These guidelines can be used by all relevant health authorities, competent to authorize the use or disposal of drugs. In many countries drug disposal will also involve environmental and waste management authorities, and experts at ministerial, regional and local level. Depending on the situation in the country, the appropriate authority may be a department responsible for pharmaceutical management within the ministry of health, the drug regulatory authority (if different from the former), a regional or local health authority (pharmaceutical officer) or the ministry of environment, etc. It is the responsibility of the qualified appropriate authority to implement the guidelines in coordination with regional and local health authorities, as well as with the directors of health facilities that face the problems of drug disposal.
A local task force or advisory committee should be established at an early stage to assess, analyse and address the problem of drug disposal, and to monitor activities. Furthermore, it is suggested that such a task force has a maximum of five members and that meetings are held as near to the site of the stockpile as possible. Members may be chosen from:
• the drug regulatory authority or ministry of health;
• the ministry of the environment;
• the audit section of the ministry of health;
• institutional pharmacists;
• a qualified hazardous waste expert may be appointed by the authority to be responsible for pharmaceutical waste disposal. If this is done the person appointed should become a member of the task force. The individual can be an expert in environmental management, a registered water chemist, hydrogeologist or sanitary engineer. The choice of expert depends on the technical problems to be faced.
Nongovernmental organizations with pharmaceutical programmes may also have to deal with unusable waste stocks of pharmaceuticals that require disposal. Disposal should be undertaken in conjunction with the relevant authority where such exists.
In non-emergency situations large stockpiles do not usually accumulate, and waste pharmaceuticals are best disposed of on a routine basis, small quantities at a time. This should be organized on a local and institutional level.