Environmental conditions can enhance the need for medicines and devices which in turn can trigger an inflow of donations, which may be unwanted, unnecessary, inappropriate, out of warranty, expired, and polluting.

Women and girls are disproportionately affected by the lack of access to basic water, sanitation, and hygiene facilities, due to their needs during periods of increased vulnerability to infection around menstruation and reproduction cycles. Additionally, other groups may have special needs in terms of hygiene practices. For this reason, disaggregate and understand the different groups of people in the community that may have special needs and behaviours when performing hygiene actions. For example, women may be provided with disposable or reusable menstrual pads which will need to be handled after every use. as a consequence, women may need special and additional messages tailored to handle these specific items and the messages need to be created accordingly women’s beliefs. Regarding other groups such as persons with disabilities or HIV/AIDS, create special messages explaining actions that are environmentally sensitive regarding special items they may be using. Regarding sexual health items, messages need to be oriented towards the safe disposal of items such as condoms. Condoms cause problems by clogging sewage drains.

Air pollution
Soil pollution
Natural resource depletion

• Greenhouse gas emissions and air pollution from long-distance/air transport instead of procuring items locally.
• Soil pollution from solid waste disposal.
• Natural resource depletion at source from the manufacture of unwanted, unused items.

International donations of medicines and technologies are often made without local consultation on need, assessment of local relevance, or local capacities to maintain equipment. There have been many incidences of medicines donated that are out of date or nearing expiry and of medicines that are not used in the local context. This causes substantial problems in waste disposal for countries and health services that are least able to take on this additional burden.

Such donations are often transported by airplane, fueled by fossil fuels. Fossil fuels contribute to climate change and cause local air pollution.

Donations of medicines and medical devices can contain chemicals, substances, or materials damaging to the environment and not in compliance with national or international guidelines.

• Request specific medicines and devices according to the needs of the population and the capacity of healthcare.
• Always reject unwanted or inapplicable donations.

• Accept donations of medicine and medical devices only if they have been provided to meet locally identified needs and can be effectively stored, distributed, used, and are compliant with national and international quality standards.
• Provide a list of needed and preferred medicines and medical devices and ensure fundraising teams only accept items that are on this list.
• Advise donors that financial donations to purchase local medicines and medical devices are essential in order to avoid international transportation and boost the local economy.

A number of developing countries reported receiving Covid-19 vaccinations that had waste management problems associated with them, these included doses that were close to expiry; inability to maintain the cold chain, including vaccinations being stuck in customs where they lost their efficacy.

# of inappropriate donations rejected

# of donors persuaded to give money instead of drugs

# of avoided inappropriate medicines and medical devices

Prevention of environmental damage

Time and effort to promote a concerted campaign to donors to stop inappropriate donations; to change to donating money instead of items, and to reject inappropriate donations.