However, Frost & Sullivan revealed that in 2009, the industry made approximately USD 200million in revenue by managing, processing and disposing close to 16,000 tonnes in discarded medical devices, equipment and bio-waste. The entire country's medical waste management activities are governed by three concessionaires appointed by the Ministry of Health.
Management of clinical waste in Malaysia is based on the ‘cradle-to-grave' concept, where the concessionaires bear most of the responsibilities for every step in the life cycle of medical waste, which includes collection of waste from the healthcare providers, transport to treatments sites, disposal, and supply of the consumables. The initial stage of waste disposal, which is waste segregation and storage, is performed by healthcare providers.
Nurul Fatiha, Consulting Analyst, Frost & Sullivan, commented that the industry is expected to hit a double digit growth of 12.8 percent annually and triple its revenue base to USD 670 million by 2015. This good outlook can be attributed to the general increase in demand for healthcare services stemming from demographic changes: population growth and ageing; changes in disease patterns; growing off-shore medical tourism; and outbreaks of infectious diseases (H1N1, Bird Flu etc).
While demographic trends and health tourism increase population size and reciprocally higher demand for medical care, the ageing of population and life style associated diseases are sources of chronic and very often debilitating conditions that require substantial healthcare resources, which at the end of therapeutic process are turned into waste. It is estimated that by the year 2035 Malaysia will become an "old" nation with 10% of the total population being over 65 years of age.
The infectious diseases not only contribute to the higher consumption of healthcare services but also generate more waste through the use of disposables of personal hygiene care. Pandemic like the A(H1N1) influenza, the Bird flu and the Severe Acute Respiratory Syndrome (SARS) outbreak have in the past intensified infection control activities in Malaysia. In the recent strategy to combat the spread of pandemic influenza, the Malaysian Ministry of Health had outlined that any material coming in contact with ‘isolated patients' are to be handled as potentially infectious. At the same time, all disposable items and personal protective equipments like facial masks are to be regarded as clinical waste and to be disposed accordingly; resulting in an increase in the clinical waste volume generated.
Expansion of medical tourism industry in Malaysia with more than 420,000 medical tourists seeking care in 2009 also means higher production rate of hospital waste. Alongside the building of new hospitals and increments of beds to accommodate this segment, all these are core driving factors increasing the business size of hospital waste concessionaire.
"Waste management and disposal is pegged against the growth of the healthcare services sector. The more patients seek treatment, the higher production of hospital waste" says Nurul Fatiha.
According to a recent survey, Frost & Sullivan estimated that the total load of hospital waste in Malaysia may soon reach 33,000 tonnes per annum by 2020. Current incinerators design and capacity can only support incineration up to 18,000 tonnes of waste annually and it is very likely that in order to cope with the immediate and the long-term need of the industry, the three concessionaires may invest in building new incinerators or increase the capacity of their existing facilities.
Aside from increasing the current incinerators capacity, there are other opportunities to be found by improving the process of waste management from hospital to incinerators. Innovative products that decreases waste handling risk factor, waste compacting technology and automated waste delivery system is expected to be widely adopted by hospitals in Malaysia.
Other clinical waste-related businesses like supplies, equipment, replacement parts vendors and equipment service specialists, together with technology and environment consulting companies, healthcare facilities architects and designers and many other indirectly related businesses are expected to grow in tandem with the annual clinical waste generation in the country.
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