Addressing solid waste management and climate change: a triple win for Lao PDR

The Lao People’s Democratic Republic (PDR) is committed to strong action on climate change mitigation and adaptation.

At the same time, smart climate policies – beyond the health sector – can bring substantial benefits for health and other areas. In other words, climate change mitigation and adaptation can have many co-benefits, for health and beyond.

When decision-makers understand the links between climate mitigation and adaptation strategies, and the environmental, economic and social determinants of health, they can maximize health co-benefits, save costs and contribute to more equitable outcomes for vulnerable populations.

Better solid waste management, for example, can bring a triple win for the environment, society and health. This brief highlights how, and the tangible benefits that can be achieved.

Climate change action has many benefits
Lao PDR is particularly vulnerable to climate change, with projections of more extreme weather, a 2–3°C rise in temperature by 2050, and a 10–30% increase in rainfall.

Across all sectors – including agriculture, energy, forestry, transport and waste – the Government has made a strong commitment to reduce greenhouse gas emissions and implement climate change mitigation strategies.

To understand co-benefits from climate change mitigation and adaptation work, the World Health Organization (WHO) conducted research and consulted with Lao experts from various sectors as part of a Green Climate Fund readiness project. Lao experts unanimously chose to focus on solid waste management as a sector where climate change action could bring significant health co-benefits.

Opportunities to improve solid waste management
Lao PDR currently has low waste collection rates and limited segregation of organic and recyclable materials. There is limited recycling and resource recovery, the use of open dumping and burning is extensive, and many landfills are poorly managed. Medical and hazardous waste can be dumped in municipal waste disposal sites and on vacant land without treatment.

With rapid urbanization and changing lifestyles, there has been a doubling of waste in Lao PDR in the past 20 years. About 910 000 tonnes are generated each year; this is expected to rise to 1.4 million tonnes by 2035.

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Poor solid waste management harms the environment, society and health
Solid waste contains a wide range of chemical, biological, and physical hazards and contributes significantly to global greenhouse gas emissions. It can also harm health.

Around the world, environmental factors that can be modified – including the poor management of solid waste – are responsible for 24% of deaths (and 28% of deaths among children under 5).

The top 10 causes of death in Lao PDR all have established links to poor solid waste management (see the figure on next page).

Poor solid waste management can lead to exposure to hazardous materials through air, water, soil and food contamination. Risks include diseases spread by mosquitos, rodents, cockroaches, flies and dogs. Diarrhoea, intestinal worms, hepatitis A and leptospirosis can arise from poor waste management.

Here are the facts:
1. It is estimated that the waste sector is responsible for 12% of ambient air pollution in Vientiane. Globally, it has been estimated that open burning accounts for 29% of fine particles – the most damaging – in air pollution.
2. A total of 2686 deaths in the country could be attributed to air pollution in 2019. Of 528 deaths due to lower respiratory infections, 184 (35%) were children.
3. In 2019, air pollution also cost the Lao people more than 80 000 disability-adjusted life years (years lost to ill health, disability or early death). Again, young children suffered disproportionately.

Poor solid waste management is costly
The health and economic costs of uncollected waste is estimated in low- and middle-income countries at US$ 375 per tonne, far higher than the actual costs of collection and disposal of US$ 30 to US$ 115 per tonne.

Air pollution from all sources is estimated to impose health costs equal to 6.1% of the global gross domestic product (more than US$ 8 trillion in 2019).

Some groups are more vulnerable
Groups who are vulnerable to the harmful health effects of poor solid waste management include children, older people and the chronically ill, who are more sensitive to exposure to hazardous substances from solid waste.

People more frequently exposed to these hazards, such as waste workers and those living close to open dump or burning sites, are also more vulnerable.

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Lao PDR has the opportunity for a win–win– win
The country already has climate change mitigation and adaptation strategies that would improve solid waste management, for example in the draft National Strategy on Climate Change of the Lao PDR.

Moving to a more environmentally sustainable approach to solid waste management would save money, and deliver a wide range of health benefits, through improvements to the quality of the air, water, soil and food. It would reduce people’s exposure to litter and odour, disease vectors and hazardous materials, improve livelihoods and working conditions, and protect vulnerable people.

To improve solid waste management, the multiple regulatory agencies that oversee it in Lao PDR must collaborate, with other policy actions offering direct benefits to health, the economy and society.

Six priority steps to implement Lao PDR’s strategies
Lao stakeholders identified six priority steps to improve solid waste management and achieve gains for the climate, society and health:

1. Work across agencies and stakeholders to maximize the benefits for the climate, society and health.
2. Use the principles of the waste hierarchy (see chart below) to reduce, reuse and recycle to minimize waste; collect and segregate waste better (including hazardous waste); and dispose of waste carefully (including phasing out open dumping and open burning).
3. Develop behaviour change communication campaigns for the public and health care workers.
4. Engage with communities to integrate adaptation into solid waste management so systems can withstand extreme weather.
5. Use the available evidence for co-benefits to promote the implementation of existing strategies.
6. Strengthen monitoring and evaluation systems to track progress, make any adjustments that might be needed and provide accountability to stakeholders.

WHO supports the Government’s climate change work
WHO has been supporting the Government’s responses to climate change to enhance the health and well-being of its citizens. For example, the Ministry of Health has been working with WHO to install autoclaving systems in health care facilities to disinfect or treat infectious waste and replace burning. Upcoming support includes assessing the feasibility of establishing regulated medical recycling facilities as well as developing national action plans for environmentally sustainable healthcare waste management.