This document provides an overview and agenda for a session on the Sustainable Procurement Index for Health (SPIH) project. It introduces the moderator and speakers for the session. The session will include an overview of the SPIH concepts, a discussion of the piloting phase where the SPIH was tested, and feedback from the piloting phase. It will conclude with a question and answer period. The objectives of the piloting phase are outlined as understanding how easy or challenging the SPIH is for suppliers to complete and buyers to review, and gathering feedback on the SPIH structure, criteria, and implementation. An overview of the piloting process and the types of feedback requested from participants is also provided.

2. Moderator
and Speakers
• Dr. Rosemary Kumwenda, Team Leader, HIV,
Health and Development, UNDP Eastern Europe
and Central Asia and SPHS Coordinator
• Dr. Kristian Steele, Associate, Arup
• Callum Newman, Associate Director and Group
Leader for International Development, Arup
• Anna Tuddenham, Consultant, Arup
• Terry Ellis, Associate, Arup
Dr Kristian Steele
Kristian.Steele
@arup.com
Anna Tuddenham
Anna.Tuddenham
@arup.com
Terry Ellis
Terry.Ellis
@arup.com
Callum Newman
Callum.Newman
@arup.com
Dr Rosemary
Kumwenda
Rosemary.Kumwenda
@undp.org

3. WHYA
SUSTAINABLE
HEALTHSECTOR?
• The health sector, whose mandate is to
prevent and cure disease, makes a major
contribution to the global climate crisis.
In fact, if the global health sector were a
country, it would be the fifth-largest
greenhouse gas emitter on the planet.
(Health Care Climate Footprint Report)
• The health sector purchases a broad
array of products.The production,
packaging, transportation, use and
disposal of these products has a
significant impact on the health of
people and the environment.

4.  Established in 2012, SPHS brings together seven United Nations agencies and three global
health financing institutions, committed to introducing sustainable procurement in the global
health sector and beyond.
 The SPHS annual cumulative purchasing power is between 3 to US$5 billion, which
represents a sizable portion of the global pharmaceutical and other health products markets.
The common principles of procurement that are important in the UN procurement system are:
1. Best value for money
2. Fairness, integrity and transparency
3. Effective international competition, and
4. The interests of the United Nations

5. Sustainable Health in Procurement Project (SHiPP)
Project Duration
• Four years, 2018-2021
Programme Objective
• Strengthen sustainable procurement
in the UN system and in strategic
countries to leverage purchasing
power and drive policy and market
demand for sustainable
manufacturing and waste
management in the health sector
Project Location
• Global and in 10 selected project
countries (EECA: Moldova and
Ukraine, Africa: South Africa,
Tanzania and Zambia, Asia: China,
India,Viet Nam, Latin America:
Argentina, Brazil)
Development Objective
• Promote sustainability in the health
sector supply chain to improve
human health and reduce
greenhouse gases, resource
depletion, and chemical pollution

7. Agenda
• Project scope and SPIH concepts 15 mins
• Overview of piloting phase 15 mins
• Feedback from the piloting phase 10 mins
• Q&A 20 mins
This session is being recorded.
Please post your questions in the chat and we will answer
these in the second half of the session.

8. 1. Project scope and SPIH concepts

9. 1.1 Introduction to the Project
This project is working to create the Sustainable Procurement Index for
Health (SPIH). This will:
• Be a globally established, recognised and adaptable measurement tool
for policy makers, manufacturers, suppliers, procurers, and healthcare
facilities end users
• Provide an incentive for entities to improve their environmental and
social sustainability record
• Provide consistency and certainty to the supply chain
• Cover key sustainability themes which are global imperatives

10. 1.2 Project ambition
• To accelerate sustainable procurement in the health sector, by:
• Supporting the decision making of buyers, and providing certainty to
suppliers
• Provide a robust and transparent method, that clearly communicates
expectations for supply chain performance
• Being proportionate and relevant, respecting the materiality and
capability in the supply chain
• Not just focus on risk, but provide clear pathways for stakeholders to
improve their performance

11. 1.3 SHiPP countries
• A four year global project supported by Sida
• UNDP and Health Care Without are developing and piloting a set of
sustainable health procurement practices and policies
• The SPIH development fall under this programme
• Lower and middle income country focus: India, China, Brazil, Argentina,
Moldova, South Africa, Ukraine, Tanzania, Viet Nam, Zambia

12. 1.4 Project plan
We have completed the piloting phase, which determined the structure of
SPIH and its key principles, and developed a first version. We have just
concluded the piloting phase and are now developing the training
materials and user guidance.
Definition
2020H1
Development
2020H2
Piloting
Early 2021
Training
Summer 2021

13. 1.5 Key stakeholder groups
• Buyers
• Suppliers
• Non-government organisations
• Regulatory agencies
• Research bodies
• Other standards bodies
• Expert Panel

14. 1.6 How we engaged
• Survey issued to the Expert Group – good response rate, with some
follow up interviews
• Ongoing interviews with informants with particular emphasis on
suppliers
• Survey also launched to wider base of suppliers
• Extensive literature review and best practice analysis (including from
other sectors)

15. Questions

16. 2. SPIH concepts

17. 2.1 Where in procurement?
• The SPIH focuses on a use case during a specific
procurement activity (a buying event), rather than being a
market monitoring tool or supplier/contract performance
tool.
• Buyer led solution will send a stronger signal for now; a
supplier led solution could appear voluntary.
• It aims to support ‘shaping the market’ by leveraging
procurement events with long term potential to transition to
a market based/labelling scheme type solution

18. 2.2 Organisation or product?
• Stakeholder engagement highlighted that there was interest for the
SPIH to consider both organisational aspects of a supplier, and
product-specific aspects.
• A hybrid approach was developed, which tests both
• Arranged around a performance hierarchy, meaning that the SPIH
has:
• Organisational emphasis for ‘baseline’ performance
• Product focus for leading performance
• An example of this concept is presented here for the GHG topic area:
More product focus
More organisation focus

19. 2.3 Key theme areas
• The SPIH looks at four key themes which represent key
global sustainability challenges.
• Within each theme, there are a series of sub-themes –
these range from organisational aspects (governance)
through to product specific considerations (such as use
of restricted substances in a product).
• The four themes and the sub-themes within are:
GHG emissions
• Governance
• Measurement
• Target setting
• Supply chain
issues
Resource depletion
• Governance
• Manufacturing
• Supply chain
issues
Chemicals and
toxicity
• Management
• Restricted
substances
• Disclosure
Human and labour
rights
• Policy and
governance
• Audits
• Equality and
gender issues

20. The levels of
the SPIH
2.4 How the SPIH is structured

21. 2.5 Levels concept and scoring
• The scoring system is based on a
pass/fail principle.
• Each module has a pass threshold of
50%.
• All the modules within a level must
be passed to attain the SPIH level.
• Some modules will be product- or
situation-specific therefore would not
be counted.
• The criteria and scoring approach will
be transparent.

22. 2.6 Criteria development
Theme Question Weighting Criteria / response Score
Scope
Do you measure your
Scope 1 & 2 GHG
footprint?
50%
No 0
Yes, following a recognised
methodology [from list]
20
Yes, following another
methodology
10
Reporting
Do you report your
GHG footprint?
50%
No 0
The results are published
internally
10
They are provided on request 10
Yes, they are published on our
website
30

23. 2.6 Criteria development
SPIH level Question Weight Criteria/response Score
Recycled
content of
product
Have you calculated the
recycled content of the
product?
17%
No 0
Yes, each product has <49%
post-consumer recycled
content
15
Yes, each product has >50%
post-consumer recycled
content
30
Waste and
circular
economy
Are major components of
the product recyclable?
8%
No 0
Yes 20
Waste and
circular
economy
Does the manufacturer
operate a take-back
programme?
8%
No 0
Yes 20
Energy use in
manufacturing
Have you calculated the %
use of renewable energy in
final manufacturing stage?
8%
No 0
Yes, each product has <49
renewable energy used in final
manufacturing stage
10
Yes, each product has >50%
renewable energy used in final
manufacturing stage
20
Energy use in
manufacturing
Are your procedures in line
with ISO5001 or similar
energy management
approach?
8%
No 0
Yes, in line with ISO5001 20
Yes, in line with another
energy management approach
10
Water use in
manufacturing
Have you quantified water
use at final manufacturing
stage?
6%
No 0
Yes 20

24. 2.7 Performance banding
over time
• We received many comments on using the
index to shape the market and it is one of
the key drivers for the Index
• Providing clear signals on expectations
and requirements of suppliers is key
• We are considering a potential model
whereby the ‘baseline’ requirements or
scoring systems become progressively
more challenging over time.
Example: For a given criteria, what is considered
‘Level 1’ performance in 2021 would become
‘baseline’ performance in 2023. A ‘Level 4’
requirement in 2021 would become a ‘Level 1’
requirement in 2030 etc.. This provides a clear
signal to the market on the expectations of the
buyer

25. 2.8 The Tool
We have provided an Excel-based Tool to support the
piloting phase.

26. 2.8 The Tool
The Tool has five worksheets
• SPIH scoring worksheet
• Four theme worksheets
Module
results
Theme
worksheets
Level
achieved

27. 2.8 The Tool
• Within each theme worksheet,
the supplier would complete
the light green shaded cells.
• Each module is presented in
turn.
• Each question has the relevant
weighting presented.
• Depending on the response, the
required evidence will be
presented.
Module
information
Question
weighting
Response
area

28. Questions

29. 3. Overview of piloting phase

30. 3.1 Piloting objectives
• Users’ understanding of the SPIH structure and its scoring
methodology;
• Supplier’s perspective – how easy or challenging is it to
address the questions in the SPIH?;
• Buyer’s perspective – how easy or challenging is it to review
the submission by the supplier?; and
• Content – do the questions make sense? Is the scoring fair
and balanced? Are the questions in the correct levels?.

31. 3.2 Organisations
• We paired buyers and suppliers together to work
through the pilot
• Geography, in particular reflecting SHiPP countries;
• Size of organisation, reflecting both large and small
companies; and
• Also included one supplier working with two buyers,
and a wholesaler.

32. 3.3 Products
• A mix of product supply, covering
a range of potential healthcare
commodities including
pharmaceuticals
Product selected
Antiretroviral drug: Tenofovir DF 300mg +
Lamivudine 300mg + Dolutegravir 50 mg; fixed
dose combination (TLD)
Dolutegravir Disp tabs 10 mg
Enzyme: Dornase alfa
Medical face masks
Syringes
Antiseptic disinfectant: Aurorub
Disposable diaper
Enhle Laundry Disinfectant industrial laundry
detergents

33. 3.4 Piloting process
The process for the piloting exercise was as follows:
Ad hoc support from Arup available
Arup to update the SPIH criteria

34. 3.5 Feedback requested
• Structure of SPIH – the general structure
and organisation of the criteria, modules
and levels within the SPIH, and ability to
understand;
• Content of the criteria – including specific
criteria within any module, the number of
criteria, the scoring and weightings
applied;
• Buyer/supplier specific questions –
relevance of modules, adequate guidance,
barriers to implementation;
• Concerns regarding deployment or
requirements in procurement; and
• Other observations

35. 3.6 General feedback - positives
• They understood the general approach of the SPIH,
its structure and scoring mechanisms;
• They understood the questions within each theme
(although some specific feedback on content was
received, discussed further below);
• They welcomed the consistent approach that the
SPIH can potentially bring to sustainability
considerations in procurement.

36. 3.7 General feedback - constructive
• Detail on technical terms: Some participants asked for
further detail or clarification on certain questions and
themes to support them in responding or reviewing
responses
• Confidentiality: Some participants felt that disclosing some
of the information required to support their answers might
conflict with intellectual property or commercial interests.
This was particularly a concern for pharmaceutical products.
• Use of SPIH by wholesalers: It is not clear how a wholesaler
might use the SPIH and it could be challenging to engage
with multiple product manufacturers.
• Different versions of the SPIH: Some participants identified
situations in which it might be more useful to split the SPIH,
e.g. into separate sustainability themes, or focusing only on
the organisational or product elements.
We’ll be
providing more
information and
support to users
in the User
Guide

37. Questions

38. 4. Next steps
• In the next phase of work, we will be producing
user guidance to help with the application of the
SPIH;
• We expect the SPIH Tools and User Guidance will be
released in late September.

39. 5. Q&A
• Please type your questions in the chat.
Dr Kristian
Steele
Anna
Tuddenham
Terry Ellis
Callum
Newman
Dr Rosemary
Kumwenda

40. Thank you