps. Not only does this linear system contaminate, but it also wastes resources.
In Maharashtra, officials reported that the small clinics were aware of the rules but refused to cooperate because they felt the fee for garbage collection was too exorbitant. As a result, the government began promoting ‘cluster’ solutions, where small clinics dispose of waste at a larger local hospital for a token fee, to raise compliance. Another gap in implementation is the digital tracking system: Barcoding of biomedical waste bags was mandated in 2016, but most hospitals find it difficult to install it due to system limitations. Only a few states (such as Kerala) had introduced GPS tracking and barcodes for waste movement by 2019. This implies that in most places, accountability breaks down once waste has passed from the generator, creating a risk of illegal dumping or illicit recycling.
Shortcomings in biomedical plastic waste management pose serious public health and environmental risks. Improperly disposed of HCPs can lead to infection and harm populations. For instance, sharp instruments such as used needles or lancets with regular waste have resulted in needle-stick injury and disease transmission such as hepatitis and Human immunodeficiency Viruses (HIV) among waste pickers and sanitation workers. Scavenging for biomedical disposables for reuse is another hazardous practice observed in the informal waste economy, where used syringes are harvested illicitly, cleaned, and resold for reuse.
India's waste management is mostly linear - ‘make-use-dispose’ - with most plastics usually ending up in incinerators or dumps. Not only does this linear system contaminate, but it also wastes resources. There are a few missed opportunities where the principles of CE can be implemented:
Enhanced Segregation and Recycling: The largest opportunity lies in separating non-infectious plastic waste and recycling it rather than treating it all as infectious. By educating staff to segregate plastics that have not come in contact with the toxic content, hospitals and clinics can export clean plastics to recycling channels.
Reusable Products: In the past, most medical devices (syringes, surgical devices, even gowns) were intended to be sterilised and reused. Now, advances in materials science and sterilisation technologies may allow for safer and cost-effective reusables. Strong polymer or metal alternatives for surgical trays, respirator masks, or gowns can be sterilised repeatedly.
Extended Producer Responsibility (EPR): Incorporating producer responsibility could also strengthen circular economy solutions. For example, syringe, IV bag, and drug blister pack producers can be required to enable take-back programmes or fund recycling/disposal. India has implemented EPR for general packaging waste under the Plastic Waste Management Rules (2016, revised 2022). However, biomedical plastics are predominantly outside general municipal waste streams, reducing the scope of EPR regulations. Policymakers can address this issue by requiring companies to implement reverse logistics for returned products or collaborate with certified waste disposal services.
Technology-enabled Tracking and Transparency: GPS-enabled tracking and bar-coding, as mandated, must be implemented across all states to leave an auditable trail from generation to final disposal. This prevents waste from ‘escaping’ into the environment or the informal economy. Extending the digital tracking to cover hand-offs to recyclers is also important.
Newer Technologies: India can also leverage novel technologies to recover value from biomedical plastics that are not readily recyclable. Chemical recycling or energy recovery may be a bailout for extremely mixed or dirty plastics at the lowest end of a circular hierarchy.
The forthcoming revision of biomedical waste guidelines or regulations can make recycling goals for particular types of waste and the elimination of single-use plastics compulsory in healthcare. To turn circularity into reality in healthcare, various efforts must be amplified and integrated into the healthcare industry’s regulations and routine practices. This would allow India to turn biomedical plastic waste into a sustainable development opportunity, rather than a public health nuisance, closing the loop on one of the longest linear sectors in the economy.
K. S. Uplabdh Gopal is an Associate Fellow with the Health Initiative at the Observer Research Foundation.
The views expressed above belong to the author(s). ORF research and analyses now available on Telegram! Click here to access our curated content — blogs, longforms and interviews.
Dr. K. S. Uplabdh Gopal is an Associate Fellow within the Health Initiative at ORF. His focus lies in researching and advocating for policies that ...
Read More +
PREV
.jpg)