An evaluation conducted by the State Audit Institution (SAI) has revealed significant challenges in managing medical waste in Montenegro, primarily due to an absence of strategic documentation, weak institutional oversight, and insufficient data recording, according to the SAI’s announcement.

The SAI has released the Performance Audit Report titled “Performance of Medical Waste Management in Montenegro.”

This audit was carried out under the leadership of the competent Collegium of the State Audit Office, which includes Dr. Branislav Radulović, a Senate member and head of the Collegium, alongside Nikola N. Kovačević, Senate chairman and Collegium member. The findings indicate that medical waste management in Montenegro is not adequately accomplished.

“The aim of the audit was to assess whether the relevant authorities and public health institutions (PHI) have established the necessary conditions for effective medical waste management while ensuring proper oversight and control,” the statement clarified.

“The audit focused on various subjects, namely the relevant authorities and public health institutions: the Ministry of Ecology, Sustainable Development and North Development; the Ministry of Health; health institutions (including the Clinical Center of Montenegro; Clinical Hospital Center of Berane; Nikšić General Hospital; Bar General Hospital; Capital City Health Center; Montefarm Pharmacy Association; and the Institute of Public Health) as well as the Inspection Affairs Directorate,” it added.

The SAI emphasized that the Ministry of Health and related institutions have failed to establish an effective supervisory system, which, as per the SAI, has resulted in poor execution of planned activities and difficulties in waste tracking.

“Numerous actions from the previous medical waste management strategy remain unimplemented; specifically, only 52 percent of activities were completed, while the execution status for 28 percent remains unclear,” reported the SAI.

The report pointed out that waste management plans expired at the end of 2020, and no new plans have been adopted since, leading to a lack of well-defined targets, guidelines, and protocols for the disposal of specific types of waste, particularly pathoanatomical waste.

“The audit highlighted that the facilities for disposing of pathoanatomical waste are insufficient, and there is a lack of systematic records pertaining to its generation and management. Inadequacies in handling pathoanatomical waste and the international movement of medical waste could have severe repercussions for both the environment and public health,” the audit disclosed.

The DRI stated that while the Ministry of Health has set up a commendable record-keeping system for medical waste, which is now being transferred to the concessionaire, the audit determined that this system does not categorize medical waste by type.

“Furthermore, there are inconsistencies and disagreements concerning the duration of the concession contract for medical waste disposal. A notable issue is the lack of data regarding medical waste produced in health institutions outside the public health sector, as well as discrepancies in the reported waste quantities. Although some public health institutions adopt good practices, these are not uniformly implemented across the sector,” it noted.

“To enhance the medical waste management system, the competent Collegium of the SAI has issued 20 recommendations to the auditees, who must present the SAI with an Action Plan for implementing these recommendations by April 21, 2025, and a Report on the implementation of the recommendations by September 19, 2025. Given the critical nature of the issues identified in medical waste management, the audit report has also been submitted for information to the Committee on Tourism, Agriculture, Ecology, and Spatial Planning of the Parliament of Montenegro,” stated the SAI.

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