UN Informal Interagency Task Team on Sustainable Procurement in the Health Sector (IIATT-SPHS) IPC Meeting 30-31 May 2013 Geneva, Switzerland Susan Wilburn, Technical Officer, WHO Rino Meyers, UNDP
UN Informal Interagency Task Team on Sustainable Procurement in the Health Sector
Outline Introduction of entities involved in the IIATT-SPHS The problems/issues targeted by the IIATT-SPHS The Global policy context The opportunity of joint UN action The objectives of the IIATT-SPHS The strategies of the IIATT-SPHS The current stage of the initiatives and timeline for future actions Challenges and concerns Concluding remarks
Core participants UN Agencies UNDP UNFPA UNOPS WHO (HQ and EURO involved) UNICEF UNEP
Additional participants
The policy context: Global and Regional Sustainability Agenda Global UN Conference on Sustainable Development Rio + 20 Environmental Management Group: Greening the Blue UNSG Sustainable Energy for All (SEFA) Initiative Strategic Approach to International Chemicals Management: strategy for strengthening the engagement of the health sector in the implementation of the strategic approach Environment due diligence Minamata Convention on Mercury, 2013 Europe Regional Regional Framework on climate change and health Health 2020 (Creating resilient communities and supportive environments; Strengthening health systems)
The issues targeted by the IIATT-SPHS The health sector as an agent and a recipient of environmental problems: Contributor of greenhouse gas emissions and toxic chemicals in the environment Responsible for detection and management of emerging health problems due to exposure to toxic chemicals in the environment and climate change
The issues targeted by the IIATT-SPHS Procurement of pharmaceuticals and medical devices Toxicity to health and the environment Greenhouse gas emissions
The issues targeted by the IIATT-SPHS: Greenhouse gas emissions Breakdown of the NHS Carbon Footprint 2010 (Represents 25% of public sector carbon footprint) CO2 Emissions (MtCO2)
The opportunity for joint UN action Production, distribution, use and disposal of pharmaceuticals and medical devices is an important area of concern from an environment and health point of view UN agencies (UNDP, WHO, UNFPA, UNICEF, UNOPS) procurement for the health sector represents a sizable part of the market (3 billion USD in 2012) The UN has a critical mass of procurement in some segments of the market that could help orienting the market towards more sustainable directions
Introduction of environmental aspects into health procurement: INTERAGENCY APPROACH: 3 Levels Impact on International Standards Procurement Procedures Product Specifications WHO and UN pre-qualification programmes (medical devices, drugs, condoms), WHOPES (pesticides) - products and manufacturing sites Environmental weighting in evaluations Including environmental standards, criteria and characteristics INTERAGENCY APPROACH
Objectives of the IIATT-SPHS To develop solid and transparent scientific consensus on criteria for sustainable procurement related to the health sector that would be: Evidence based Technically sound Cost effective Applicable in countries/suppliers from different parts of the world To develop harmonized tools for procurement, capacitybuilding and the necessary procedures to enable the implementation, monitoring and evaluation of green procurement by the UN
Strategies of the IIATT-SPHS In order to accomplish the objectives, the IIATT-SPHS has developed a detailed Route Map and Action Plan initially facilitated by the Sustainable Development Unit of the NHS The Route Map outlines the strategy, achievements and activities of the different UN Agencies with regard to sustainable procurement in the health sector
Should we bring in the road map?
Virtuous circle of green procurement in the health sector Release of toxic products Resource consumption (electricity, water) Greenhouse gas emissions HEALTH CARE SYSTEM Reduction of GHG emissions Reduction of toxic releases Reduced disease burden Improved resource efficiency Less pressure on health care system Improved health outcomes and environmental benefits
16 Current stage of initiatives Mapping of existing approaches to: Environmental criteria in tender processes Carbon footprinting of pharmaceutical products Energy efficiency and access to energy and forecasting needs Chemical safety and waste management Corporate social responsibility of suppliers and application to their supply chain Interagency workshops with invited experts/stakeholders Identification of options for the development of a UN shared approach to establishing technical quality standards that include sustainability aspects in the field of pharmaceuticals and medical devices and articulation of the business case for the UN and for governments
Concrete initiatives undertaken so far Carbon footprint assessments: Pilot projects in Tajikistan and Montenegro Monthly reporting of carbon footprint of freight Modification of bidding processes: Application of the Kaiser Sustainability Scorecard and the Substitute It Now List developed by ChemSec Development of organizational strategies for green procurement 17
Timeline of future actions Scoping phase (until the end of 2013) Mobilize a wide range of stakeholders to build consensus on a set of critical priority areas and objectives for sustainable procurement Consensus on putting the main focus of the scoping proposal on the greening aspect of sustainable procurement Ensure that the findings of the consultation contribute to the development of WHO guidelines Financial contribution of the different agencies: UNDP: 50,000 USD UNICEF: 10,000 USD UNOPS: 10,000 USD UNFPA: 15,000 USD Stockholm County Council: approx. 15,000 USD ( 100,000 SEK) Swedish Medical Agency: approx. 15,000 USD (100,000 SEK) Total: 115,000 USD (approx.) Technical workshop in Bonn, 29-30 August 2013
Timeline of future actions Development of a Joint Programming Proposal UN initiative to integrate green procurement activities for the health sector After the scoping phase, starts the 2 years timeframe for guideline development
Vision Towards the development of a Joint Programming Proposal Market-shaping approach: WHO Prequalification Programme for medicines and lab equipment Strategy Development of green procurement guidelines for pharmaceuticals and medical devices us the WHO evidence-based approach Incorporation of activities related to green procurement in the health sector Methodology will include toxicity aspects of the products to the environment (including the manufacturing process) and greenhouse gas emission impacts Initial list of subprojects: Medical waste management (Global Fund) Carbon footprint assessments of health projects/health sectors Development of Life Cycle analyses of key products Development of strategic plans/models for sustainable national health systems 20
Main concerns 1. Sustainable procurement of pharmaceuticals and medical products will make the products more expensive Experience in many domains has shown that sustainability guidelines were providing an innovation push and often resulted in more cost efficient production. In addition sounder financial accounting systems (such as life cycle costing approaches) all underline this type of argument Opportunity for Win-Win
Main concerns 2. Sustainable procurement of medicines will create market imbalances against manufacturing companies from developing countries Incorrect assumption that manufacturing companies from developing countries are less inclined towards innovation Innovative financing is evidenced by recent offers from IFC and Gates Foundation (limited to companies from emerging markets)
Main concerns 3. Sustainable product of medicines will reduce the quality and efficacy of the therapy depriving patients of the most effective treatment The potential substitution of medicines by less toxic pharmaceuticals will happen only if the clinical value for the patient is equivalent Substitution options exist to improve sustainability of the manufacturing process e.g. use of solvents in processing, energy efficiency, water conservation and waste management
The way forward: UN Initiative on green procurement for the health sector Scoping and mapping exercise, gap analysis Continue to raise awareness and build the business case for UN agencies and health policy leaders to support the initiative WHO guideline development including implementation plan Tools for implementation, monitoring and evaluation developed and tested including tools for: 1. Demonstrating the business case for implementation 2. Tracking, monitoring and reporting of results Training workshops for implementation Evaluate and report on impacts: health, economic, social & environmenta
Thank you for your attention