Greening health sector - Innovations for sustainable development


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Greening health sector - Innovations for sustainable development

  1. 1. Greening the Health SectorInnovations for Sustainable Development Dr. Christoph HamelmannRegional Practice Leader HIV, Health and Development UNDP Europe and Central Asia Brown Bag Discussion UNDP New York, 7 November 2012
  2. 2. The 3 Pillars of Sustainable Development Social Economic justice growth Environment Protection
  3. 3. Health and the 3 Pillars of SD Social Justice Economic Growth Environment Environmental Impact on Human Right to Health Health Sector and GDP Health Health Sector & Health Sector Impact onUniversal health coverage Employment Environment Social Protection Health and Human Capital Social Determinants of Health & Innovations Health Social Inclusion Investment in Health Inclusive Growth Health & Resilience Gender & Health Health Governance
  4. 4. Overview• ECIS/RBEC Health & Environment programming context• 2012 Greening the Health Sector initiatives and projects• Lessons learnt and next steps
  5. 5. ECIS/RBEC Health & Environment programming context
  6. 6. Parma Declaration
  7. 7. Parma Declaration Content Focus WHO Europe Regional Committee + UNECE Ministerial Environment & Ministerial Health Task Force Board WHO Europe Environment & Health MoH & MoE of 53 member states UNDP, UNEP & others
  8. 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. 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 savedMinisterial European Environment and Health Task Force Meeting, Bled / Slovenia 2011
  10. 10. UNDP & UN Sustainable Procurement
  11. 11. UNDP & UN Sustainable Procurement
  12. 12. UNDP IntranetProgramme and Operations Policies and ProceduresHome > Contract and Procurement Management > Procurement Overview > Environmental Considerations4.0 ProceduresUNDP’s “green” procurement policy promotes thefour “R” strategies: • re-think the requirements to reduce environmental impact; • reduce material consumption; • recycle materials/waste; and • reduce energy consumption.
  13. 13. Whole Product Life-Cycle Approach
  14. 14. ECIS/RBEC H&E Programming Context
  15. 15. ESA
  16. 16. Economic Commission for Europe Report Regional Preparatory Meeting Public procurement47. Sustainable public procurement was supported as afirst critical step to further the green economy at thenational as well as the sub-national level. Concreteprogress was proposed in the form of sustainable publicprocurement targets that could be met by an increasingnumber of countries over the years.
  17. 17. UNDP & UN Green Procurement What is missing:• How far have we come in practice?• What is our monitoring framework?• What are our targets?
  18. 18. UNDP’s Global Fund Related Health Sector Procurements 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- 22,664,462 36,319,625 69,921,736 72,303,829 ceuticals) 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 88,114,050 122,914,715 146,319,041Volker Welter, Sviatlana Kavaliova, Global Fund Partnership, PSO/BOM, Copenhagen
  19. 19. UNDP’s Global Fund Grants in ECIS HIV TB Malaria Belarus   Bosnia & Herzegovina   Kyrgyzstan    Montenegro   Tajikistan    Turkmenistan  Uzbekistan 
  20. 20. ECIS/RBECGreening the Health Sector Initiatives
  21. 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. 22. 1 The World’s First GHG Protocol Product Life Cycle Accounting & Reporting Standard Sector Guidance forPharmaceutical and Medical Device Manufacturers
  23. 23. Sustainable Procurement2 in the Health SectorInformal UN Interagency Task Team on Sustainable Procurement in the Health Sector (IATT – SPHS)
  25. 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. 26. Environmental Toxicity Risk Predicted Environmental Concentration: PECPredicted No-Effect threshold Concentration: PNEC Risk calculation: PEC PNEC
  27. 27. 2010/84(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.
  28. 28. Health Care Waste
  29. 29. OVERVIEW OF THE GEF GLOBAL PROJECT (EEG):Demonstrating and Promoting Best Techniques andPractices for Reducing Health Care Waste to Avoid Environmental Releases of Dioxins and Mercury
  30. 30. Pre-Qualification Programme
  31. 31. Health Market PowerUS $ 3 Billion annually Pre-Qualification Schemes
  32. 32. The overall UN Baseline footprint indicators in reduced sustainable through set procurement targets and established and timelines shared publicly Sustainability Value allintegrated into resources and a all decision ‘Minimize making Waste’ approach processes Account and Report impacts regulate for of decisions on total cost of health and the ownership environment Agree Agree baseline sustainable and indicators.development Act to reducedefinition and resource waste structures
  33. 33. Informal UN IATT – SPHS Route Map
  34. 34. Informal IATT-SPHS Organizational Link Chief Executive Board (CEP) HLCM UNDG HLCP Procurement Network WG Sustainable Procurement
  35. 35. Global FundBoard Composition Board Members:
  36. 36. GAVI AllianceBoard Composition
  37. 37. informalIATT - SPHS
  38. 38. 3 The World’s First ‘Development of a full carbon footprint and Georgia: Justice for Allmarginal abatement cost analysis for Global FundHIV and TB grants to help ascertain hot spots and areas for action to reduce the footprint’
  39. 39. UNDP Global Fund Grants in Pilot Project HIV TB PeriodMontenegro Round 5 2005 - 2010 Round 9 2010 - 2015 Round 6 2007 - 2012Tajikistan Round 6 P1 2007 - 2009 Consolidated 2009 - 2011 R6/R8 Round 8 P2 2011 - 2014 Round 6 P1 2007 - 2009 Consolidated 2009 - 2011 R6/R8 Round 8 P2 2011 - 2013
  40. 40. Marginal Abatement Costs
  41. 41. Steering Group as Cross-Practice Work Montenegro Tajikistan 1 HHD/1 EEG 1 HHD/1 EEG BRC 2 HHD/1 EEG Copenhagen 1 BOM
  42. 42. In-Built Internal Capacity Building• Production of Quick Start Manual• Webinar trainings course• Provision of automated calculator and analysis tool
  43. 43. Expected Outputs• Methodology of carbon foot printing and MAC for global health initiatives established and published• Costed recommendations for action by countries
  44. 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. 45. Sustainable Energy for All (SE4ALL)Ensuring universal Doubling the share of Energy Access Renewable Energy Doubling the rate of Improvement in Energy Efficiency
  46. 46. Greening Health Sector – link to SE4ALL
  47. 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. 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. 49. Lessons Learnt (2)How to With aleverag budget ofe US$ 50k27,000,000,000 ???????annually
  50. 50. “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.”From the Afterword by Helen Clark in "Partnerships for Global Health: Pathways to Progress" - 2012 Cambridge International Development Report, launched on 22 October 2012
  51. 51. Special Thanks toVolker Welter, Jens Wandel, CamillaBruckner, Hakan Bjorkman, Martin Krause, Sonia Roschnik Twitter: @cahamelmann