1) UNDP is working to promote sustainable procurement practices and reduce the environmental impact of the health sector through various initiatives. 2) Projects include developing carbon footprint methodologies for Global Fund grants and engaging manufacturers on reducing health care waste. 3) Lessons indicate using partnerships and market power can help green billions in development aid annually, but goals and monitoring are needed.

1. Greening the Health Sector
Innovations for Sustainable
Development
Dr. Christoph Hamelmann
Regional Practice Leader HIV, Health and Development
UNDP Europe and Central Asia
Brown Bag Discussion
UNDP New York, 7 November 2012

2. The 3 Pillars of Sustainable Development
Social Economic
justice growth
Environment Protection

3. Health and the 3 Pillars of SD
Social Justice Economic Growth Environment
Environmental Impact on
Human Right to Health Health Sector and GDP
Health
Health Sector & Health Sector Impact on
Universal health coverage
Employment Environment
Social Protection Health and Human Capital
Social Determinants of
Health & Innovations
Health
Social Inclusion Investment in Health
Inclusive Growth
Health & Resilience
Gender & Health
Health Governance

4. Overview
• ECIS/RBEC Health & Environment programming
context
• 2012 Greening the Health Sector initiatives and
projects
• Lessons learnt and next steps

5. ECIS/RBEC Health & Environment
programming context

6. Parma Declaration

7. Parma Declaration Content Focus
WHO Europe Regional
Committee +
UNECE
Ministerial Environment & Ministerial
Health Task Force Board
WHO Europe
Environment & Health
MoH & MoE of
53 member states
UNDP, UNEP & others

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. 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. UNDP & UN Sustainable Procurement

11. UNDP & UN Sustainable Procurement

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. Whole Product Life-Cycle Approach

14. ECIS/RBEC H&E Programming Context

15. ESA

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. UNDP & UN Green Procurement
What is missing:
• How far have we come in practice?
• What is our monitoring framework?
• What are our targets?

18. UNDP’s Global Fund Related Health Sector
Procurements
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- 22,664,462 36,319,625 69,921,736 72,303,829
ceuticals)
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
Volker Welter, Sviatlana Kavaliova, Global Fund Partnership, PSO/BOM, Copenhagen

19. UNDP’s Global Fund Grants in ECIS
HIV TB Malaria
Belarus  
Bosnia & Herzegovina  
Kyrgyzstan   
Montenegro  
Tajikistan   
Turkmenistan 
Uzbekistan 

20. ECIS/RBEC
Greening the Health Sector Initiatives

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. 1 The World’s First
GHG Protocol Product Life Cycle
Accounting & Reporting Standard
Sector Guidance for
Pharmaceutical and Medical Device Manufacturers

25. Sustainable Procurement
2 in the Health Sector
Informal UN Interagency Task Team on Sustainable
Procurement in the Health Sector (IATT – SPHS)

26. CARBON FOOTPRINT OF HEALTH
SECTOR PRODUTS & SERVICES
CARBON FOOTPRINT OF OWN
PROCUREMENT AND SUPPLYCHAIN
MANAGEMENT OPERATIONS

27. 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

28. Environmental Toxicity Risk
Predicted Environmental Concentration:
PEC
Predicted No-Effect threshold Concentration:
PNEC
Risk calculation:
PEC
PNEC

29. 2010/84
(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.

30. Health Care Waste

31. 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

32. Pre-Qualification Programme

33. Health Market Power
US $ 3 Billion annually
Pre-Qualification
Schemes

34. The overall UN Baseline
footprint indicators in
reduced sustainable
through set procurement
targets and established and
timelines shared publicly
Sustainability
Value all
integrated into
resources and a
all decision
‘Minimize
making
Waste’ approach
processes
Account and Report impacts
regulate for of decisions on
total cost of health and the
ownership environment
Agree
Agree baseline
sustainable
and indicators.
development
Act to reduce
definition and
resource waste
structures

35. Informal UN IATT – SPHS Route Map

36. Informal IATT-SPHS Organizational Link
Chief Executive
Board (CEP)
HLCM UNDG HLCP
Procurement
Network
WG
Sustainable
Procurement

37. Global Fund
Board Composition
Board Members:
http://www.theglobalfund.org/en/board/constituencies/

38. GAVI Alliance
Board Composition

39. informal
IATT - SPHS

40. 3 The World’s First
‘Development of a full carbon footprint and
Georgia: Justice for All
marginal abatement cost analysis for Global Fund
HIV and TB grants to help ascertain hot spots and
areas for action to reduce the footprint’

41. UNDP Global Fund Grants in Pilot Project
HIV TB Period
Montenegro Round 5 2005 - 2010
Round 9 2010 - 2015
Round 6 2007 - 2012
Tajikistan Round 6 P1 2007 - 2009
Consolidated 2009 - 2011
R6/R8
Round 8 P2 2011 - 2014
Round 6 P1 2007 - 2009
Consolidated 2009 - 2011
R6/R8
Round 8 P2 2011 - 2013

42. Marginal Abatement Costs

43. Steering Group as Cross-Practice Work
Montenegro Tajikistan
1 HHD/1 EEG 1 HHD/1 EEG
BRC
2 HHD/1 EEG
Copenhagen
1 BOM

44. In-Built Internal Capacity Building
• Production of Quick Start Manual
• Webinar trainings course
• Provision of automated calculator and analysis
tool

45. Expected Outputs
• Methodology of carbon foot printing
and MAC for global health initiatives
established and published
• Costed recommendations for action
by countries

46. 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

47. Sustainable Energy for All (SE4ALL)
Ensuring universal Doubling the share of
Energy Access Renewable Energy
Doubling the rate of
Improvement in
Energy Efficiency

48. Greening Health Sector – link to SE4ALL

49. 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)

50. 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

51. Lessons Learnt (2)
How to With a
leverag budget of
e US$ 50k
27,000,0
00,000 ???????
annuall
y

52. “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.”
From the Afterword by Helen Clark in "Partnerships for Global Health: Pathways to Progress" -
2012 Cambridge International Development Report, launched on 22 October 2012

53. Special Thanks to
Volker Welter, Jens Wandel, Camilla
Bruckner, Hakan Bjorkman, Martin
Krause, Sonia Roschnik
christoph.hamelmann@undp.org
Twitter: @cahamelmann