The concept of health economics has been used successfully by developed nations in health services programs management. Health economics attempts to incorporate the principles of economics (consumption, distribution and allocation of resources) into the implementation and financing of health programs. Health economics is therefore an application of economic theory to practical problem solving. These principles should be considered by the developing countries when they plan solid waste management strategies (1). The World Bank has stressed the need to reduce the cost of health care services (2). After realizing the role health economics can play in developmental stages when resources are scarce, many countries have begun experimenting with cost reduction ideas. Health economics can be used to make excellent management decisions about the allocation of resources in governmental agencies, community-based organizations, and for-profit and nonprofit organizations.
Without adequate and comprehensive means of revenue generation, many services cannot be sustained. Budgetary constraints continue to threaten valuable programs underwritten by the governments of many developing countries. In addition, the developed countries have underwritten several programs, continuation of which may be difficult for developing nations because they lack personnel with health economics training. Citizens who have enjoyed many free services may be forced to contribute financially to the operation of some programs, despite the general belief that the government should take care of them.
Policy makers in the developing countries should devise better ways of using their limited resources, especially in the collection and disposal of solid waste. Today, many developing countries serve as manufacturing centers for a variety of high-technology products. Waste generated from such manufacturing may require special handling, necessitating specialized education and training. A majority of the developing countries are having problems dealing with domestic waste and many will eventually face the need to manage specialized waste concomitantly.
The management of solid waste is a problem in developing countries as evidenced by littered refuse and scavenging animals. This situation is further exacerbated when unionized workers go on strike and waste is not collected. The streets are covered to the extent that automobiles have to maneuver to pass through. In some localities, when solid waste is collected, it is burned or dumped in open fields and left uncovered.
In many countries, governments are at present responsible for the collection and disposal of solid waste. Financial constraints will limit the prosperity and even the survival of many developing countries until they transfer health economics knowledge, such as fee setting, into their decision-making processes. Because many businesses do not foresee making money on solid waste, they are not interested in the "garbage business."
The author believes that when operating solid waste disposal programs, a government must consider the formation of an advisory committee, which will oversee output indicators and advise its government from time to time on how things could be improved. The committee, in conjunction with the government, must formulate the goals and objectives of the program and determine schedules for monitoring and evaluating activities.
Two realistic approaches are suggested to supplement current practices in the management of solid waste:
* determining the total cost of the project, offsetting amounts available from traditional government allocation, then determining the gap to be funded by household and industrial levy; or
* determining the total cost of the project, adding a profit target (if the government is constitutionally allowed to engage in profit making), then determining the amount to be funded by traditional government …