FOSTERING SUSTAINABLE HEALTH PROCUREMENT HOW PROCURERS CAN CHANGE THE GLOBAL HEALTH SECTOR MAY 11, 2016
WWW.SAVINGLIVESUSTAINABLY.ORG
UN CITY, COPENHAGEN
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A ONE-DAY DIALOGUE ON GOOD PRACTICES IN SUSTAINABLE PROCUREMENT IN THE GLOBAL HEALTH SECTOR MEETING REPORT
Introduction
A DIALOGUE ON GOOD PRACTICES IN SUSTAINABLE PROCUREMENT IN THE GLOBAL HEALTH SECTOR On May 11, 2016, more than 40 health procurement experts and practitioners came together at UN City in Copenhagen to explore the latest sustainable procurement initiatives, share good practice examples, and advance the dialogue on how sustainable procurement practices can be harmonized and scaled up across the global health sector. Organized by UNDP and UNFPA, and supported by LeaderLab and the Sustainable Procurement in the Health Sector (SPHS) Secretariat, the meeting was a milestone in the work of the SPHS, which was established at UN City in 2012. It also kicked off a broader engagement with public procurers, who jointly explored how sustainable practices and policies in the public and private spheres could be harmonized and scaled-up across the global health sector. SAVING LIVES SUSTAINABLY Participants addressed the question of how to provide critical life-saving medical products and services to individuals while also addressing environmental problems. This is a real challenge for procurers, who know that environmental hazards like climate change have an immediate impact on people’s health and well-being and that their work should not be compromised by inaction which, in turn, may increase the environmental footprints of their collective endeavor. By harnessing the normative, operational, and financial power of the UN, the health industry, and public and private organizations throughout the international community, the organizers expressed a commitment to tackle this challenge. They left with a renewed commitment to engage their networks, activate the group's purchasing power, and convert what they heard into action. This report captures the highlights of the dialogue and discusses next steps.
OUR FOCUS: To provide critical, lifesaving medical products and services to individuals while also addressing environmental problems. 24% of the global burden of disease is due to environmental factors 23% of all deaths can be attributed to environmental factors US$2-4b per year = the estimated direct costs to health from climate change by 2030 250,000 additional deaths per year are expected between 2030 and 2050 from climate change Sources: Annette PrüssÜstün et al. (2016), "Preventing disease through healthy environments: A global assessment of the burden of disease from environmental risks", World Health Organization, http://www.who.int/quantifying_ehimpacts/publicat ions/preventingdiseasebegin.pdf World Health Organization (September 2015), "Climate change and health", Fact sheet no. 266, http://www.who.int/mediacentre/factsheets/fs266/en/
The meeting will not end today – sharing good practices will help us to learn more about sustainable procurement, intensify collaboration, and make the health sector more sustainable through our practices. – Camilla Brückner, Director, UNDP Nordic Representation Office 1
SNAPSHOT
SNAPSHOT OF PARTICIPANTS
44 individuals from 28 organizations
16 joined online Sixteen people connected online from:
28 joined the dialogue in person Twenty-eight individuals participated in the dialogue at UN City in Copenhagen, representing organizations from the public and private sectors, NGOs, and the United Nations: Central Denmark Region, Regional Development, and Department of Procurement & Clinical Engineering Concept Foundation Confederation of Danish Industry EPEA Aarhus ApS - Cradle to Cradle Foundation TEM / CSR Skåne Health Care Without Harm Marie Stopes International (MSI) Nordic Center for Sustainable Healthcare Novo Nordisk A/S Secretariat for Green Procurement - Plan Miljø Swedish County Councils and Regions United Nations Development Programme (UNDP) United Nations Global Compact United Nations Population Fund (UNFPA) Universidad de Politecnica de Madrid United States Agency for International Development (USAID)
Health Care Without Harm (United States) Health Care Without Harm Europe Karex KfW German Development Bank National Agency for Public Procurement (Sweden) Pfizer United Nations Development Programme (UNDP) UNDP Belarus UNEP DTU Partnership United Nations Office for Project Services (UNOPS)
MODERATOR Toke Falk Sabroe, LeaderLab SPEAKERS Camilla Brückner, UNDP Nordic Representation Office Eric Dupont, UNFPA Procurement Services Branch Rosemary Kumwenda, UNDP/SPHS Secretariat Mirjana Milic, UNDP/SPHS Secretariat Ignacio Sanchez Diaz, UNDP/SPHS Secretariat Amelie Mahler, UNFPA Procurement Services Branch Alfonso Buxens, UNDP Karin Lonaeus, Swedish County Councils and Regions Anne Gadegaard, Novo Nordisk and the Coalition for Sustainable Pharmaceuticals and Medical Devices Anja Leetz, Health Care Without Harm Europe Goh Miah Kiat, Karex Lorea Coronado-Garcia, UNDP
What did participants want to discuss? The dialogue kicked off with conversations about participants' experiences with sustainable procurement, the challenges they face, and what they would need to improve their practices and to have a bigger impact on introducing sustainable procurement in the global health sector. A "platform of platforms" — Procurers identified a need for an online space where they could connect with global leaders and key stakeholders from the global health sector, to share knowledge and best practices related to sustainable health procurement. Officially launched at the dialogue, the new online engagement platform, www.savinglivesustainably.org, addresses that need and was named a "platform of platforms". Tracking impact and progress — Participants were interested in learning how to capture data to track and monitor whether their procurement practices were becoming more or less green, and identify the key hotspots and opportunities to improve the environmental performance of their procurement. Collaboration with suppliers and manufacturers — In the transition to sustainable health procurement, procurers acknowledged the importance of ensuring fair play for their global base of suppliers and manufacturers. They recognized that securing fair play across a diverse range of suppliers and manufacturers requires a gradual, tailored approach that takes account of different circumstances and contexts.
OUR DIGITAL PRESENCE THE DIALOGUE TOOK PLACE ON TWITTER THROUGH #ACT4HEALTH
42,000 USERS WERE REACHED DURING THE DIALOGUE 82% ENGAGEMENT CAME FROM WOMEN! 2
CUTTING EDGE PROCUREMENT
THE SPHS ONLINE ENGAGEMENT PLATFORM SAVINGLIVESUSTAINABLY.ORG
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CUTTING EDGE SUSTAINABLE HEALTH PROCUREMENT AT THE UN Presentation by Mirjana Milic, SPHS Associate Coordinator, UNDP A new online engagement platform Recognizing how crucial it is to link both supply and demand and public and private organizations from the global health market, the SPHS Secretariat has launched an online knowledge hub and engagement platform: savinglivesustainably.org. Much more than a website, the interactive online engagement platform helps everyone to connect and share insights, activities, events, training opportunities, publications, and successes in nine focus areas: chemicals, energy, medical products, packaging, procurement, resource efficiency, transportation, waste management, and water. The platform will expand and evolve over time as the SPHS Secretariat introduces other sophisticated features, such as an interactive map to view and join events and activities. The Secretariat is also continually posting news and stories to expand the network, improve knowledge, and scale up sustainable health procurement. Q: What other areas and regions will you focus on in the future? The mandate of the SPHS is global, but the current focus is on Asia. An important upcoming event is the "Saving Lives Sustainably: Asia Forum 2016" in Bangkok, Thailand, November 7-11. The event will bring together technical experts, suppliers, and manufacturers from across the global healthcare industry. The Forum aims to facilitate a dialogue between all stakeholders who are concerned about or involved in sustainable manufacturing.
Gain an eco-innovative advantage
Special Remarks by Lorea Coronado-Garcia, Sustainable Procurement Specialist, UNDP Part of improving sustainable health procurement is supporting suppliers and manufacturers to provide greener and more innovative products. To do this, UNDP is inviting technical experts in the SPHS network to link up with suppliers and manufacturers to share their expertise and provide technical support with scanning products and processes, technical and financial appraisals of opportunities, and the implementation of eco-innovative projects. More information available at: savinglivesustainably.org UNDP is thrilled about the SPHS development and the momentum in this room and across the health sector. We also recognize there is a lot of learning still to do. We want to make sure expertise is being transferred to manufacturers in every part of the world that requires facilitation across the network.
GOODPRACTICES
GOOD PRACTICES IN SUSTAINABLE PROCUREMENT UNFPA Presentation by Amelie Mahler, United Nations Population Fund (UNFPA) Procurement Services Branch In 2007, United Nations Secretary-General Ban Ki-Moon called for the UN become more climate-friendly and environmentally sustainable. As one of the biggest public procurers of condoms (USD 18 million purchased in 2015), UNFPA's Procurement Services Branch (PSB) responded to this call by focusing on where it could have the biggest impact. In 2013, PSB introduced a green procurement strategy based on collaboration with suppliers and stakeholder engagement. In this presentation, Amelie reported the positive results of an eco-condom pilot project and two research studies conducted under the new strategy.
Condom manufacturers go green UNFPA is currently engaged with 12 condom manufacturers in different regions on green procurement and sustainable production, providing training opportunities, quarterly conference calls, and face-to-face meetings to share ideas on cost and energy savings, such as reducing wastewater and insulating dipping tanks to minimize air conditioning. Beginning in 2013, UNFPA tenders require suppliers to comply with five eco-requirements: IS0 14001 certification within 36 months, a wastewater treatment plan, an air pollution reduction plan, a plan for saving energy and using renewable energy, and using packaging that is FSC-certified (or equivalent). The financial and environmental savings are already impressive: UNFPA is committed to working with manufacturers to meet the new eco-requirements over time so they are able to gradually adjust production, equipment, and find the greatest savings. We recognized we could not simply put strict top-down requirements on suppliers — our supplier base is small and in developing countries. So instead we work together.
Extending condom shelf life and saving on shipping A research study on extending condom shelf life found that condoms that were six to nine years old were still in compliance with requirements for condoms that expired at five years. A longer shelf life will mean less waste as fewer condoms are thrown away early. Another study on reducing condom pack size found that rectangular packages, which use less foil than square packs, were of comparable quality. Less foil means a smaller sized pack and ultimately lower shipping costs.
Next steps Include environmental criteria in WHO/UNFPA prequalification guidance for male/female condoms Continuous monitoring of implementation Extend environmental criteria to other products Work on alternative packaging Establish a procurement tool that rewards the environmental achievements of suppliers ISO 14001 certification of PSB
Q: How did suppliers react to the new requirements and was there a tipping point when they became partners? At the beginning, we saw some skepticism that they could do it. But they were interested and knew that environmental sustainability was in everyone’s interest, so they wanted to be on top of it. Engaging with the group and giving them a very clear roadmap with deadlines in our LTAs and bidding process helped give them a push. 4
GOODPRACTICES
UNDP
Two big wins
A collaboration with four UNDP suppliers has resulted in two major successes: CO2 emissions & shipping costs drop dramatically To reduce CO2 emissions, the PSM Team looked to air freight as "low hanging fruit", since average CO2 emissions from sea freight are significantly lower. To measure the potential cost and carbon savings, PSM Team developed an emissions reduction scenario for shipments between Mumbai and Harare, which represents 95% of total procurement for Zambia and Zimbabwe. The results were substantial:
81% decrease in CO2 emissions 49% decrease in shipping costs Smaller leaflets save space, costs & materials In an effort to reduce materials and save shipping costs, the PSM Team conducted a pilot project for the Mumbai-Harare shipping lane that eliminated an outer shipping box and replaced a large multilingual product leaflet with one written only in local languages. The results:
Original packaging
Cost savings: 15% Waste reduction: 12% Shipping capacity: 16.7% increase CO2 emissions: 13% kg reduction per unit
New reduced packaging
The first delivery will be made to South Sudan in May 2016 and to Zimbabwe the following month.
For UNDP to remove the leaflet and the external packaging from a pharmaceutical product is very innovative. It can be scary to those who might be challenged on liability, but if the liability issue was handled, we would love to not include the big leaflets. It is a very good sign, that this initiative can open such conversations." - Anne Gadegaard, Novo Nordisk "
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Presentation by Alfonso Buxens, Procurement & Supply Management (PSM) Advisor, UNDP The UNDP Global Fund Health Implementation Support Team (UNDP GF-HIST) manages $200-300m in procurement funds every year to meet the needs of global health-related projects in 24 countries (listed below) and difficult contexts, such as South Sudan. Sometimes the Support Team develops framework/LTA for a supply of ARV of TLE formulation to serve specific country offices. One of these framework agreements, with 4 manufacturers in India, has had great success in terms of environmental impact and cost savings.
UNDP's collaboration with suppliers involves four main activities: Sustainability Baseline Initiative: UNDP works with its suppliers to develop and monitor sustainability initiatives in the supply chain. A questionnaire of the 4 LTA holders gave a snapshot of the improvements they had made so far and what they could do to improve their environmental performance. This baseline has been instrumental in developing minimum parameters for suppliers. Sustainability Call-off Criteria: In 2016, UNDP PSM introduced realistic sustainability criteria for suppliers to fulfill within 9 months of starting their LTA. All 4 suppliers have fulfilled the requirements without an impact on price. In 2016, ISO 14001-certification or equivalent, halt the use of PVC plastic, use chemicals in compliance with the EU Reach List, and other requirements, have been incorporated in the UNDP minimum sustainability qualification criteria, under the LTA for a supply of ARV of TLE formulation.
CO2 Emission Reporting for Logistics: Data and analytics for CO2 emissions were collected from suppliers on a quarterly basis to create environmental performance metrics. A trade lane scenario for Mumbai to Harare calculated the potential CO2 reduction of switching from air to sea freight, and this has resulted in dramatic carbon and cost savings (see sidebar). Although making the switch was not straightforward — sea freight requires more time and planning and UNDP had to streamline its requirements, stock deliveries and plan orders in collaboration with suppliers — pilot was a success and sea freight now accounts for 84% of PSM's shipments. Packaging Optimization and Innovation: Streamlining packaging is never a straightforward process. Changes need to be brought in with care and in collaboration with suppliers and regulatory authorities since packaging and information requirements are tied to both WHO prequalification and national regulatory rules. A pilot project to do away with extra packaging and introduce a smaller product leaflet is already achieving positive results (see sidebar). The LTA holders are very supportive of this effort as it has simplified production and manufacturing and brought down costs and prices. However, these changes need to be introduced very carefully and seriously to ensure there are no ill effects down the road. The main goal of all of this is to treat more patients. Environmental improvement is not enough — without cost savings, we cannot serve more people, which is the reason why we exist. Countries where UNDP implements Global Fund grants (October 2015): Afghanistan, Belarus, Belize, Bolivia, Bosnia & Herzegovina, Chad, Cuba, Djibouti, Haiti, Guinea Bissau, Iran, Iraq, Kyrgyzstan, Mali, Sao Tome & Principe, South Sudan, State Of Palestine, Sudan, Syria, Tajikistan, Turkmenistan, Uzbekistan, Zambia, and Zimbabwe.
GOODPRACTICES
SWEDISH COUNTY COUNCILS AND REGIONS Presentation by Karin Lonaues, Sustainability Strategist, Swedish County Councils and Regions Sweden's 21 county councils are responsible for procurement for health care, dental care, and public transport. Since 2010, the councils have cooperated and coordinated their work, procuring 13 billion euro worth of goods. These products, from pharmaceuticals to gloves and surgical instruments, come from developing countries where the risks of environmental, human rights, and labor rights violations are high. Through its code of conduct for suppliers, contract clauses, desktop follow-up, audits, and corrective action plans, the councils not only try to ensure the products they procure are manufactured in a sustainable and responsible way but also try to create broader demand for sustainable products.
Public procurement makes a difference, but challenges remain National procurement practices are having an impact globally. A 2015 SwedWatch report showed improvements to working conditions in the surgical instrument factories in Pakistan where the councils procure from, and last year the councils were able to detect trafficking and bonded labour in a Malaysian factory supplying surgical gloves. But three major challenges remain: updating sustainability criteria for procurement and harmonizing it with UN agencies; improving coordination between the 21 county councils to avoid duplication of work, especially with followups; and creating a more transparent supply chain to ensure compliance. What has been one main lesson or takeaway? Address how you will follow up on the requirements you set and think of the whole evaluation process, especially social responsibility. Decide on these parts before you set your goals.
We cannot conduct healthcare in Sweden to the detriment of people in other parts of the world. But it is also a matter of creating demand for sustainable products.
COALITION FOR SUSTAINABLE PHARMACEUTICALS AND MEDICAL DEVICES (CSPM) Presentation by Anne Gadegaard, Senior Global Advisor, Novo Nordisk The Coalition for Sustainable Pharmaceuticals and Medical Devices (CSPM) is a consortium of suppliers set up by the NHS Sustainable Development Unit (SDU) to examine the environmental impacts of NHS services and take action to reduce its carbon footprint. One discovery was that pharmaceuticals accounted for 11% of the NHS carbon footprint, which prompted the Coalition to develop a priority list of 20 GHG-intensive pharmaceuticals it will use to work with suppliers to identify carbon reduction opportunities. These product guidelines are available as a free download.
GHG hotspots: where to target The carbon footprint of pharmaceuticals or medical devices does not end with production and distribution. How these products are used by healthcare professionals and patients also burns energy, uses water, and generates waste. The CSPM has also made guidelines to how you can assess a patient carbon footprint. A case has been prepared for the entire lifecycle of care for diabetes – from GP consultations to patient travel, emergency department visits, in-patient bed days, survival procedures, and self-management – and identified "hotspots" where savings and CO 2 reductions might be achieved (see chart). Take action >To join CSPM, receive the newsletter, or download GHG guidance on products, visit www.sduhealth.org.uk/cspm 6
GOODPRACTICES
REFLECTING ON GOOD PRACTICES Following the presentations on good practices in sustainable health procurement, participants reflected on some common themes, from identifying areas with the biggest impact to collaborating across sectors and sharing risks and investments.
Finding a niche Whether it was UNFPA, UNDP, or the Coalition for Sustainable Pharmaceuticals, procurers were looking at where to start. UNDP said they had to look internally and UNFPA did the same as they saw the bulk of their purchases were condoms. Wherever we’re working, we need to ask, "What is our niche?" We all need to do an internal baseline and see where we can have the biggest impact. This will also help to keep UN organizations from feeling overburdened." – Rosemary Kumwenda, SPHS Coordinator, UNDP
Sharing the investment, sharing the risk
"
Seeing low-hanging fruit What stood out for me were the big financial savings on freight that UNDP realized. I think it is a very good place to start and a place where economy and sustainability can be gained. This could be low-hanging fruit. But there is a worry that the UN will buy goldplated solutions that developing country suppliers cannot offer. It sounds like few suppliers are involved so far, and I wonder about the potential for scaling up and involving small suppliers." – Dialogue participant "
Collaborating "We do not need to be repetitive with our quality assurance requirements when we go to suppliers. There are confidentiality agreements between suppliers and procurers, but we should try to share the evaluations to make our lives easier and make it easier for suppliers." – Dialogue participant
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One challenge we face as procurers is that we are usually below what the market can offer us. We end up looking for ways to fit suppliers into our requirements rather than learning from them what they can offer, and we find only small cost savings. We need to get information about sustainable products and solutions from the market much earlier than we do today so that we have the time and resources to fit them into our procurements." – Christian Leth Christensen, Central Denmark Region "
As a procurer it is easy to pass the risk to the supplier, but you may end up paying higher prices. We are trying to do a couple of procurements where 10% of procurement is awarded to a corporation that is interested in doing a project/innovation with us. We build in the risk and leave room for price change – but we share the risk, the profit, the savings. It is a model to get new products developed and get it delivered. The other way is to do a product innovation at one hospital then see if it scales up and actually results in orders. Maybe this is a more innovative way to approach it. Sometimes we might lose money, but usually, I think we will gain." – Dialogue participant "
We need action to increase the spend towards sustainable procurement. For Novo Nordisk, it is clear that sustainable products are not just about saving the planet but should become a part of core business and take on the risk of patenting them." – Anne Gadegaard, Novo Nordisk "
Potential avenues to connect Special Remarks by Anja Leetz, Director, Health Care Without Harm Europe Health Care Without Harm is a global non-profit organization that has been working for 20 years to make the health sector more sustainable. Anja Leetz invited participants to connect to two sustainable health procurement initiatives: Global Green and Healthy Hospitals, a global network of hospitals and health centers committed to reducing their ecological footprint and promoting environmental health. Case studies and more information available at: www.greenhospitals.net The annual CleanMed conference on environmental sustainability for leaders in healthcare sustainability is a good opportunity for engagement: www.cleanmed.org and www.cleanmedeurope.org As an NGO, we are very interested in engaging with suppliers. Sometimes we refer to a paradox between supply and demand – if there’s demand we’ll invest / if there are green alternatives we'll buy them. Events like this help to address this paradox, as do SPHS, Global Green and Healthy Hospitals, and CleanMed.
PRIVATE SECTORINSIGHTS
PRIVATE SECTOR INSIGHTS Sustainable supply chains in the global health aid market: hotspots & opportunities
KAREX
Presentation by Goh Miah Kiat, CEO, Karex As condom manufacturing has shifted to Asia over the last 25 years, Karex has seen a big opportunity to change the landscape to greener production. In the hot tropical climates of Malaysia and Thailand where Karex operates, green manufacturing practices make both environmental and financial sense. At its four facilities, Karex has introduced water and energy-saving methods as drought and water shortages become more common and global temperatures climb. Making these changes is not just about going green, he says, but saving money to ensure the price of condoms remains stable and affordable for consumers.
We don’t think going green is about being more expensive – we think the extra costs we put into insulation and other areas will be made back in savings. It is a very long-term goal.
The first green condom factory in the world Karex recently opened an ISO 14001, ISO 50001, and LEED-certified condom factory in Hat Yai, Thailand, a steel and glass structure with a multitude of green features: Energy: 50% of the energy Karex uses is for heating and drying condoms, but introducing more efficient heaters to the dipping lines, reduced electricity consumption by 25%. Passive cooling is also key architectural element that reduces the need for air conditioning. Solar panels are planned to reduce reliance on energy from the grid. Water: Consumption of potable water is down significantly by collecting rainwater and condensation from AC units to flush toilets and clean. Karex is also exploring reusing treated wastewater from its cooling towers in production. Location: The factory is surrounded by rubber plantations within a planned rubber city set up by the Thai government, thereby reducing the carbon footprint of long-distance transportation of raw materials. Donor pressure can drive greener manufacturing "A lot of the money that goes into buying condoms comes from donors, and donors are applying pressure to go green. This helped me make my decision to go green. Communication on where the donors are is very important."
NOVO NORDISK Presentation by Anne Gaadegard, Senior Global Advisor, Novo Nordisk As one of the largest pharmaceutical companies in the world, Novo Nordisk has a big impact in terms of procurement. Using a triple bottom line approach, the company sees procurement as part of a broader effort to create a sustainable health system and bring benefits to the people they are helping to treat. A signatory to the UN Global Compact since 2002, Novo Nordisk uses a responsible sourcing model that does not look at products in an isolated way, but rather looks at how they are produced, too.
Good diabetes management may reduce carbon emissions
We can no longer just look at the cost of a product. We need a mindset change – when you are in a hospital and deciding what product to buy, you need to look at how much hospital time a patient will need if you buy that product. How we do things and what the product does both need to be considered.
Most of Novo Nordisk's products are related to managing diabetes. As part of its commitment to financial, social, and environmental responsibility, the company conducted a case study that looked at GHG emissions for total diabetes management and per year, in order to measure the carbon footprint of products and patients. It discovered that good diabetes management not only extends a patient's life, but may also lead to reduced carbon emissions, in part through less travel and energy spent on GP appointments, emergency room visits, and hospital stays. Must-win battles Anne Gadegaard pointed to three "must-win battles" for 2016-18: mapping supply chain risks cost-effectively, mitigating risk with key high-risk suppliers and increasing leverage through collaboration, such as through UNsponsored dialogues like these. "I like working with the UN because you can create a platform that assists the conversation and takes away any potential tension. Let’s bring our lessons from managing quality and bring them to the conversation - together with the procurers and other decision makers in the value chain."
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INNOVATIVETOOL
INTERNATIONAL ENVIRONMENTAL CONVENTIONS ON CHEMICALS Stockholm Convention on Persistent Organic Pollutants (POPs)
For procurers, three elements are important: substances that must be eliminated, restricted, and reduced. There are guidelines for some of these substances. From UNDP's and a health procurement perspective, the important substances are DDT and PVC. Minamata Convention on Mercury
Mercury is used in a variety of medical products, like thermometers, vaccines, and laboratory chemicals. Research shows there is no connection to disease from mercury, but there is still a health risk. There are safe and cost-effective mercury alternatives. Vienna Convention for the Protection of the Ozone Layer and the Montreal Protocol on Substances that Deplete the Ozone Layer
Ratified by all countries. Ozone-depleting substances (ODS) are still being produced and used in different sectors, in air conditioning, heating, etc. There are ecolabels that certify the use of non-ODS. Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and their Disposal
The disposal of hazardous healthcare waste must be done at an approved facility authorized by a relevant national authority. We need to start asking our suppliers for third-party certification that the disposal is authorized. Rotterdam Convention on the Prior Informed Consent Procedure for Certain Hazardous Chemicals and Pesticides in International Trade
The Convention does not apply to pharmaceuticals, rather, the chemicals listed in the Convention include pesticides sometimes procured by global health organizations as a disease control vector in regions at high risk of malaria transmission. 79
HEALTHCARE PROCUREMENT & COMPLIANCE WITH INTERNATIONAL ENVIRONMENTAL CONVENTIONS ON CHEMICALS Presentation by Ignacio Sanchez Diaz, Greening Health Systems Specialist, UNDP Realizing there was not a tool to track UNDP's progress in green procurement and monitor its practices, the SPHS team aims to develop a Green Procurement Index Health (GPIH) that defines green procurement criteria and captures supplier data on the products UNDP procures. One of the first things the team decided to include in the index was international environmental conventions on chemicals, which are legally binding and well recognized by countries. It looked at 1,500 products and conducted eight case studies, then developed checklists, indicators, and guidance on specific Conventions (see sidebar). An innovative tool emerged from this work: a guide for procurement practitioners, "Healthcare Procurement Compliance with International Environmental Conventions on Chemicals". This guide will allow procurers to measure and monitor product compliance with the five Conventions. It will be published in June 2016 and shared with the network on the SPHS platform. Internally, UNDP is in conversation to see how it can begin implementing the tool and involve suppliers in gathering more product data. This will be an ongoing process, and will eventually involve setting standards for suppliers, conducting audits, and using a scoring tool to reward companies that do more. What kind of feedback are you looking for? "It will be useful to understand from each of the SPHS members how the procurement process is done, how they process orders, control data from one agency to another, etc. The tool may not be 100% applicable to everyone, but you can take the checklist and use it in your day-to-day procurement processes." - Ignacio Sanchez Diaz, UNDP Monitoring compliance of the UNDP procurement with the international environmental conventions is a new approach, so we will need to engage with companies to get them onboard. We are asking them to provide information they have not provided before, thus, we will need to engage with them and explain why we need the information and how it will be used going forward. Based on the initial feedback we are confident that suppliers will be able to provide this information." Gregory Soneff, Team Leader, Global Procurement Unit, Procurement Support Office, UNDP "
What's next? An Automated Report Dashboard (Excel sheet) that will allow procurers to assess whether products comply with the Conventions and whether they are making progress with green procurement. We are also working on developing a Red List of Chemicals, and will begin by prioritizing 50 to 100 toxic chemicals.
What's next?
HOW CAN WE STAY CONNECTED AND MOVE THE SUSTAINABLE HEALTH PROCUREMENT AGENDA FORWARD? 1. Register, explore and collaborate at www.savinglivesustainably.org I really encourage you to come together and share your knowledge and practice through the SPHS. Communication is vital and the SPHS online engagement platform can bring all of our initiatives together under one umbrella. For all the organizations that are questioning where to start, they can now explore what others are doing. Some procurement agencies are more advanced than others, but this is the beauty of the various initiatives – people are doing different things and have a diversity of experiences, and through our synergies we can have a true impact." – Special remarks from Ignacio Sanchez Diaz, SPHS 2. Attend the Saving Lives Sustainably: Asia Forum 2016 "
The Saving Lives Sustainably: Asia Forum 2016 will be held in Bangkok, Thailand, November 7-11, 2016. The Forum aims to facilitate a dialogue between all stakeholders concerned about or involved in sustainable manufacturing, so that they can exchange knowledge and practice on the latest sustainable production techniques, share concrete examples of the benefits and savings brought by sustainable manufacturing, and develop a “Catalogue of good practices in sustainable healthcare manufacturing” on how manufacturers can implement change that can simultaneously generate positive social, environmental, and financial benefits. Each day of the Forum will focus on a particular thematic area and sessions will also be tailored for non-experts of environmental and social issues, therefore explicitly addressing participants with different kinds of professional backgrounds. The SPHS Secretariat and UNFPA welcome proposals on keynote speakers, session topics, and other ways your organization can contribute.
Wrapping up
CLOSING REMARKS
Rosemary Kumwenda, SPHS Global Coordinator and Senior Policy Advisor at UNDP, closed the day of dialogue, thanking the moderator, presenters and participants for insightful and rich conversations, and the organizers, especially UNFPA and the SPHS Secretariat, for making the dialogue possible. It is now clear, she said, that we all want to make the SPHS a front-running and far-reaching platform of global leaders and key stakeholders from the global health sector. "We have a hunger to know more and share more." She closed with a passionate appeal for participants to participate at the Saving Lives Sustainably: Asia Forum in Bangkok in November 2016. She invited participants to get in touch with the SPHS Secretariat and UNFPA to indicate their interest in participating at the Forum. 10
Resources UNFPA guide "Safe disposal and management of unused, unwanted contraceptives" helps countries to develop or update waste disposal policies, and builds awareness and capacity in the management of contraceptive waste. Download the guide at: http://www.unfpa.org/resources/safe-disposal-andmanagement-unused-unwanted-contraceptives
UNDP guide for procurement practitioners "Healthcare Procurement and the Compliance with International Environmental Convention on Chemicals", presents a practical guide aimed at assisting the procurement practitioners to monitor compliance of healthcare procurement using the relevant International Conventions for environmental safeguarding. Download the guide soon at: http://savinglivesustainably.org
Leaderlab video "About us" gives information on how this transformation agency helps governments, cities and companies shape their strategies, leadership, innovation and partnerships to help bring new game-changing innovations to the market and drive sustainable growth. Watch the video: at http://leaderlab.com/#section-about-leaderlab-frontpage
Fostering Sustainable Health Procurement – Meeting Report All rights reserved © 2016 UNDP June 2016 SPHS Secretariat, UNDP Istanbul Regional Hub Dr. Rosemary Kumwenda, SPHS Coordinator, UNDP Mirjana Milić, SPHS Associate Coordinator, UNDP Ignacio Sanchez Diaz, Greening Health Systems Specialist, UNDP Nevra Gomdeniz, Communications Specialist, UNDP Amelie Mahler, Procurement Assistant, UNFPA Sandy Pederson, Rapporteur, Seed Edit Contact: info@savinglivesustainably.org Website: www.savinglivesustainably.org The content, analysis, opinions and policy recommendations contained in this publication do not necessarily reflect the views of the United Nations Development Programme, United Nations Population Fund, LeaderLab or any of the member organizations of the SPHS.