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Greening the Health Sector - Innovations for Sustainable Development (2012)
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Greening the Health Sector - Innovations for Sustainable Development (2012)


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  • 1. Greening the Health Sector Dr. Christoph Hamelmann Regional Practice Leader HIV, Health and Development UNDP Europe and Central Asia Brown Bag Discussion UNDP New York, 7 November 2012 Innovations for Sustainable Development
  • 2. The 3 Pillars of Sustainable Development Economic growth Environment Protection Social justice
  • 3. Health and the 3 Pillars of SD Social Justice Economic Growth Environment Human Right to Health Health Sector and GDP Environmental Impact on Health Universal health coverage Health Sector & Employment Health Sector Impact on Environment Social Protection Health and Human Capital Social Determinants of Health Health & Innovations Social Inclusion Investment in Health Inclusive Growth Gender & Health Health & Resilience Health Governance
  • 4. Overview • ECIS/RBEC Health & Environment programming context • 2012 Greening the Health Sector initiatives and projects • Lessons learnt and next steps
  • 5. ECIS/RBEC Health & Environment programming context
  • 6. Parma Declaration
  • 7. Parma Declaration Content Focus Ministerial Environment & Health Task Force WHO Europe Environment & Health MoH & MoE of 53 member states UNDP, UNEP & others Ministerial Board WHO Europe Regional Committee UNECE+
  • 8. Parma Declaration Content Focus • Climate change and health • Water and sanitation • Out- and indoor air quality • Prevention of diseases arising from chemical, biological and physical environment • Addressing obesity and injuries through safe environment, physical activity and healthy diet • Environment and health information system Apply also to operations of the health sector: Greening of Health Sector
  • 9. Health Sector in the ECIS Region • Accounts for 7.5 % of GDP • Technology intensive with significant consumption of resources, associated with environmental pollution and degradation • Accounts for an estimated 4.2 % of greenhouse gases (GHG) in the ECIS region • Up to 25 % of these GHG can be reduced within short-term, more through long-term measures • Reductions have also direct positive impact on life-years saved Ministerial European Environment and Health Task Force Meeting, Bled / Slovenia 2011
  • 10. UNDP & UN Sustainable Procurement
  • 11. UNDP & UN Sustainable Procurement
  • 12. UNDP Intranet Programme and Operations Policies and Procedures Home > Contract and Procurement Management > Procurement Overview > Environmental Considerations 4.0 Procedures UNDP’s “green” procurement policy promotes the four “R” strategies: • re-think the requirements to reduce environmental impact; • reduce material consumption; • recycle materials/waste; and • reduce energy consumption.
  • 13. Whole Product Life-Cycle Approach
  • 14. ECIS/RBEC H&E Programming Context
  • 15. ESA
  • 16. Economic Commission for Europe Report Regional Preparatory Meeting Public procurement 47. Sustainable public procurement was supported as a first critical step to further the green economy at the national as well as the sub-national level. Concrete progress was proposed in the form of sustainable public procurement targets that could be met by an increasing number of countries over the years.
  • 17. UNDP & UN Green Procurement • How far have we come in practice? • What is our monitoring framework? • What are our targets? What is missing:
  • 18. Volker Welter, Sviatlana Kavaliova, Global Fund Partnership, PSO/BOM, Copenhagen UNDP GF Partnership: Procurements in US $ Description 2008 2009 2010 2011 Pharmaceuticals 36,131,584 40,730,863 50,343,211 64,318,230 Health products (non-pharma- ceuticals) 22,664,462 36,319,625 69,921,736 72,303,829 Civil works NA 6,490,317 218,144 7,095,562 Other services NA 4,573,245 2,431,624 2,601,420 Total: 58,796,046 88,114,050 122,914,715 146,319,041 UNDP’s Global Fund Related Health Sector Procurements
  • 19. UNDP’s Global Fund Grants in ECIS HIV TB Malaria Belarus   Bosnia & Herzegovina   Kyrgyzstan    Montenegro   Tajikistan    Turkmenistan  Uzbekistan 
  • 20. ECIS/RBEC Greening the Health Sector Initiatives
  • 21. • Source of leadership, expertise and guidance • Promoting culture of measurement and responsibility in carbon governance • Evaluation and costing of best practices and innovations, standardization of implementation mechanisms for scale-up • Shaping policies, locally, nationally, internationally • Partnerships with government, industry and other stakeholders
  • 22. Sector Guidance for Pharmaceutical and Medical Device Manufacturers 1 GHG Protocol Product Life Cycle Accounting & Reporting Standard The World’s First
  • 23. Sustainable Procurement in the Health Sector Informal UN Interagency Task Team on Sustainable Procurement in the Health Sector (IATT – SPHS) 2
  • 25. Environmental Hazard (PBT) • Persistence (degradation) easily degraded slowly degraded • Bio-accumulation No significant potential to bio-accumulate Potential to bio-accumulate • Toxicity low, moderate, high, very high
  • 26. Environmental Toxicity Risk Predicted Environmental Concentration: PEC Predicted No-Effect threshold Concentration: PNEC Risk calculation: PEC PNEC
  • 27. (6) The pollution of waters and soils with pharmaceutical residues is an emerging environmental problem. Member States should consider measures to monitor and evaluate the risk of environmental effects of such medicinal products, including those which may have an impact on public health. The Commission should, based, inter alia, on data received from the European Medicines Agency, the European Environment Agency and Member States, produce a report on the scale of the problem, along with an assessment on whether amendments to Union legislation on medicinal products or other relevant Union legislation are required. 2010/84
  • 28. Health Care Waste
  • 29. OVERVIEW OF THE GEF GLOBAL PROJECT (EEG): Demonstrating and Promoting Best Techniques and Practices for Reducing Health Care Waste to Avoid Environmental Releases of Dioxins and Mercury
  • 30. Pre-Qualification Programme
  • 31. Health Market Power US $ 3 Billion annually Pre-Qualification Schemes
  • 32. The overall UN footprint reduced through set targets and timelines Baseline indicators in sustainable procurement established and shared publicly Sustainability integrated into all decision making processes Value all resources and a ‘Minimize Waste’ approach Account and regulate for total cost of ownership Report impacts of decisions on health and the environment Agree sustainable development definition and structures Agree baseline and indicators. Act to reduce resource waste
  • 33. Informal UN IATT – SPHS Route Map
  • 34. Chief Executive Board (CEP) HLCM Procurement Network WG Sustainable Procurement UNDG HLCP Informal IATT-SPHS Organizational Link
  • 35. Global Fund Board Composition Board Members:
  • 36. GAVI Alliance Board Composition
  • 37. informal IATT - SPHS
  • 38. Georgia: Justice for All The World’s First3 ‘Development of a full carbon footprint and marginal abatement cost analysis for Global Fund HIV and TB grants to help ascertain hot spots and areas for action to reduce the footprint’
  • 39. HIV TB Period Montenegro Round 5 2005 - 2010 Round 9 2010 - 2015 Round 6 2007 - 2012 Tajikistan Round 6 P1 2007 - 2009 Consolidated R6/R8 2009 - 2011 Round 8 P2 2011 - 2014 Round 6 P1 2007 - 2009 Consolidated R6/R8 2009 - 2011 Round 8 P2 2011 - 2013 UNDP Global Fund Grants in Pilot Project
  • 40. Marginal Abatement Costs
  • 41. Steering Group as Cross-Practice Work Tajikistan 1 HHD/1 EEG Copenhagen 1 BOM BRC 2 HHD/1 EEG Montenegro 1 HHD/1 EEG
  • 42. In-Built Internal Capacity Building • Production of Quick Start Manual • Webinar trainings course • Provision of automated calculator and analysis tool
  • 43. Expected Outputs • Methodology of carbon foot printing and MAC for global health initiatives established and published • Costed recommendations for action by countries
  • 44. Next Steps • Facilitating and supporting requests to broaden scope on country level • Scale-up to all UNDP global fund countries • Sensitization of Global Fund Secretariat and Board; advocacy for policy change (grant proposal criteria) • Promoting application to other global health initiatives including policy changes through their financing institutions
  • 45. Sustainable Energy for All (SE4ALL) Ensuring universal Energy Access Doubling the share of Renewable Energy Doubling the rate of Improvement in Energy Efficiency
  • 46. Greening Health Sector – link to SE4ALL
  • 47. Lessons Learnt (1) • Use existing dynamics, drivers and partnerships to move the agenda • Direct engagement with manufacturers, suppliers and forwarders shows results • Use joint market power and convening role to optimize impact • Build on commitments made by funders and policy makers and convince through progress in practice; goal: to green US $ 27 billion annual development aid for health (DAH 2011)
  • 48. Lessons Learnt (2) • Put more emphasis on result-focused approach; provide monitoring tool, agree on milestones and targets • Technical problems and lack of standards are to be solved as critical milestones, and not be an excuse for lack of action • ‘Think big’ since we are dealing with one of the biggest global threats
  • 49. Lessons Learnt (2) How to leverag e US$ 27,000,0 00,000 annuall y With a budget of 50k ???????
  • 50. From the Afterword by Helen Clark in "Partnerships for Global Health: Pathways to Progress" - 2012 Cambridge International Development Report, launched on 22 October 2012 “For UNDP, the message is clear: when the environment is harmed, so too is the potential to lift human development.” “Discourse around global health needs to address the linkages between equity, sustainability and health outcomes explicitly.”
  • 51. Special Thanks to Twitter: @cahamelmann Volker Welter, Jens Wandel, Camilla Bruckner, Hakan Bjorkman, Martin Krause, Sonia Roschnik