Healthcare waste management and antimicrobial resistance: a critical review

The rapid growth of populations and urbanization has led to a significant increase in healthcare waste, posing serious health risks. A search on Google Scholar identified seven relevant articles from Ethiopia that examine the relationship between improper waste management in healthcare facilities (HCFs) and the rise of antimicrobial resistance (AMR) genes. This review aims to highlight key concepts, evidence sources, and knowledge gaps specific to the Ethiopian context. The unsafe disposal of antibiotics through leaks and solid waste has contributed to what some are calling a 'silent pandemic,' raising concerns about emerging infectious diseases. Studies have revealed alarming rates of infectious agents and AMR in healthcare wastewater. Isolates of C. jejuni, Escherichia coli, Enterococcus faecalis, and Enterococcus faecium from various healthcare waste sites in Ethiopia demonstrate high levels of AMR genes. Additionally, research indicates that HCFs produce significant amounts of waste, with high per-person daily waste production rates. Leachate from landfills containing this waste can negatively affect soil health, biological activity, water quality, agriculture, animal health, and human well-being. To mitigate these risks, effective waste management practices and the promotion of alternative antimicrobial use are essential strategies for reducing the emergence of pandemic diseases in developing countries.