Urban Medical Waste Disposal

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Main actors

City Government, National Government, Private Sector

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Ongoing since 2020

Innovative Emergency Solutions during COVID-19.

With the global outbreak of COVID-19 and the subsequent ecological crisis, many cities are facing the challenge of increased medical waste. Based on experiences from the 2003 outbreak of SARs, the Chongqing municipality has developed emergency solutions to address urban medical waste disposal, which have been successfully applied in Wuhan and Chongqing. This provides a model that other cities can follow for the disposal of medical waste and the improvement of urban safety resilience during the pandemic.

Sustainable Development Goals

Ensure healthy lives and promote well-being for all at all ages
Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation
Make cities and human settlements inclusive, safe, resilient and sustainable
Ensure sustainable consumption and production patterns
Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels

Guangzhou Award

This project was shortlisted for the 'Guangzhou Award' in 2020.

Chongqing, China

Size and population development
In 2018 the National Bureau of Statistics China estimated the Chongqing municipality as having a population in excess of 31 million people and the city of Chongqing with a population of 8 million. The Chongqing municipality covers an area of 82,403km2 and the city an area of 5,472.8km2. The most recent population data is from the 2010 census. Information from the national census conducted in November/December 2020 is not yet available.

Population composition
The predominant religions in Chongqing are Chinese Folk religions, Taoist traditions and Chinese Buddhism. The language native to Chongqing is Southwestern Mandarin.

Main functions
Chongqing lies at the confluence of the Yangtze and Jialing rivers and is centered on a hilly peninsula encircled by both rivers. Chongqing is 1,025 km northwest of Hong Kong, and 1,800 km southwest of Beijing. It is known as one of the four furnace cities of China, with blazingly hot and humid summers and cold, foggy winters. The Yangtze River starts here and winds through the municipality and makes its way towards Shanghai on the eastern seaboard more than 1,600 kilometres away.

Main industries / business
Chongqing is the key economic hub of western China. The city is a major center of iron and steel production, and shipbuilding, as well as chemical and pharmaceutical production. It is China’ s biggest producer of automobiles with an annual production of over 3 million vehicles in 2016 and also produced more than 8 million motorcycles. Additionally, Chongqing produced 58 million laptops – one third of the world's production in 2016. It also produced 280 million mobile phones that year, which was 15 per cent of China’s total mobile phone production. Chongqing has benefited from national policies such as the Go West strategy, the Chongqing Liangjiang New Area, the Yangtze River Economic Belt, the Belt and Road Initiative and the Chengdu-Chongqing Cities Cluster Development Strategy, as well as the establishment of a Chongqing Pilot Free Trade Zone.

Political structure
Chongqing is one of the four municipalities under the direct administration of the central government of the People’s Republic of China along with Beijing, Shanghai and Tianjin. It is the only such municipality located deep inland and the largest of the four.

Administrative structure
Chongqing municipality is divided into 38 subdivisions consisting of 26 districts, 8 counties, and 4 autonomous counties. The municipality has a People's Congress that is elected for a term of five years. The People's Congress nominally appoints the mayor and approves the nominations of other government officials. The People's Congress, like those of other provincial jurisdictions, is generally seen as a symbolic body. It convenes in full once a year in the Great Hall of the People to approve party-sponsored resolutions and local regulations and duly confirm party-approved appointments. The municipal People's Government serves as the day-to-day administrative authority, and is led by the mayor, who is assisted by vice mayors and mayoral assistants. Each vice mayor is given jurisdiction over specific municipal departments.

Due to the sudden outbreak of COVID-19, the disposal of medical waste became an urgent priority for the municipal governments of Chongqing and Wuhan. The city of Wuhan’s daily medical waste rapidly increased from 45 tons to 247 tons, far exceeding its daily disposal capacity. The Wuhan government had only one private operator for medical waste disposal and requested help from the Ministry of Ecology and Environment of the People’s Republic of China (MEE). MEE and Wuhan municipal government asked the China Energy Conservation and Environmental Protection Group (CECEP) to provide a solution. CECEP selected a private operator from Chongqing, Gient, who were the only supplier able to provide assistance at that time.

Wuhan emergency medical waste disposal center and the permanent medical waste disposal plant have a capacity of 30 tons/day respectively and serve 388 hospitals in the 16 districts of Wuhan, benefiting approximately 14 million residents. The emergency disposal center for medical waste was built in 14 days, taking into account the need to limit the risks of infection within it.

The construction of the emergency medical waste disposal center is based on several partnership models between the central government-municipal government, government -industries, city-city and state-owned companies-private companies. MEE, the lead partner made an urgent decision to approve the construction of two disposal plants.

  • CECEP was responsible for the investment, construction and operation of the plants,
  • Chongqing Gient was responsible for in-situ technology and equipment,
  • Wuhan Environmental Investment Group provided the local support for CECEP
  • Chongqing Municipal Government provided the administrative support for rapid procurement of complete sets of equipment required by Gient for the two plants.

Early in the COVID-19 crisis, Chongqing municipality increased their daily capacity to 90 tons/day for medical waste disposal. This expansion  involved 426 front-line management and disposal staff and 125 special vehicles for medical waste and help to safeguard the health of 32 million residents and their environmental safety.

The Emergency Mechanism included a daily report, dispatch, analysis and research. A warning system was applied to the operation load of disposal facilities. If 80% load was exceeded, other forms of temporal emergency disposal facilities should be started (such as mobile disposal facility, incineration plants, etc.).

The department in charge of transportation ensured a clear pathway for vehicles loading medical waste and the department of healthcare and the economic and information commission ensured the provision of medical protective equipment.

Due to the lockdown, it was not possible to have a participative process during the design phase. However, during the implementation phase, many volunteers, medical staff, low-income people and women were involved.

As there are no manufacturers for medical waste disposal equipment in Wuhan, the only operator for medical waste disposal could not respond to complicated situations due to lack of technical capability. Chongqing is a leading city in the manufacturing of complete sets of equipment for medical waste disposal and is well serviced by Gient and a group of supporting factories, forming a powerful industry chain.

An advance-funding construction and operation model was adopted for Wuhan emergency medical waste disposal center. In the first instance, the hospitals were not charged for the construction and operation of new waste disposal facilities. After the end of the outbreak, Wuhan Municipal Government audited the investment, then an agreed lump sum was paid to construction and operation units. The construction fund of the permanent disposal plant shall be borne by the construction party, and the investment will be gradually recovered through the subsequent provision of charged medical waste disposal services to the hospitals in Wuhan.

With the help of Chongqing, an emergency disposal center for COVID -19 medical waste was constructed and operated in Wuhan, including processed medical waste from LeiShen Shan and HuoShenShan makeshift hospitals and other 16 districts, ensuring service provision for Wuhan residents. The rapid completion of Wuhan emergency medical waste disposal center played a significant role in the timely disposal of   medical waste during COVID-19. It processed 1/4 of the medical waste from Wuhan including two large makeshift hospitals. After the completion of a 60t/day medical waste disposal plant, the annual disposal capacity can achieve 19800 tons with 100% safe disposal. This has both improved Wuhan’s medical waste disposal capacity and provides a model for other cities around the world.

From the outbreak of COVID-19 to July 11, 2020, the accumulated medical waste disposal in Chongqing amounted to 11600 tons, meeting the requirements of “all receivable”, “daily clear”, “safe disposal”. The principle of 100% environmental supervision to the hospitals and 100% collection and disposal of medical waste in Chongqing was implemented to ensure the scientific regulation of medical waste, which effectively prevented secondary infection and virus spread.

Challenge:  powerful resource scheduling and integration
Solution: good collaboration and efficient decision-making mechanism

Challenge: the conflict between the prevention and control capacity for medical waste disposal
Solution: the government and the community should pay prevention-based medical waste disposal “margin” far exceeding daily needs

Challenge: insufficient policy and regulation support
Solutions: improving regulations, standards, facilities and technology; ensuring data quality control, enhancing training and awareness; achieving standardized medical waste management.

Lessons learned
The construction of Wuhan emergency medical waste disposal center in 14 days (instead of 10 months under normal circumstances) demonstrated a rapid and replicable approach. In the permanent disposal plants, new technologies have been adopted to create an environmentally friendly and smart work environment, preventing the operators from infection. The most important attributes to achieve the desired outcome were collaboration and technology. The collaboration involved a large number of people involved nationally, a clear division of responsibilities and quick response.  Hundreds of officials, experts, technicians, workers, medical staff and volunteers were involved.

Measures taken to sustain the innovation over time:
Establish a mechanism to keep track of the results and ensure continuous improvement of the innovations to guarantee the continuous use of the facilities and emergency mechanism post-pandemic.

Undertake studies on what Chongqing can learn from the Wuhan experience, such as regular training for staff related to medical waste, regional collaboration for co-disposal of medical waste, rational planning of medical waste disposal facilities.

Because of the successful application of innovative solutions in Wuhan, MEE encouraged Chongqing to share its Wuhan experience with other cities. Several cities in China are already re-organizing their capacity of medical waste disposal facilities based on this model and building environmentally friendly medical waste disposal facilities. At the same time, plans for emergency disposal facilities should be prepared to improve the local medical waste disposal capacity in case of another large-scale outbreak of the pandemic.

The Solid Waste Management Center of CEEB won the national award for its excellent contribution against COVID-19. After this meeting, as the only city winner in the medical waste management and disposal sector, Chongqing is ready to share its innovations with other Chinese and global cities.

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Guangzhou International Award for Urban Innovation
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Guangzhou International Award for Urban Innovation

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