Motivation, leadership, a well-understood national policy and training matter as much as equipment in a successful healthcare waste management programme, says Richard Carr, WHO’s specialist on the issue. There is no advantage in having an incinerator if no one knows how to use or maintain it, says Carr. "There are plenty of technologies that can be used; it is just a matter of getting people motivated," he says.

WHO has produced an aide-memoire for health system managers to use in planning a system for waste disposal: it contains advice and a checklist. It can be viewed or downloaded at www.healthcarewaste.org or obtained by writing to Richard Carr at WHO: carrr@who.int