The XII Healthy Hospitals Seminar (Seminário Hospitais Saudáveis - SHS 2019)
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This presentation was delivered by Dr. Rosemary Kumwenda (UNDP Team Leader for HIV, Health and Development in Eastern Europe & Central Asia and SPHS Coordinator) at the XII Healthy Hospitals Seminar 2019 (SHS Seminar 2019) which took place on 11-12 November 2019 in São Paulo – Brazil. The overall theme of SHS 201 is, “Health for Climate: Leading Sustainable, Low-Carbon Supply Chains,” and aims to highlight conscious and sustainable consumption as a central strategy for tackling climate change. In this sense, the health sector, as a major consumer of production inputs, natural resources and technologies, has an important role to play, leading the transformation of all supply chains into the necessary transition to a low carbon economy.
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The XII Healthy Hospitals Seminar (Seminário Hospitais Saudáveis - SHS 2019)
- 1. Health for Climate: Leading sustainable low carbon supply chains Sustainable Health in Procurement Project (SHiPP) Dr.RosemaryKumwenda UNDPTeamLeaderforHIV,HealthandDevelopmentinEasternEurope&CentralAsia andSPHSCoordinator XII Healthy Hospitals Seminar (Seminário Hospitais Saudáveis 2019) 11-12 November 2019 São Paulo – Brazil
- 2. Presentation Outline 2. UNDP Strategic Plan & Signature Solutions 5. Compendium of good practice 3. SPHS 1. UNDP at a Glance 4. SHiPP
- 3. UNDP at a Glance On the ground in about 170 countries and territories Works to eradicate poverty while protecting the planet Helps countries develop strong policies, skills, partnerships and institutions so they can sustain their progress Support countries’ efforts to achieve the SDGs, which guide global development priorities through 2030 UNDP Administrator is the Vice-Chair of the UN Sustainable Development Group (UNSDG) - unites the funds, programmes, specialized agencies, departments & offices of the UN system that play a role in sustainable development.
- 4. UNDPStrategicPlanandSignatureSolutions • Signature solution 1: Keeping people out of poverty. • Signature solution 2: Strengthen effective, inclusive and accountable governance • Signature solution 3: Enhance national prevention and recovery capacities for resilient societies • Signature solution 4: Promote nature-based solutions for a sustainable planet • Signature solution 5: Close the energy gap • Signature solution 6: Strengthen gender equality and the empowerment of women and girls
- 5. HIV,HealthandDevelopment (HHD)Service Offer Inequalities & Social Exclusion Gender equality and empowering women and girls (CSO capacity development) Inclusion of key populations at risk of HIV - LGBTIQ Urbanization, HIV and health Governance for Health Legal, policy, regulatory environments for HIV and health Governance to address NCDs and accelerate tobacco control Sustainable financing for HIV/ health, NGO social contracting Anti-corruption in health systems Intellectual Property and access to medicine Social, economic and environmental determinants (SEEDs) of health Resilient & Sustainable Systems for Health Implementation support/capacity for large-scale health programmes (GFATM implementation support) Universal Health Coverage (in partnership w/ WHO). Inclusive social protection (LGBTIQ, People Living with HIV and other key populations) Planetary Health Health Procurement
- 6. Established in 2012, SPHS brings together seven United Nations agencies and three global health financing institutions, committed to introducing sustainable procurement in the global health sector and beyond. The SPHS annual cumulative purchasing power is around US$5 billion, which represents a sizable portion of the global pharmaceutical and other health products markets. The common principles of procurement that are important in the UN procurement system are: 1. Best value for money 2. Fairness, integrity and transparency 3. Effective international competition, and 4. The interests of the United Nations
- 7. SHiPP Summary Project Duration • Four years, 2018-2021 Programme Objective • Strengthen sustainable procurement in the UN system and in strategic countries to leverage purchasing power and drive policy and market demand for sustainable manufacturing and waste management in the health sector Project Location • Global and in 10 selected project countries (EECA: Moldova and Ukraine, Africa: South Africa, Tanzania and Zambia, Asia: China, India, Viet Nam, Latin America: Argentina, Brazil) Development Objective • Promote sustainability in the health sector supply chain to improve human health and reduce greenhouse gases, resource depletion, and chemical pollution
- 8. Project Rationale International commitments Health sector must align its actions with international commitments in order to protect local and global health. Developing countries Engage developing countries in moving the global health care supply chain away from a polluting model. Governments and health systems Governments and health systems in countries are seeking ways to foster sustainable procurement in the health sector. Health care supply chains Move the health care supply chain towards a model that prioritizes environmental sustainability, human rights, poverty reduction Child protection and gender equality.
- 10. Project Outcome Development Objective Promote sustainability in the health sector supply chain to improve human health and reduce greenhouse gases, resource depletion, and chemical pollution Hazardous chemicals Resource conservationGreenhouse gas reduction
- 11. Health & Environment • WHO estimates that, globally, 1/4 of deaths (23%) are due to a modifiable environmental factor. • In Latin America and Caribbean, more than 80% of the pop lives in cities with air pollution causing health problems and productivity losses. • LAC is responsible for only about 10% of global GHG emissions, but is highly vulnerable to the effect of climate change, which incurred costs of around $100 billion in 2015 (UN Environment). • Emissions from incinerating waste can contribute to asthma, heart attacks and strokes, which are exacerbated by air pollution. • Meanwhile, non-incineration options create less pollution and also have a far smaller carbon footprint.
- 12. Sustainable Procurement • UNDP’s HIV, Health and Development Strategy Note (2016-2021) Connecting the Dots under Action Area 3: Building sustainable and resilient systems for health and the SPHS engagement strategy with Manufacturers of health commodities • Strategy and vision of Health Care Without Harm, • Sweden’s “Results strategy for global action on socially sustainable development - Basic Health”. SHIPP is in Alignment with Key Policies and Strategies
- 13. Engagement with suppliers and manufacturers on sustainable production, procurement and disposal of health commodities
- 14. Engaging with suppliers can stimulate the participation of more sustainable bidders Target Communication e.g. SMEs, disadvantaged and vulnerable groups
- 15. Product Life Cycle: An Opportunity to Reduce Impact 4. Reusable, chemicals of concern, end of life, worker, patient, community impacts 5. Take Back Programme, Recyclable, Reusable, Reprocessable, worker, community impacts 1. Responsibly, humanly sourced, worker, community impacts 2. Energy efficient, chemicals of concern, worker, community impacts 3. Fuel use, emissions, packaging
- 16. Monitoring of compliance with International Environmental Conventions on Chemicals
- 17. Environmental Questionnaire for Suppliers and Manufacturers of Health Commodities
- 18. Compendium of Good Practices – UNDP Corporate • 1% levy charged on tickets, proceeds to maintain UNDP’s climate neutrality including the monitoring and offsetting of our carbon footprint. • Sustainable UNDP Challenge Fund to support Offices greening efforts is being designed. • ‘Greening the Blue’ training tutorial is mandatory for all to increase staff awareness and engagement. • Single-use plastics banned from UNDP cafeterias and events with immediate effect. • Sustainable procurement policy is being updated and will direct offices to consider and cost sustainability options in all the procurements
- 19. Compendium of Good Practices – UNDP Corporate
- 20. Compendium of Good Practices Ukraine & Moldova • Law on Public Procurement changed • Private & sustainable manufacturing and supplying of commodities • Training modules on climate change for health care professionals • Health sector energy assessment in Moldova
- 21. Compendium of Good Practices Africa Research on Energy Efficiencies in the Health: • Leading to policy changes • Shows high consumption areas • Opportunities for financial saving • SADC Pooled Procurement for member countries
- 22. Compendium of Good Practices Viet Nam • Ban of Plastics from the Health Sector • LEA on health procurement & existing models • Revision of Environmental Law • TA implementation of Stockholm/Minamata
- 23. Change in Health Care Catalyzes Broader Change Transforming the Global Economy Transforming Policy and Key Markets – Food, Materials, Energy, etc. Transforming the Health Sector
- 24. Thank you for your attention. We invite you to come sail with us!
Editor's Notes
- In support of implementing the SDGs, UNDP's Strategic Plan includes three platforms: multisectoral country-support platforms for the SDGs; and a global development advisory and implementation services platform. The Strategic Plan identifies six “signature solutions” along which UNDP aligns its resources and expertise, seeking to increase its impact on poverty eradication, governance, energy access, gender equality, resilience and environmental sustainability. The Strategic Plan is built on the principles of universality, equality and leaving no one behind.
- SPHS Task Team is, through a transparent and inclusive engagement process, leveraging its normative and market power, lowering the environmental impact of its procurement, with a final aim of improving human health and well-being. UNDP hosts the Secretariat for the SPHS Task Team More info: The informal Interagency Task Team on Sustainable Procurement in the Health Sector (SPHS) was established in May 2012 in Copenhagen, Denmark. The aim for establishing the Task Team was to facilitate and coordinate the introduction of sustainable procurement in the health sector among members and to leverage the standard-setting and joint procurement volumes of member agencies to influence the global health sector (governments and other international development partners) and beyond. Thereby, the SPHS Task Team intends to act as driver for transformational change towards sustainable health systems and inclusive green economies. The SPHS envisions the United Nations as a leader in sustainable procurement in the health sector. Steps such as integrating sustainable procurement systems into global health sector policies and practices, setting targets and timelines for an overall reduction in the United Nations environmental footprint and ensuring the principle of doing no harm, are among the main objectives of the SPHS. The SPHS members conduct high volume procurement in the health sector, representing a sizable portion of some segments of the global pharmaceutical and other health products markets. The cumulative purchasing power of SPHS members in the global health sector is about USD 5 billion annually. This purchasing power can be leveraged with the SPHS members’ standard-setting role (by referencing corporate policies and standards as well as international conventions and commitments), to engage actively and, where feasible, jointly with suppliers and manufacturers to introduce and enhance sustainable procurement in public health. The SPHS members are actively working in the field of sustainable procurement both within the UN system and at a governmental level by facilitating awareness-raising and capacity building as well as developing guidance on sustainable procurement.
- The Sustainable Health in Procurement Project (known as ShiPP) addresses the intersection between health, human rights and the environment in developing countries. It promotes procurement practices that consider environmental and social impacts, as well as cost-efficiency and affordability when defining how processes can be sustainable and mainstreams Gender and human rights including Anti corruption, transparency and accountability. The project also aims to aggregate demand for sustainable manufacturing and waste management in a critical number of project countries and to slowly but surely move the supply chain towards greater sustainability. The expected outcome is a corresponding positive impact on the environment and on the health of patients, hospital staff, workers at medical product manufacturing sites and of local communities.
- There is increasing recognition from the health sector that in order to protect local and global health, it must align its actions with international commitments such as the Paris Climate Treaty, the Stockholm Convention on Persistent Organic Pollutants and the Sustainable Development Goals. While sustainable procurement is far from institutionalized, and indeed somewhat novel in most developing country settings, demand is emerging in these countries with governments and health systems requesting support to foster sustainable procurement in the health sector. The potential exists to engage developing countries in collaboratively moving the global health care supply chain away from a polluting model that threatens human health and the environment at each stage of this chain—from production, to consumption to disposal. The opportunity represented by this project, is to move the health care supply chain in developing countries toward a model that prioritizes environmental sustainability, human rights, poverty reduction and gender equality.
- General Objective = Strengthen sustainable procurement in the UN system + strategic countries in the South to leverage purchasing power and drive policy and market demand for sustainable manufacturing and waste management technologies within the health sector. Specific objectives: 1. Develop UNIVERSALLY ADAPTABLE CRITERIA AND STANDARDS for sustainable manufacturing, distribution and content of products procured by the health sector. 2. Strengthen capacity for sustainable procurement in the health sector in at least 10 project countries. 3. Strengthen capacity for sustainable production, supply and disposal of health care products in at least 10 project countries. 4. Strengthen the understanding and application of appropriate indicators and monitoring and evaluation processes that help promote accountability for sustainable procurement in the health sector.
- Hazardous chemicals Substitute chemicals of concern for more sustainable, less toxic substances Mercury-free measuring devices (Minamata Convention on Mercury) PVC and DEHP –free medical products Less toxic disinfectants, sterilants and cleaning products Greenhouse gas reduction Procurement of renewable energy Substitute low-carbon anesthetic agents Energy-efficient biomedical devices, lighting, and HVAC systems Resource conservation Water, water management Substitute non-burn waste treatment technologies (Stockholm Convention on POPs) Effluent in manufacturing We learn from EU hospitals !! Case studies shared widely
- Roughly a quarter of all human disease and death on the planet can be attributed to what the WHO broadly defines as environmental factors. These include unsafe drinking water, poor sanitation and hygiene, indoor and outdoor air pollution, workplace hazards, industrial accidents, automobile accidents, climate change, poor land use practices and natural resource management. For children, the rate of environmentally caused deaths is as high as 36 percent. Environmental health factors play a significantly larger role in developing countries, where poor water quality and the lack of sanitation, along with indoor and outdoor air pollution make major contributions to mortality. – WHO, 2006 (BEFORE new GBD Air Pollution of 7 million excess deaths, Lancet, December 2012) Latin America also has some of the most serious environmental problems in the world: air pollution in several Latin American cities is the worst anywhere; rivers flowing through industrial centers are tremendously contaminated by industrial wastes; the rate of deforestation is alarming; soil erosion is severe. The region is facing some significant challenges: More than 80 per cent of the population lives in cities where air pollution and inefficient transport cause health problems and productivity losses. And while the region is responsible for only about 10 per cent of global greenhouse gas emissions, it is highly vulnerable to the effect of climate change, which incurred costs of around $100 billion in 2015
- SDG 3 Good Health and Well Being SDG 5 Gender Equality SDG 7 Affordable and Clean Energy SDG 8 Decent Work and Economic Growth SDG 11 Sustainable Cities and Communities SDG 12 Responsible Consumption and Production SDG 13 Climate Action SDG 16 Peace, Justice and Strong Institutions. The project will align with several key policies and strategies: - The government of Sweden’s Results strategy for global action on socially sustainable development 2014–2017 under the results contributing to Improved Basic Health. The project will also align with the UNDP Corporate Strategic Plan 2014-2017 Changing with the World (under revision), specifically contributing significant results to improving the environment and strengthening health systems. The project also aligns strongly with UNDP’s HIV, Health and Development Strategy Note (2016-2021) Connecting the Dots under Action Area 3: Building sustainable and resilient systems for health. The project also clearly aligns with and will contribute to results under a number of sustainable development goals (SDGs). Finally, the project aligns with the strategy and vision of Health Care Without Harm. The health sector is the only industry that has healing as its mission, and that tries to live up to the Hippocratic oath to ‘first do no harm’. SDG12: Achieving economic growth and sustainable development require reduction in ecological footprint by changing production & consumption of goods and resources. Efficient management of natural resources, & the way we dispose of toxic waste & pollutants, are important targets to achieve SDG12 Encouraging industries, businesses and consumers to recycle & reduce waste is equally important A large share of the world population is still consuming far too little to meet even their basic needs. Halving food waste at the retailer and consumer levels is also important for creating more efficient production & supply chains. SDG 12 facts and figures: 1.3 billion tones of food is wasted every year, while almost 2 billion people go hungry or undernourished. The food sector accounts for around 22 % of total greenhouse gas emissions, largely from the conversion of forests into farmland. Globally, 2 billion people are overweight/obese. Only 3 % of the world’s water is fresh (drinkable), & humans are using it faster than nature can replenish it. If people everywhere switched to energy efficient lightbulbs, the world would save US$120 billion annually. 93% of the world’s 250 largest companies are now reporting on sustainability. SDG 12 selected targets: Promote public procurement practices that are sustainable, in accordance with national policies and priorities Substantially reduce waste generation through prevention, reduction, recycling and reuse Achieve the sustainable Mgt and efficient use of natural resources Achieve the environmentally sound Mgt of chemicals and wastes throughout the life cycle & reduce their release to air, water and soil to minimize impacts on human health/environment Encourage companies to adopt sustainable practices
- What is the impact of a product? This diagram is a simplified view of a product’s life cycle and it’s important to know that each step of the way, from materials extraction to production to manufacturing to packaging to product use and then the end-of-life, there are environmental impacts and resulting human health impacts. What hospitals and health systems are looking for are measurable ways to reduce those impacts and to ask about them or specify them in the purchasing process. Example: Why does this kit have a non-recyclable tray?? Health care purchasers may want to know: --where was this product made? Was it made within 200 miles of our facility? Is it local? --was this product made without chlorine bleach to reduce the release of dioxin, which is a PBT in the environment --Was this product packaged in recyclable packaging or a reusable tote? --Does this product contain chemicals that can cause respiratory distress when used? --Is this product recyclable or will the company take it back for recycling?
- Our theory of change – we need your help! What you can do help us share your successes and failures and what lessons you have learnt.