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Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
Carbon Footprinting and Healthcare
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Carbon Footprinting and Healthcare

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  • 1. Climate Change and HealthcareGreenhouse gas accounting in the healthcaresectorPresented by:Tom Penny (Environmental Resources Management)Laura Draucker (World Resources Institute)26th April 2013Boston
  • 2. Contents1. Climate Change and Healthcare2. Initiatives, Standards and Support3. Measuring and Reducing4. Q&A
  • 3. Contents: Climate Change andHealthcare1. A Brief Introduction to Climate Change2. The Healthcare Picture3. Future Trends
  • 4.  Climate system, processes and interactions are complexIntroduction to Climate ChangeIPCC
  • 5. Global Greenhouse Gas EmissionsTotal GHGsGt CO2e / year(2005)44WRI, 2009
  • 6. Question“is  the  healthcare  sector  a  major  source  of  global  greenhouse  gas  emissions?”a) less than 2%b) 2 to 10%c) greater than 10%
  • 7. Healthcare Greenhouse Gas Emissions Healthcare roughly 3-5% of global GHG emissions United States healthcare roughly 8-12% of country GHG emissionsERM estimate Total global health expenditure US$ 6.5 TrillionWHO Global Health Expenditure Atlas, 2012 Current population roughly 7.1 BillionUnited Nations
  • 8. Why is Healthcare a GHG Issue? Population likely to increase (31%) to 9 billionby 2050United Nations Increased demand on healthcare6.57.07.58.08.59.09.510.02010 2020 2030 2040 2050 2060 2070Globalpopulation(billion) XBBC
  • 9. Future Trends: Increase in Spend Spend on healthcare per capita Average: $948 USD High: $7,960 (United States), $4519 (Canada), $3440 (UK) Low: $44 (India), $56 (Indonesia), $191 (China)WHO Global Health Expenditure Atlas, 2012 (in $USD) Potential global healthexpenditureUS$ 57 TrillionIf all of current population had theequivalent healthcare spend as US010,00020,00030,00040,00050,00060,000Totalspend($USDBillion)Global Healthcare Spend(if country spend was the average)
  • 10. Where is the Challenge? Crucial for industry to measure what is currentlybeing done and target areas for significantreductions Real reductions need to be realized to meetfuture challenges (for example) new care pathway models telemedicine unused medicines remanufacture of medical devices
  • 11. Contents: Initiatives, Standards andSupport1. Introduction to GHG Protocol2. Standards3. Support available
  • 12. Flashback  to  1998…
  • 13. The Greenhouse Gas Protocol is a partnership between the World ResourcesInstitute and the World Business Council for Sustainable Development.GHG Protocol is built on the expertise of WRI and WBCSD, combined withthe  insight  and  experience  of  hundreds  of  the  world’s  leading  organizations.A global partnership
  • 14. The Greenhouse Gas Protocol, led by WRI and WBCSD, provides the foundationfor comprehensive measurement and management strategies to reduceemissions and drive more efficient, resilient, and profitable businesses andorganizations.Mission
  • 15. http://www.youtube.com/watch?v=_urMCfkPdus
  • 16. Corporate StandardCorporate Value Chain(Scope 3) StandardProject Protocol Product StandardGHG Protocol Standards
  • 17. The Corporate Standard• Helps companies prepare a true andfair inventory of their GHG emissions• Aids the development of effectivereduction strategies• Supports credible and consistentreporting• Available in seven languages• First to introduce the concepts of scope1, 2, and 3Over 85% of respondents to a 2010 Carbon Disclosure Project survey of2487 companies either directly used GHG Protocol or used it through theirparticipation in a climate change program that used GHG Protocol.
  • 18. Related Corporate Standard sectorpublicationsOffice-basedorganizationsUS public sector Agricultural sector Scope 2 accountingUnder development
  • 19. The Scope 3 Standard• To be used in conjunctionwith the CorporateStandard• Includes requirements anduser-friendly guidance forquantifying and reportingScope 3 emissions• Includes upstream anddownstream emissionsorganized into 15 differentscope 3 categories
  • 20. Why is consideringfull value chain(scope 3) emissionsimportant?Note: Chart represents average breakdown of emissions by category from scope 3 road testersScope 1 & 2, 21%1. Purchasedgoods andservices, 34%2. Capitalgoods, 1%3. Fuel- andenergy-relatedactivities, 4%4. Upstreamtransportationand distribution,4%5. Wastegenerated inoperations, 1%6. Businesstravel, 7%7. Employeecommuting, 2%8. Upstreamleased assets, 1%9. Downstreamtransportationand distribution,2%11. Use of soldproducts, 16%12. End-of-lifetreatment of soldproducts, 3%13. Downstreamleased assets, 1%15. Investments,3%Scope 1 & 2emissionsScope 3emissionscategories
  • 21. The Product Life Cycle Standard
  • 22. • Entities perform product level assessment to meet demandsfrom:– Customers wanting measurement and disclosure of product-level GHGinformation– Investors demanding more transparency– Consumers seeking greater clarity and environmental accountabilityDrivers for Product Level Assessments(Carbon Footprints)
  • 23. Full suite of GHG measurementstandards
  • 24. • Since their launch in October 2011, several in- person trainingshave been offered on the Scope 3 and Product Standards• To reach wider audiences, we are currently:– Offering quarterly webinar training• May 7 – 9 , Scope 3 Standard• June 4 -6 , Product Standard• Visit our website for more information and to register:www.ghgprotocol.org– Developing e-learning online trainings for both standardsGHG Protocol Capacity Building
  • 25. • Tools and guidance available on our website:– List of third party databases for secondary data sources– Uncertainty calculator and guidance– Supplier engagement guidance– Reporting template• Product Standard sector guidance built on the GHGProtocol:– Information and Communication Technology ( ICT) (underdevelopment)– ENCORD Guidance for Construction Companies– Concrete PCR– Pharmaceutical products and medical devices• Tools and guidance are developed based on stakeholderneedsGHG Protocol Tools and Guidance
  • 26. Contents: Measuring and Reducing1. Impacts within the healthcare sector2. Healthcare carbon footprinting guidance3. Benefits, case studies and initiatives
  • 27. Question“Are  direct (eg hospital energy, etc) or indirectoperations (eg manufacture of consumables,etc) more significant for healthcare GHGemissions?”a) Direct operations <50%b) Direct operations >=50%
  • 28. Healthcare Impacts: Direct & Supply ChainX ~35% DirectState of Green Business 2013, GreenBiz
  • 29. Healthcare Impacts: UK NHS FootprintUK NHS Footprint 2010
  • 30. Why was the Guidance DevelopedNHS undertook an organizational carbonfootprint in 2010 – pharmaceuticals 1/3rdSummits held by NHS Sustainable DevelopmentUnit (SDU) – promote low carbon healthcare2011 summit identified need for guidance to aidin the carbon footprinting within the sectorSteering Group put together to developguidance
  • 31. Who Developed the Guidance Association of British Healthcare Industries Association of British Pharmaceutical Industries AstraZeneca Baxter Healthcare British Generic Manufacturers Association Environmental Resources Management GlaxoSmithKline Hull and East Yorkshire NHS Trust Johnson & Johnson Medicines and Healthcare products Regulatory Agency National Institute for Health and Clinical Excellence NHS Commercial Medicines Unit NHS Sustainable Development Unit Novo Nordisk Pfizer SustainPharma UK Department of Health United Nations Development Programme (UNDP) Europe and Central Asia Western Health Australia World Resources Institute
  • 32. Healthcare Carbon Footprint Guidance Aimed to supportconsistent quantificationof the carbon footprint ofpharmaceutical productsand medical devicesNHS SDU GHG Protocol
  • 33. What can the Guidance be Used ForInternal product appraisals• eg hotspot analysis or eco-design initiativesPerformance tracking• eg products GHG emissions over timeReporting• eg product GHG emissionsNOT FOR: Comparative claims• eg favourable environmental performance of one product over another
  • 34. Who Should Use the GuidanceThe guidance aims to provide Clarity on life cycle stage and process inclusions/ justified exclusions Guidance on challenging aspects of the inventory calculation process Requirements/recommendations on primary & secondary dataneeds, sources and data quality appraisal Requirements/recommendations with regard to reportingGuidance is intended for Producers within the sector or value chain Healthcare services / regulators /policy makers Procurement teams
  • 35. Structure of the Guidance Section 1: Introduction Section 2: Core Principles Section 3: R&D, Clinical Trials & Marketing Section 4: Pharmaceutical Products Section 5: Medical Devices Section 6: Distribution & Delivery Section 7: Use Phase Section 8: End-of-Life Section 9: Reporting & Assurance Section 10: Care Pathways
  • 36. Section 4: Pharmaceutical Products37 Guidance  ‘modules’  provided  for  production  processes  or  stages  with  similar accounting challenges and data needs. These can be combined todevelop a profile for the production of the final, packaged productActive Pharmaceutical Ingredients■ Synthetic organic chemicals■ Cell cultures■ Egg-based cultivation■ Conjugate vaccines■ Plant-based extraction■ Human & animal-derivedDelivery Mechanisms■ Solid dose forms■ Liquid dose forms■ Creams & ointments■ Patches■ Gases■ Administering devices■ Packaging
  • 37. Section 5: Medical Devices38 Guidance  provided  for  similar  product  ‘groups’ with similar accountingchallenges and data needs.Medical Device Categories■ Passive, Single Use Devices with Multiple Components/Materials■ Passive, Single Use Devices with Few Components/ Materials■ Passive, Multiple Use Devices■ Implantable Devices■ Energy Consuming DevicesJohnson & Johnson
  • 38. Example Process Diagram39
  • 39. Example Processes to Include/Exclude40Include these non-attributableprocesses:•Chemicals used for cleaning•Sterilisation•Refrigerant leakage associated withproduct manufacturingInclude these attributable processes:• Material and chemical inputs• Material and chemical transport• Energy/fuel generation andconsumption• Waste disposal• Solvent manufacture, use anddisposal• Catalyst manufacture, use anddisposal• Solvent recovery and incineration• Process emissions from synthesisExclude these attributable and non-attributable processes:• Packaging of material & chemical inputs• Disposal of input packaging (eg IBCs, drums, pallets, etc)• Production and disposal of consumables (eg gloves and protective clothing,filters, cartridges, etc)
  • 40. Drivers and BenefitsHelp to identify supply chain risks, threats & opportunitiesUnderstand product life cycle & whole value chainHelp improve operating efficiencyDrive product innovationAlign with customers and industryIdentify cost reduction and efficiency savingsPrioritize sustainability activities and future product strategies
  • 41. NHS SDU Sustainable DevelopmentUnit set up in 2008 Working across the healthsector in England To develop organisations,people, tools, policy andresearch which willenable organisations topromote sustainabledevelopment, to mitigateand to adapt to climatechange.
  • 42. NHS SDU Carbon Reduction Strategyimplemented (2009 – 2014) New plan currently underpublic consultation Respond to questionnaireonline www.sdu.nhs.uk/sds Open between 29th January2013 – 31st May 20132009 - 2014 2014 - 2020
  • 43. UNDP UNDP mission is to partner with people at all levels of society tohelp build nations that can withstand crisis, and drive and sustainthe kind of growth that improves the quality of life for everyone UNDP operates in over 177 countries and procures approx $2.9billion per year (80% from developing countries) Sustainable Development is a central agenda as of 2015 Development of a carbon footprint and marginal abatement cost analysis forGlobal Fund HIV and Tuberculosis (TB) grants Contributed to GHG guidance document Sustainable specifications for critical products Training for sustainable procurement for various segments of the workforcedepending on their role. Guidance for country offices
  • 44. PfizerPregabalin case study Drug for the treatment of neuropathic pain Launched in the US - September 2005 Sales $3.69 billion (2011) $ 4.16 billion (2012)Change in process Process 1 (2005-2006) Classical chemistry, carbon based solvents. Used to launch the product Process 2 (2006-2010) Enzymatic chemistry, all chemical processes use water as solvent Process 3 (2010-present) Enzymatic process, all chemical processes use water as solvent. One key by-productwhich was incinerated in process 2 is now recovered and converted to high qualityproduct, albeit with a relatively high energy process
  • 45. PfizerSolvent, reagent and energy reduction gives a saving of 3 million tonnes of CO2emissions. Or equivalent to 500,000 US cars off the road for a year.01002003004005006007008009001000LifeCycleEmissions(kg/kgAPI)Total Carbon DioxideEmissionsWaste Disposal &RecoveryIn-process EnergyRaw MaterialManufacturing
  • 46. GlaxoSmithKlineAnnual sales £27.4bn Pharmaceuticals (68%), Consumer Healthcare (19%), Vaccines (13%)Sustainability and carbon footprinting core part of business20202015GSK Environmental Strategy10% reduction in value chainCarbon Footprint25% reduction in value chainCarbon Footprint20% reduction in water usewithin our own Operations20% reduction in our water impactacross the whole Value Chain• 25% Reduction in Operationalwaste to landfill• 25% Reduction in hazardousand non-hazardous waste• Zero Operational waste to landfill• 50% Reduction in hazardous &non-hazardous waste
  • 47. GlaxoSmithKlineTaking action: recycling inhalersQ: How do you currently dispose of your/yourchild’s  asthma  inhaler  device  when  you  have  finished using it?Put it in thedomesticwaste bin athome63%23%Put it in the recyclingbin at home11%Take to a pharmacythat offers arecycling serviceOther  mentions  ≤  10%Key information Around 40% of GSK’s  carbon  footprint comes from propellantsreleased from inhalers. Scheme recycles any inhaler not just GSK New ways of managing manufacturing waste Pharma distribution supplier: no extra trips needed, used tohandling medicines, good tracking processes and willingness topartner Pharmacist: Patient interactions, medicines review, device use Many being returned full or partially full Worked with supplier to use recycled aluminium (9ktCO2esaved)Feb 2013: 115,006 inhalers collected in the UK resulting in807 tonnes CO2e savings
  • 48. What are the nextsteps?Final  Thoughts…
  • 49. Questions?Laura Draucker, PhD Senior Associate, Sustainability Manager World Resources Institute +1 202 729 7828 ldraucker@wri.orgTom Penny Senior Consultant, Product Sustainability Services Environmental Resources Management +44 203 206 5386 tom.penny@erm.com
  • 50. Thank YouLaura Draucker, PhD Senior Associate, Sustainability Manager World Resources Institute +1 202 729 7828 ldraucker@wri.orgTom Penny Senior Consultant, Product Sustainability Services Environmental Resources Management +44 203 206 5386 tom.penny@erm.com

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