Essay 1 · MRx
What is Pharmaceutical Waste and What are Turkey's Main Pharmaceutical Zero-Waste Policies?
What is pharmaceutical waste?
Pharmaceutical wastes are simply drugs and medicines that can no longer be used. They may be generated by a range of activities and locations in healthcare facilities, including pharmacies, distribution centres and hospitals. Pharmaceutical waste also contains contaminated pharmaceuticals, such as vaccines, as well as spent biological products for therapy and transdermal patches.
Turkey's approach to pharmaceutical waste
Turkey has an extensive zero-waste policy towards pharmaceutical and medical waste. This includes broadly: separate collection of waste on the facility they're generated, temporary storage of the waste, and also the transport and disposal.
The color-coded segregation of waste materials (such as serum or medicine bottles being collected in blue recycling bags), strict incineration protocols (waste is only disposed in licensed, high-temperature incineration plants) are also important parts of Turkey's zero-waste policy. Additionally, local municipalities have set up medication waste collection bins in several community hubs, family health centers and similar locations.
Essay 2 · MRx
5-Step Guide to Waste Disposal: How is the Disposal Process Handled?
1 — Generation and Source Segregation
The process begins the moment an item is discarded. Historically, all trash was thrown into a single bin, creating massive sorting crises down the line. Today, professional guidelines emphasize segregation from the start. Households and industries must separate waste into distinct streams: organic matter, recyclables (paper, plastic, glass), and hazardous materials. The EPA notes that separating waste at this initial stage drastically reduces contamination rates, making subsequent recovery steps feasible.
2 — Collection and Logistics
Once segregation is done the waste enters the logistics phase. City governments deploy specialized fleets to collect different waste streams on a regular schedule. This process with trucks is enhanced with sensors that indicate whether a bin is full or not, preventing unnecessary route extensions that would increase their carbon footprint.
3 — Transfer and Resource Recovery
Although source segregation occurs at home, post-collection processing remains technically necessary to eliminate cross-contamination. Collected waste streams are transported to Materials Recovery Facilities (MRFs), where automated systems execute precise sorting. This step filters out misplaced non-recyclables that slipped through the initial phase and categorizes recyclables into their specific industrial category, such as separating plastics by their distinct polymer types. Consequently, this rigorous quality control ensures that materials meet the strict purity standards required for industrial manufacturing.
4 — Advanced Treatment Processing
Materials that cannot undergo direct recycling are routed to specialized treatment facilities, depending on their chemical composition. Organic waste is processed through composting or anaerobic digestion. Meanwhile, non-recyclable dry waste is directed toward thermal treatment, predominantly in modern Waste-to-Energy (WtE) plants. Instead of letting this trash occupy valuable land, controlled combustion processes convert the combustible materials into steam and electricity, effectively transforming a logistical challenge into a localized energy resource.
5 — Final Disposal
The absolute last resort in the hierarchy is secure containment. Residual materials that cannot be recycled, composted, or converted to energy are transported to engineered sanitary landfills. Unlike the toxic dumps of the past, modern landfills are highly regulated engineering structures lined with high-density polyethylene (HDPE) to prevent toxic liquid runoff from contaminating groundwater. Furthermore, methane gas collection systems are installed to capture greenhouse gases, fulfilling the final regulatory mandate of environmental containment.
Essay 3 · MRx
Turkey's Current Goals in Improving Pharmaceutical Waste Disposal
The future plan for pharmaceutical waste management in Turkey aims to guide the country toward an increasingly circular and participatory model rather than a reactive one.
Led mainly by the Ministry of Environment, Urbanization and Climate Change in close collaboration with the Ministry of Health, Turkey's strategic objectives aim at strengthening institutional enforcement, making family-level collections part of daily life, and achieving ambitious sustainability targets.
One of the most important targets is improving the technology of waste processing equipment. The state is currently favoring high-efficiency, localized medical waste processing equipment — such as 304-grade stainless steel containment units — to eliminate micro-leakages during transit.
Plans like the 12th National Development Plan (2024–2028) and the newly updated National Circular Economy Strategy and Action Plan (UDESEP) released in late 2025 demonstrate Turkey's strict waste disposal improvement strategy. Facilities like İZAYDAŞ and İSTAÇ are being tasked with expanding their waste-to-energy infrastructure, ensuring that the thermal treatment of chemical compounds directly offsets national grid power usage.
Essay 4 · PharmHive
Data and Tracking in Pharmaceutical Zero Waste
The Zero Waste Project system is an important approach for planning sustainable cities. It aims to prevent, reduce, reuse, and recycle waste. It is believed that approaches like the Zero Waste Project will contribute not only to preventing environmental pollution in a physical sense, but also have the potential to bring about social solidarity and economic improvement.
The Ministry of Environment and Urbanization launched the "Zero Waste" project in 2017. In the following years, regulations such as charging for plastic bags, deposit-refund systems, and the Paris Agreement were implemented into regular life in Turkey. With these regulations, it became obligatory for public institutions and organizations to adopt the Zero Waste Management System as of 1 June 2020.
When it comes to pharmaceutical waste, until 2009, a considerable amount was disposed of in landfills and covered with lime. The Zero Waste regulation explains how pharmaceutical waste will be collected and properly disposed of. According to this regulation, healthcare services such as hospitals, pharmacies and pharmaceutical warehouses are responsible for their pharmaceutical waste, and medicine waste generated by households is managed by municipalities. In Istanbul, the most populated city in Turkey, there are currently 39 district municipalities. Additionally, for districts that are far from the landfill, there are waste transfer stations with a capacity suitable for waste quantities and in places where route optimization is provided.
Currently, there are 104 transfer stations in Turkey, 59 of which are in metropolitan cities and 45 in non-metropolitan provinces. Since 2010, the number of municipal waste landfills has increased from 46 to 93. In addition, the proportion of the municipal population with landfill services increased from 59% to 89%. As of 2022, there are 9 incineration, 11 compost, and 2,866 recycling facilities.
In 2023, Pendik had the most amount of medicine waste collected by the Zero-Waste Project, collecting 7,460 kilograms of medicine waste in that year. However, out of 39 districts, only 18 shared their data on the amount of pharmaceutical waste collected in 2023.
Table 1. Investigation result according to drug indications (n=4,852)
| Group |
Cold and Flu |
Pain Killer |
Antibiotics |
Vitamins |
Hormones |
Cholesterol |
Other |
| Group A |
624
(25.59%) |
692
(28.38%) |
159
(6.52%) |
428
(17.56%) |
153
(6.28%) |
103
(4.22%) |
279
(11.44%) |
| Group B |
728
(30.16%) |
587
(24.32%) |
138
(5.72%) |
208
(8.62%) |
357
(14.79%) |
43
(1.78%) |
353
(14.62%) |
Table 1. Investigation result according to drug indications (n=4,852)
Figure 1. Percentage distribution of pharmaceutical waste according to their indications
Figure 2. Percentage comparison between two groups of pharmaceutical waste according to indications
Figure 3. Percentage distribution of pharmaceutical waste according to their pharmaceutical dosage forms
According to the findings, although there was a 2% difference between cold medications and painkillers, no statistically significant difference was found (p<0.05). While the vitamin and statin group (cholesterol drugs) showed more disposal in the group with a high-income level, hormone drugs showed more disposal in the group with a lower income level. The fact that the antibiotic group was low in both groups shows that restricting access to antibiotics in line with the rational drug policy implemented in the country is effective. Since the period in which the research was conducted coincided with the COVID-19 pandemic, the number of wastage of drugs used in cold and flu infections increased. This indicates that hoarding habits led to unnecessary drug intake, and therefore an increase in waste drug amounts (15%). Consequently, different policies regarding rational drug use need to be developed.
When dosage forms of waste medicines are analyzed (Figure 3), it is seen that solid and liquid dosage forms take the first two places. In Group B, the amount of waste generated by liquid dosage forms is quite high. Considering that the majority of liquid dosage forms are in syrup form, it is concluded that the pediatric population is higher in this group. Wastes from creams or ointments, which constitute the semi-solid group, were found to be relatively less and in similar amounts in both groups. The fact that there were almost no products requiring a cold chain reveals that this group only took as much as they needed. Most of collected drugs were expired (56.75%), and disposed of with their original secondary container (46.25%). It is a matter of concern that 10.75% of the total quantity of waste pharmaceuticals was never used.
Waste management is a crucial process for all countries. Methods such as incineration and underground burial are employed for non-recyclable wastes, yet these practices have the potential to exacerbate various environmental concerns. A review of studies conducted for the pharmacy and pharmaceutical industry revealed that waste pharmaceuticals are increasingly prevalent in Turkey, with limited disposal options. Unused or wasted pharmaceuticals represent a significant global challenge. The health sector and the consumption of health-related products are growing rapidly. Unfortunately, there is currently no process for the recovery of the waste drug molecule. Consequently, on-site separation and waste minimisation methods are being applied or attempted in Turkey and around the world with the aim of reducing pharmaceutical waste.
Sources (Essay 4)
Henden Şolt, H.B. (2023). Evaluation of the Zero Waste Project in Istanbul District Municipalities from the Perspective of Sustainable Urban Planning. Sustainability, 15, 11896. https://doi.org/10.3390/su151511896
J. Fac. Pharm. Ankara / Ankara Ecz. Fak. Derg., 48(3): 835–839, 2024. doi: 10.33483/jfpau.1473405
Köksoy, S. (2024). Unused, expired pharmaceuticals and their disposal practices among the general public in Burdur-Türkiye: a cross-sectional study. BMC Public Health, 24(1), 1303. https://doi.org/10.1186/s12889-024-18788-0
Saka, O.M. (2024). Investigation of the prevalence of expired and unused pharmaceuticals in the Ankara region. Journal of Faculty of Pharmacy of Ankara University, 48(3), 835–839. https://doi.org/10.33483/jfpau.1473405
Yönten, E. et al. (2026). İlaç Atıklarının Çevreye ve Halk Sağlığına Etkileri, Geri Dönüşümü ve Mevzuat Çerçevesi. Journal of Anatolian Environmental and Animal Sciences. doi: 10.35229/jaes.1768361
Essay 5 · MRx
What Would Happen if the Pharmaceutical Waste Disposal System Had Ceased to Exist?
If there were no specific use of thermal incineration or any kind of dedicated containment, hundreds of thousands of tons of outdated and unused medicines would be dumped into municipal landfills or flushed down toilets. Enormous doses of hormones (as present in combination pills), psychiatric medications (depressants, stabilizers) and cardiovascular drugs would pass completely unaltered through water treatment plants and enter household tap water.
Without means to lock up pharmaceuticals in pharmacy drop-boxes or destroy them, every single bottle of strong medications such as morphine and other opioid analgesics would end up in municipal trash cans and landfills. Wildlife, stray animals, and even farm animals near garbage dumps would inevitably ingest deadly combinations of pharmaceuticals.
The pharmaceutical manufacturing plant produces large quantities of chemically hazardous waste, off-specification batches and toxic solvents during synthesis. The resultant products and wastes would otherwise have to be stockpiled if it were not for permitted disposal methods.
Sources (Essays 1, 3 & 5)
Sağlık Kuruluşlarında Tıbbi Atık Yönetimi (Çevre ve Şehircilik İl Müdürlüğü). webdosya.csb.gov.tr/...
TIBBİ ATIKLARIN KONTROLÜ YÖNETMELİĞİ (TC Cumhurbaşkanlığı Resmi Gazete). mevzuat.gov.tr/...
vertisa.com.tr — Tıbbi Atık Bertaraf Yöntemleri
atikyonetimi.ibb.istanbul — Tıbbi Atıkların Toplanması ve Bertarafı
istac.istanbul — Atık Yönetimi
Aydoğan, Ö., Varank, G., & Bilgili, M.S. (2011). Medical waste management in Gaziantep. Journal of Engineering and Natural Sciences / Sigma, 3, 132–140.
Mollamahmutoğlu, A., & Bekmezci, S. Türkiye'de tıbbi atık yönetimi, bertarafına yönelik son gelişmeler ve Ankara'daki uygulamaları. İnşaat Mühendisleri Odası (İMO).
Essay 6 · PharmHive
The Role of Municipalities in Collecting and Processing of Pharmaceutical Waste in Turkey
Pharmaceutical waste is regularly disposed of in great amounts, especially in the bigger cities of Turkey. Consequently, municipalities are required to take on a great responsibility on waste disposal to prevent environmental hazards. According to Aydın's article published in 2019, "hospital waste consists of 3% chemical and pharmaceutical waste" which alone is a critical amount when the total number of hospitals in big cities is considered.
In İstanbul, a recent action was taken by Ataşehir municipality in order to improve the collection of pharmaceutical waste. The municipality placed over 140 waste medicine collecting boxes all around the district, and the collected waste which exceeded 660 kilograms in only 5 months was safely separated and sent to proper disposal centers.
Not only municipalities alone work for a better environment — the Istanbul Chamber of Pharmacists has also collaborated with the Beşiktaş municipality to place medicinal waste bins in pharmacies. The municipality has conducted an effective strategy by this collaboration since citizens are more likely to be aware of the waste bins, and it also allows for a healthcare professional, like a pharmacist, to inform patients about it. The collected pharmaceutical waste is then sent to special facilities like İSTAÇ for proper disposal.
İSTAÇ is a company which operates alongside the İstanbul Metropolitan Municipality with the aim of advancing the zero-waste movement. They have factories for waste disposal, and their services include medical waste management. Their primary methods of pharmaceutical waste disposal involve strictly guided incineration protocols, since a thermal destruction route is required for pharmaceutical waste — unlike certain other medical waste which can be disposed of via special steam sterilization autoclaves. It is of critical importance for the thermal destruction process to be done properly, since hazardous pharmaceutical waste can contaminate aquatic habitats, recreational lakes, or even purification facilities (Efendi et al., 2022), and thus lead to a serious environmental disaster.
Up until 2013, there was a singular facility to treat potentially hazardous waste, which was İzaydaş in İzmit. Since then, many specialists in environmental sciences have conducted research to predict the future of pharmaceutical waste, which is imperative for designing an effective waste management system (Aziz Kemal Konyalıoğlu et al., 2024).
In conclusion, it is of utmost importance to always improve the zero-waste movement, and to be aware as citizens of the possibly catastrophic consequences of recklessness about improper pharmaceutical waste disposal, as well as how to fulfill responsibilities by using the many services Turkey's municipalities have provided and continue to provide.
Sources (Essay 6)
Aydın, N. (2019). Hazardous Waste Management in Turkey. Journal of Anatolian Environmental and Animal Sciences, 4(3), 312–318. https://doi.org/10.35229/jaes.558213
5 Ayda 660 Kilogram Atık İlaç Toplandı — T.C. Ataşehir Belediyesi. (2026). atasehir.bel.tr/...
İstanbul Büyükşehir Belediyesi. (n.d.). İSTAÇ Bilgilendirme Kataloğu. istac.istanbul
Aziz Kemal Konyalıoğlu, Ozcan, T., & Ilke Bereketli. (2024). Forecasting medical waste in Istanbul using a novel nonlinear grey Bernoulli model optimized by firefly algorithm. Waste Management & Research. https://doi.org/10.1177/0734242x241271065
Atık İlaç | Beşiktaş Belediyesi İklim Değişikliği ve Sıfır Atık Müdürlüğü. (2021). cevre.besiktas.bel.tr/...
Efendi, S. et al. (2022). Pharmaceutical Waste Collection Management Using Location-Routing Model in a Reverse Supply Chain. Procedia Environmental Science, Engineering and Management, 9(3), 711–724. procedia-esem.eu/...
