Presentation given by Ignacio Sanchez Diaz (UNDP) and Dr. Christoph Hamelmann (UDNP) at the Global Sustainable Development in the Healthcare and Pharmaceutical Sector: Towards Streamlining and Harmonization, 14th Sept 2015, Ispra, Italy

1. Sustainable Development
and Global Health Aid – a
UNDP Perspective
'Saving Lives Sustainably'
Ignacio Sanchez Diaz
Consultant to the SPHS and UNDP Regional HHD
Team for Greening Health Systems with focus on
Sustainable Procurement
Dr. Christoph Hamelmann
Regional Team Leader and Senior Advisor
(Europe, Central Asia and Arab States)
HIV, Health and Development
Coordinator, Sustainable Procurement
in the Health Sector (iIATT-SPHS)
Presentation at EU JRC Seminar: Global Sustainable
Development in the Healthcare and Pharmaceutical
Sector: Towards Streamlining and Harmonization
14th Sept 2015, Ispra, Italy
United Nations Development Programme

2.  Established in May 2012 in Copenhagen
 Since 2015 hosted by the UNDP Istanbul Regional Hub
 10 members
• 7 UN Agencies and
• 3 Multilateral Health Financing Institutions
 Annual joint procurement volume of around US $ 5 billion in the health
sector
Informal Interagency Task Team on Sustainable
Procurement in the Health Sector (SPHS)

3. Informal Interagency Task Team on Sustainable
Procurement in the Health Sector SPHS
Network list summary
UN-SPHS internal Gov./EU/Other
organizations
Suppliers/Manufac
turers
Overall
≈ 900 ≈ 590 ≈ 2000 ≈ 3500
Contacts in 92 countries covering
all the regions

4.  Vision: A reduced environmental burden by the health sector.
 Desired Impact: Health sector procurement policies and practices promote
and protect health and do not adversely impact on the environment or on
human health and well-being.
 The main objectives
of the SPHS are as follows:
Informal Interagency Task Team on Sustainable
Procurement in the Health Sector SPHS

5. Informal Interagency Task Team on Sustainable
Procurement in the Health Sector (SPHS)
 Outcome (specific goal/target): Task Team members adopt and implement
environmentally sound procurement policies and practices in the health
sector
 With a focus on three dimensions:
• Greenhouse gas emissions (GHG)
• Resource depletion (water, energy and material consumption)
• Chemical pollution

6. SPHS linkage to
Sustainable Development Goals (SDGs)
We aim to enhance
the global partnership
for sustainable
development by
promoting public
procurement
practices that are
sustainable.Public and Private sector connected
to Sustainable Health Procurement
as an example of financing and
implementing the SDGs
SDGs – UNIVERSALISM

7. Informal Interagency Task Team on Sustainable
Procurement in the Health Sector SPHS
 Programme on Greening Procurement in the
Health Sector
 Green Procurement Index for the Health Sector
(GPIH)
 SPHS Engagement with Suppliers and
Manufacturers Project
 First environmental inspection to a male
condom factory conducted
 Main Venues for Establishing Partnerships and
Promoting the SPHS
 Collaboration with business organizations
 On-going discussions with shipping companies
and freight-forwarders
https://goo.gl/TOuCFl

8. Informal Interagency Task Team on Sustainable
Procurement in the Health Sector SPHS
www.iiattsphs.org SPHS News Flash
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9. UNDP PROCUREMENT STRATEGY
• Cleaner supply chains
• Purchasing innovation
• Better integration with programmes
• Stronger partnerships
• Transparency, integrity, and accountability
• Measuring impact
• Assessing and building capacity

10. Compliance of UNDP Healthcare Procurement with
International Conventions
 Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and Their
Disposal
 Rotterdam Convention on the Prior Informed Consent Procedure for Certain Hazardous Chemicals
and Pesticides in International Trade
 Vienna Convention for the Protection of the Ozone Layer and the Montreal Protocol on
Substances That Deplete the Ozone Layer
 Stockholm Convention on Persistent Organic Pollutants (POPs)
 Minamata Convention on Mercury
Practical tool for UNDP procurement practitioners

11. Environmental Assessment of UNDP Healthcare Suppliers
 Development of a Standard Environmental Assessment
Questionnaire for UNDP Healthcare Suppliers
• UN Suppliers Code of Conduct
• UN Global Compact
• Global Reporting Initiative
• International technical experts consultation
 Environmental Impact Assessment of UNDP
 Implementation of green procurement criteria
• Establishment of a baseline
• Benchmarking process
D. FINAL COMMENTS

12. Continuous Engagement with Suppliers and Manufacturers
 UNDP-HCWH project “Sustainable Procurement practices in the global health aid market”
• Guidance and targets to substitute hazardous products purchased by the UN for its
health programs
• Initial Environmental Impact Assessment of key products based on the systematic
review of previous assessments and information available (WHO, EPA, etc.).
• LCA approach
• List of key products based on procurement volume and environmental impact:
Antiretrovirals, Rapid Diagnostic Test Kits, Medical devices (syringes, thermometers,
gloves, blood pressure measuring device and catheters), TB drugs, male condoms,
hormonal implants.
 Supplier engagement platform (using SPHS networking)
 Venues for establishing partnerships and engaging with suppliers: UN Global Supplier
meeting, 3GF…

13. Social Cost of Carbon – GF HIV/AIDS and Tuberculosis grants
The project has assessed the greenhouse gas emissions of
all goods procured and services commissioned to deliver
the studied HIV/AIDS and TB grant programmes in
Montenegro and Tajikistan and now more recently in
Zimbabwe.
• Measure and understand climate change impacts
• Identify priorities
• Develop response strategies to lower footprint and
impacts in priority areas
• Explore options for integration of carbon reduction
activities with programme delivery

14. Social Cost of Carbon – GF HIV/AIDS and Tuberculosis grants
The carbon footprint of HIV/AIDS grant
R8P2 in Tajikistan presented in GHG
protocol scopes across the value chain
~ 200,000 tCO2e

15. Social Cost of Carbon – GF HIV/AIDS and Tuberculosis grants
Based on our studies the carbon intensity of GF
projects are:
 HIV: 1.5kg CO2e/$
 MAL: 1.3kg CO2e/$
 TB: 1.6kg CO2e/$
If we take historical disbursement allocations as
shown and combine with a known projected
annual disbursement: ≈ $ 4.5 billion
 HIV: 56%
 MAL: 28%
 TB: 15%
Then GF programmes annual carbon pollution can
be estimated as:
 HIV: 3,753,000 tonnes of CO2e
 MAL: 1,638,000 tonnes of CO2e
 TB: 1,088,000 tonnes of CO2e
Total Global Fund carbon pollution (best
estimate):
6,479,000 tonnes of CO2e per year
An outline calculation: Rough estimate of Global Fund climate change impact
based on initial data

16. Social Cost of Carbon – GF HIV/AIDS and Tuberculosis grants
An estimate of the economic damage associated with the increase of
atmospheric CO2e levels
a value of $30 per tonne CO2e defined by Stern as the cost associated
with atmosphere CO2e concentrations stabilising at 450-550ppm CO2e
and keeping temperature rises within a safe limit of 2oC
• This means we can monetize for a programme the cost of climate
change damage
• It is estimated that GF emission levels have a Social Cost of Carbon of
approximately 6% of total GF disbursement; this means:
$194 million of social cost of carbon is incurred with each year of GF
disbursement (best estimate)

17. Healthcare Waste Management in the Context of Global
Health Initiatives
To assess the possible environmental impact
of GF grants, rapid assessments on
healthcare waste were carried out

18. Healthcare Waste Management in the Context of Global
Health Initiatives
 General waste
 Infectious waste from HIV and STI testing
 Sharps waste (including syringes from PWID)
 Pharmaceutical waste (ARVs or medicines for the treatment
of opportunistic infections)
Example: HIV / AIDS Grants

19. Healthcare Waste Management in the Context of Global
Health Initiatives
• Waste management systems do often not exist
• Basic waste logistic equipment does not exist
• Hazardous and non-hazardous waste is collected togehter
• Frequent accidents are reported (needle stick)
• Responsibilities are unclear
• Budgets for financing consumables and waste services are
missing
Waste Management Systems

20. Healthcare Waste Management in the Context of Global
Health Initiatives
 Healthcare waste treatment and disposal infrastructure extreme weak
 Simple incinerators exists which create environmental problems (Dioxin)
Available Infrastructure

21. Taking Responsibility:
UNDP is currently active to develop a practical toolkit
for healthcare waste management
Support of the Implementers
Healthcare Waste Management in the Context of Global
Health Initiatives

22. Environmentally Persistent
Pharmaceutical Pollutants (EPPP)
 UNDP was part of the Working Group of the International Conference on Chemicals
Management (SAICM):
• New proposed emerging policy issue for consideration by the International
Conference on Chemicals Management at its fourth session (ICCM4):
environmentally persistent pharmaceutical pollutants (EPPP)
 SPHS members crucial role addressing the emerging issue with EPPP:
• Engagement healthcare private sector
• Projects at global, regional and country level
• Engagement with national governments

23. Sustainable Development and Global Health Aid
Driver for transformational change towards
greener health systems and inclusive green
economies.
Saving Lives Sustainably
.© 2013 by Gavi, the Vaccine Alliance (Evelyn Hockstein)

24. Saving Lives Sustainably
Thank You!
ignacio.sanchez.diaz@undp.org
twitter: @SanchezDIgnacio
christoph.hamelmann@undp.org
twitter: @cahamelmann
www.iiattsphs.orgMedical Drugs for Pharmacy
Health Shop of Medicine
©2012 by epSos .de
http://www.undp.org/content/undp/en/home/librarypage/hiv-aids/managing-our-climate-change-risk--an-approach-for-environmental-.html
http://www.scribd.com/doc/173048077/Carbon-footprint-of-UNDP-Global-Fund-health-initiatives-in-Montenegro-and-Tajikistan
http://www.eurasia.undp.org/content/rbec/en/home/library/hiv_aids/rapid-assessment-healthcare-waste-global-fund/
https://iiattsphs.files.wordpress.com/2015/03/sphs-annual-report-2014_print_v3.pdf