Interagency Approach to Sustainable Procurement in Health Sector
1. UN Informal Interagency Task Team on
Sustainable Procurement in the Health
Sector (IIATT-SPHS)
Volker Welter
Senior Procurement Adviser
Procurement Support Office
UNDP Copenhagen
3. Agenda
• Introduction of entities involved in the IIATT-
SPHS
• The issues targeted by the IIATT-SPHS
• The opportunity of joint UN action
• The objectives of the IIATT-SPHS
• The strategies of the IIATT-SPHS
• The current stage of the initiatives
• Timeline of future actions
• Main concerns
• Concluding remarks
5. Additional participants
Public Sector
Stockholm County Council
Capital Region of Denmark
German Federal Environment Agency
Swedish Medical Product Agency
NHS
and others
Private Sector
NIRAS
Arup
Deloitte
and others
NGOs
National Substitution Group
Fairtrade
ChemSec
and others
6. 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
– Recipient of emerging diseases due to toxic
chemicals in the environment and climate
change
7. The issues targeted by the IIATT-SPHS
Procurement of
pharmaceuticals
and medical devices
Toxicity to the
environment
Greenhouse gas
emissions
8. The issues targeted by the IIATT-
SPHS
Breakdown of the NHS Carbon Footprint 2010
The pie represents
the proportional
divide of the overall
GHG emissions and
the graphic is the
proportional divide
of GHG emissions
due to procurement
9. The opportunity for joint UN action
• Production, distribution, use and disposal of
pharmaceuticals and medical devices is an important
area of concern from an environmental 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
10. Interagency Approach: 3 levels
• WHO and UNFPA prequalification programmes
(medical devices, drugs, condoms)
• WHOPES products and manufacturing sites
Impact on
international
standards
• Mandatory environmental weighting in
evaluation
Procurement
procedures
• Including environmental standards, criteria and
characteristics
Product
specifications
11. 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, capacity-
building and the necessary procedures to enable the
implementation, monitoring and evaluation of green
procurement by the UN
12. Strategies of the IIATT-SPHS
• In order to accomplish the objectives, the IIATT-
SPHS has developed a detailed Route Map
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
18. 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
19. 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
20. 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
21. 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 has been found 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
• UNOPS: 10,000 USD
• UNFPA: 10,000 USD
• UNICEF: 10,000 USD
• Stockholm County Council: approx. 15,000 USD ( 100,000 SEK)
• Swedish Medical Agency: approx. 15,000 USD (100,000 SEK)
Total: 110,000 USD (approx.)
• Technical workshop in Bonn, August 2013
22. Timeline of future actions
Development of a Joint Programming Proposal
• UN initiative to integrate most green procurement activities
for the health sector
• After the scoping phase there is a 2 years timeframe for
guideline development
23. Main concerns
1. Green 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
24. Main concerns
2. Green 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)
25. 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 the same
• Substitution options exist to improve sustainability of
the manufacturing process e.g. use of solvents in
processing, energy efficiency and water conservation
26. Main concerns
4. Scientific evidence justifying green
procurement of pharmaceuticals and
medical devices is insufficient
• Existing examples of frameworks for sustainable
procurement in health sector
• Montreal Protocol for the phase-out of HFCs and CFCs
• Minamata Convention for the phase-out of mercury-containing
medical devices by 2020
• Application of the Precautionary Principle
• Beyond clinical evidence of effectiveness of medicines, we
also need to take evidence of toxicity into account– since
there is a need to add long-term impacts of GHG, as well as
environmental contamination of active ingredient and
waste
27. Concluding remarks
The IIATT-SPHS targets the emerging environmental
problems of the health sector:
• Green house gas emissions
• Toxicity of pharmaceuticals and medical devices to the
environment and human health
The IIATT-SPHS envisions to:
• Influence the normative level through guideline
development
• Apply a market shaping approach by the formulation of
tender processes
• Develop a consensus for monitoring and auditing
compliance to sustainability criteria of suppliers and users
of health products and services