Greening the Health Sector
Dr. Christoph Hamelmann
Regional Practice Leader HIV, Health and Development
UNDP Europe and Ce...
The 3 Pillars of Sustainable Development
Economic
growth
Environment Protection
Social
justice
Health and the 3 Pillars of SD
Social Justice Economic Growth Environment
Human Right to Health Health Sector and GDP
Envi...
Overview
• ECIS/RBEC Health & Environment programming
context
• 2012 Greening the Health Sector initiatives and
projects
•...
ECIS/RBEC Health & Environment
programming context
Parma Declaration
Parma Declaration Content Focus
Ministerial Environment &
Health Task Force
WHO Europe
Environment & Health
MoH & MoE of
5...
Parma Declaration Content Focus
• Climate change and health
• Water and sanitation
• Out- and indoor air quality
• Prevent...
Health Sector in the ECIS Region
• Accounts for 7.5 % of GDP
• Technology intensive with significant
consumption of resour...
UNDP & UN Sustainable Procurement
UNDP & UN Sustainable Procurement
UNDP Intranet
Programme and Operations Policies and Procedures
Home > Contract and Procurement Management > Procurement Ov...
Whole Product Life-Cycle Approach
ECIS/RBEC H&E Programming Context
ESA
Economic Commission for Europe
Report Regional Preparatory Meeting
Public procurement
47. Sustainable public procurement w...
UNDP & UN Green Procurement
• How far have we come in practice?
• What is our monitoring framework?
• What are our targets...
Volker Welter, Sviatlana Kavaliova, Global Fund Partnership, PSO/BOM, Copenhagen
UNDP GF Partnership: Procurements in US $...
UNDP’s Global Fund Grants in ECIS
HIV TB Malaria
Belarus  
Bosnia & Herzegovina  
Kyrgyzstan   
Montenegro  
Taji...
ECIS/RBEC
Greening the Health Sector Initiatives
• Source of leadership, expertise and guidance
• Promoting culture of measurement and responsibility in
carbon governance
...
Sector Guidance for
Pharmaceutical and Medical Device Manufacturers
1
GHG Protocol Product Life Cycle
Accounting & Reporti...
Sustainable Procurement
in the Health Sector
Informal UN Interagency Task Team on Sustainable
Procurement in the Health Se...
CARBON FOOTPRINT OF HEALTH
SECTOR PRODUTS & SERVICES
CARBON FOOTPRINT OF OWN
PROCUREMENT AND SUPPLYCHAIN
MANAGEMENT OPERAT...
Environmental Hazard (PBT)
• Persistence (degradation)
easily degraded
slowly degraded
• Bio-accumulation
No significant p...
Environmental Toxicity Risk
Predicted Environmental Concentration:
PEC
Predicted No-Effect threshold Concentration:
PNEC
R...
(6) The pollution of waters and soils with pharmaceutical residues is an
emerging environmental problem. Member States sho...
Health Care Waste
OVERVIEW OF THE GEF GLOBAL PROJECT (EEG):
Demonstrating and Promoting Best Techniques and
Practices for Reducing Health Ca...
Pre-Qualification Programme
Health Market Power
US $ 3 Billion annually
Pre-Qualification
Schemes
The overall UN
footprint
reduced
through set
targets and
timelines
Baseline
indicators in
sustainable
procurement
establis...
Informal UN IATT – SPHS Route Map
Chief Executive
Board (CEP)
HLCM
Procurement
Network
WG
Sustainable
Procurement
UNDG HLCP
Informal IATT-SPHS Organizationa...
Global Fund
Board Composition
Board Members:
http://www.theglobalfund.org/en/board/constituencies/
GAVI Alliance
Board Composition
informal
IATT - SPHS
Georgia: Justice for All
The World’s First3
‘Development of a full carbon footprint and
marginal abatement cost analysis f...
HIV TB Period
Montenegro Round 5 2005 - 2010
Round 9 2010 - 2015
Round 6 2007 - 2012
Tajikistan Round 6 P1 2007 - 2009
Con...
Marginal Abatement Costs
Steering Group as Cross-Practice Work
Tajikistan
1 HHD/1 EEG
Copenhagen
1 BOM
BRC
2 HHD/1 EEG
Montenegro
1 HHD/1 EEG
In-Built Internal Capacity Building
• Production of Quick Start Manual
• Webinar trainings course
• Provision of automated...
Expected Outputs
• Methodology of carbon foot printing
and MAC for global health initiatives
established and published
• C...
Next Steps
• Facilitating and supporting requests to broaden
scope on country level
• Scale-up to all UNDP global fund cou...
Sustainable Energy for All (SE4ALL)
Ensuring universal
Energy Access
Doubling the share of
Renewable Energy
Doubling the r...
Greening Health Sector – link to SE4ALL
Lessons Learnt (1)
• Use existing dynamics, drivers and partnerships to
move the agenda
• Direct engagement with manufactu...
Lessons Learnt (2)
• Put more emphasis on result-focused approach;
provide monitoring tool, agree on milestones and
target...
Lessons Learnt (2)
How to
leverag
e US$
27,000,0
00,000
annuall
y
With a
budget of
50k
???????
From the Afterword by Helen Clark in "Partnerships for Global Health: Pathways to Progress" -
2012 Cambridge International...
Special Thanks to
christoph.hamelmann@undp.org
Twitter: @cahamelmann
Volker Welter, Jens Wandel, Camilla
Bruckner, Hakan B...
Greening the Health Sector - Innovations for Sustainable Development (2012)
Greening the Health Sector - Innovations for Sustainable Development (2012)
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Greening the Health Sector - Innovations for Sustainable Development (2012)

  1. 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. 2. The 3 Pillars of Sustainable Development Economic growth Environment Protection Social justice
  3. 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. 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 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. 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 saved Ministerial 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 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. 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 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. 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. 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. 19. UNDP’s Global Fund Grants in ECIS HIV TB Malaria Belarus   Bosnia & Herzegovina   Kyrgyzstan    Montenegro   Tajikistan    Turkmenistan  Uzbekistan 
  20. 20. ECIS/RBEC Greening 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. Sector Guidance for Pharmaceutical and Medical Device Manufacturers 1 GHG Protocol Product Life Cycle Accounting & Reporting Standard The World’s First
  23. 23. Sustainable Procurement in the Health Sector Informal UN Interagency Task Team on Sustainable Procurement in the Health Sector (IATT – SPHS) 2
  24. 24. CARBON FOOTPRINT OF HEALTH SECTOR PRODUTS & SERVICES CARBON FOOTPRINT OF OWN PROCUREMENT AND SUPPLYCHAIN MANAGEMENT OPERATIONS
  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: PEC Predicted No-Effect threshold Concentration: PNEC Risk calculation: PEC PNEC
  27. 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. 28. Health Care Waste
  29. 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. 30. Pre-Qualification Programme
  31. 31. Health Market Power US $ 3 Billion annually Pre-Qualification Schemes
  32. 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. 33. Informal UN IATT – SPHS Route Map
  34. 34. Chief Executive Board (CEP) HLCM Procurement Network WG Sustainable Procurement UNDG HLCP Informal IATT-SPHS Organizational Link
  35. 35. Global Fund Board Composition Board Members: http://www.theglobalfund.org/en/board/constituencies/
  36. 36. GAVI Alliance Board Composition
  37. 37. informal IATT - SPHS
  38. 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. 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. 40. Marginal Abatement Costs
  41. 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. 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 Energy Access Doubling the share of 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 leverag e US$ 27,000,0 00,000 annuall y With a budget of 50k ???????
  50. 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. 51. Special Thanks to christoph.hamelmann@undp.org Twitter: @cahamelmann Volker Welter, Jens Wandel, Camilla Bruckner, Hakan Bjorkman, Martin Krause, Sonia Roschnik

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