This document summarizes an webinar on effective communication for innovation in sustainable procurement in the health sector. The webinar included presentations from UNDP, Health Care Without Harm, and ETLog Health EnviroTech & Logistics GmbH. The UNDP presentation provided an introduction to the Sustainable Procurement in the Health Sector initiative and discussed procurement statistics and links to sustainable development goals. The Health Care Without Harm presentation discussed transforming health care in the era of climate change through resilience, mitigation and leadership strategies. The ETLog presentation discussed an ongoing project to reduce harmful releases from the health sector in four African countries by introducing non-incineration waste treatment and mercury-free medical devices. It emphasized the importance of

1. Welcome to the
SPHS Webinar Series
"Effective Communication for
Innovation in Sustainable
Procurement in the Health Sector"
www.savinglivesustainably.org
December 7, 2017

2. Agenda
1. Welcome remarks by the moderator
2. Introduction to speakers
3. Presentations
• UNDP: Introduction to the SPHS initiative
• Health Care Without Harm: Transforming Health
Care
in the Era of Climate Change: Resilience, Mitigation
and Leadership Strategies
• ETLog Health EnviroTech & Logistics GmbH:
Reducing UPOPs and Mercury Releases from the
Health Sector in Africa
4. Q&A

3. Speakers
John Strong
President
Greenhealth Exchange
Jan-Gerd Kühling
Managing Partner
ETLog Health EnviroTech &
Logistics GmbH

4. Sustainable Procurement
in the Health Sector
(SPHS)
Dr. Rosemary Kumwenda
SPHS Coordinator and Team Leader for Regional
HIV, Health and Development, UNDP Europe and
CIS
SPHS Webinar Series : Effective Communication
for Innovation in Sustainable Procurement in
the Health Sector, December 7, 2017
INTRODUCTION

5. Global perspectives on
health and environment
SPHS Task Team is, through a transparent and
inclusive engagement process, leveraging its
normative and market power, lowering the
environmental impact of its procurement, with a final
aim of improving human health and well-being.

6. Procurement Statistics
2015

7. Procurement Statistics
2013 - 2015

8. Procurement Statistics
2013 - 2015

9. Linking our work to the
Sustainable
Development Goals and
Key Focus Areas

10. More global than ever

11. Online Knowledge-Hub on
Good Practices in
Sustainable Health
Procurement and
Manufacturing:
www.savinglivesustainably.org

12. The SPHS global
network of collaborators

13. Communication
Statistics 2016

14. Looking Forward –
More Sustainable Health
Policies, Strategies and
Practices

15. GET IN TOUCH @ www.savinglivesustainably.org
Twitter: @UN_SPHS
We look forward to working with you on
a more sustainable global health sector.

16. Transforming Health Care
in the Era of Climate Change:
Resilience, Mitigation and Leadership Strategies
John Strong, President
Greenhealth Exchange, a Practice Greenhealth Affiliate
SPHS Webinar Series : Effective Communication for Innovation
in Sustainable Procurement in the Health Sector, December 7,
2017
PRESENTATION #1

25. The first scientific study to link health data to U.S.
climate events found that for six cases between
2002 & 2009 the health care cost totaled over
$14 billion dollars (Health Affairs, 2011).
• Smog, Nationwide, 2002
• West Nile, LA 2002
• Wildfires, CA 2003
• Hurricanes, FL 2004
• Heat Wave, CA 2006
• Flooding, ND 2009
Health Costs of Climate Change
Climate Change
Related Case
Study
Premature
Death
Illness
Total Health
Cost by Case
Study
Ozone smog
pollution
$6.3 billion $254 million $6.5 billion
Heat wave $5.2 billion $179 million $5.3 billion
Hurricane $1.1 billion $255 million $1.4 billion
Wildfire $545 million $34 million $578 million
Mosquito-
borne
infectious
disease
$190 million $18 million $207 million
River flooding $16 million $5 million $20 million
Total cost $13.3 billion $744 million $14.1 billion
Source: NRDC
Health costs in climate change related case study areas, with
costs per health effect, 2002-2009

26. 4.3
3.7
1.5 1.5
0.6
Indoor Air
Pollution
Outdoor Air
Pollution
HIV/ AIDS Tuberculosis Malaria
Source: World Health Organization 2013-2014
Annual Global Deaths (Millions)

27. What
transformation or
success lives at the
intersection of all?
Transform /
Lead
Adapt /
Anchor
Mitigate
Heal
Less Harm No Harm
What is the Role of the
Healthcare Sector?

28. • Transitioning away from fossil fuels to a low
carbon economy
• Fuels a clean energy/green chemistry
revolution that creates millions of jobs
• Reduces health impacts from fossil
fuels/toxic chemicals
• Lowers health care costs
• Helps solve the climate crisis
Climate Change: the Greatest Health
Opportunity of the 21st Century– The
Lancet 2015

30. Developing the strategy
Link to International
network of partners
Modeling innovation with
U.S. health care partners
Market Transformation
Group
Building the collaboration
with hospitals and suppliers
Sustainable Purchasing
Institute
Educating 1,400 hospitals
Elevating EPP case studies
Socializing total cost of
ownership approach
Scaling the solutions
Building demand for GX
Evaluating and specifying
better products used by
healthcare providers and
accelerating their adoption
Aggregating EPP
purchases in marketplace
and executing contracts to
drive price lower
Support women, minority-
owned businesses, local
and regional suppliers
Innovating for low-carbon,
toxic-free products and
technologies
Documenting benefits
achievedConfidential

31. • Energy
• Water
• Chemicals
• Food
• Waste
Identify Issue
•Packaging
•Recyclability
•Chemical/Material Make-up
•Transportation
•Manufacturing Process
•More
Establish
Standards
• Market Strength Through:
 Conversions &
Commitment
Leverage
Volume
GX Moves the Market
Signaling suppliers
that change is
required
Focused on
areas that make
the greatest
difference
Using purchasing
demand as agent
for change

32. To create an ecologically sustainable, equitable
and healthy world by:
accelerating the adoption and use of safer,
greener products by leading healthcare
systems,
catalyzing innovation in next generation
product development, and
inspiring similar action in other sectors.
Our Mission
33
Confidential

33. • B Corp operated as a for-profit
cooperative
• GX Member Patrons serve on
Board, Contracting Committee and
Product Subcommittees
• GX publishes annual public
benefits report
• Each owner receives benefits
reports based on their purchases
Board of
Directors
Contracting
Committee
Product
Subcommittee
Product
Subcommittee
Product
Subcommittee
Our structure
Confidential
Subject Matter Experts

34. Current owners of Greenhealth Exchange

35. GX Progress Toward Mission
Accelerate adoption, same or lower prices
Key Supplier Partner
1,800 fully curated products in
“formulary”
Beginning work with manufacturers
Results:
6% savings, increased sustainable from 31% -- 60%
7% savings, increased sustainable from 28% -- 59%
10% savings, increased sustainable from 33% -- 62%
This equaled savings of $900,000 annually for one of these systems.

36. Everyone across the globe has a right…
…to a safe and clean environment
where healthcare upholds our dictum:
First, do no harm.

37. Jan-Gerd Kühling
Managing Partner
ETLog Health EnviroTech & Logistics GmbH
PRESENTATION #2
Reducing UPOPs and Mercury
Releases from the Health Sector in
Africa
SPHS Webinar Series : Effective Communication
for Innovation in Sustainable Procurement in
the Health Sector, December 7, 2017

38. UNDP
Istanbul Regional Hub for Europe and
the CIS
Key Plaza, Abide-i Hürriyet Cd. İstiklal
Sk. No/11, Şişli, 34381
İstanbul, Turkey
Reducing UPOPs and Mercury Releases from The
Health Sector in Africa
Effective communication for innovation
in sustainable procurement in the health
sector
- Example of an ongoing project -

39. …to implement best environmental practices and
introduce non-incineration healthcare waste
treatment technologies and mercury-free medical
devices in four Sub-Saharan African countries
(Ghana, Madagascar, Tanzania and Zambia) to
reduce harmful releases from the health sector.
Overall
project
objective
Under consideration to spur sustainable
development, innovation, and the green
economy in the sector…

40. Reducing UPOPs and Mercury Releases from The Health Sector in Africa
Why sustainable, green procurement?

41. Reducing UPOPs and Mercury Releases from The Health Sector in Africa
Why effective communication?

42. Outcomes:
⚫POPs releases to the
environment reduced
⚫Country capacity built
to effectively phase-out
and reduce releases of
POPs
⚫Country capacity built
to effectively manage
mercury in priority
sectors
Indicators:
⚫Amount of un-intentionally
produced POPs releases avoided
or reduced
⚫Progress in developing and
implementing a legislative and
regulatory framework for
environmentally sound
management of POPs
⚫Countries implement pilot
mercury management and
reduction activities (green
economy)
Outcomes and
indicators of
success
Requires: Sustainable development & Innovation!

43. ⚫Main reasons for problems with HCWM:
Missing communication strategy!
Not considering that HCWM is a cross-cutting activity
Unclear and opposing interests and responsibilities are
existent
Neglecting of workflows and waste stream management
aspects
Missing know-how, innovation and underestimation of
importance of logistic
Healthcare Waste
PublicHealth
Infectiouscontrol
OccupationalH&S
Environmental
Pro.
Healthcare Waste Management MoEMoH
Lessons
learned

44. Legislative Framework:
Laws and by-laws for
HCWM on different
levels
Financial Framework:
Clear strategy in how
to finance the total
costs of HCWM
Capacity Building:
Training system for
HCWM (operational,
monitoring and institute. )
Operational HCWM:
Segregation, Collection,
Treatment and Disposal
Adapted, National
HCWM Development Plan
„HCW Action Plan“
Requirements
for a
sustainable
procurement
strategy

45. Healthcare Waste National plans,
implementation strategies, and national
policies in each recipient country
⚫National policy and regulatory framework
for HCWM and mercury phase-out.
⚫National action plan including the selection
of up to 1 central or cluster treatment facility,
2 hospitals, and 3 small rural health posts as
models.
Legislative
Framework

46. Building capacity to assess, plan, and implement healthcare waste
management (HCWM) and the phase-out of mercury
⚫Technical guidelines and SOPs to be developed
⚫Central training for national experts (duration 2 weeks) by end of
2016
⚫Training included theoretical & practical aspects, including ToT,
PPP, pricing, technical aspects, operation and maintenance etc.
⚫Participatory approach: Items and equipment specifications
commonly standardized for all countries
Capacity
building
activities
Need of building capacity to ensure sustainable
development, innovation, and the green economy?

47. Capacity
building
activities
(ToT)

48. ToT – applied
in the
countries
ToT in the
countries:
⚫Including of
relevant aspects
in official
curriculums
⚫Cooperation
with local training
providers
⚫Development of
new curriculums
(post graduation
training)

49. Make available in the region affordable non-incineration HCWM
systems and mercury-free devices that conform to BAT and
international standards (for 3 health posts, up to 2 hospitals, and
1 central or cluster treatment facility)
⚫Procurement is centrally carried out by UNDP, based on a
commonly agreed on equipment catalogue
⚫Equal distribution among four project countries in the first
phase
⚫Equipment for the second phase will be allocated according
to performance assessed in the mid-term review.
Operational
HCWM

50. Traditional
Treatment
Strategy:
(Advanced)
Incinerator
1. Combustion chamber
2. Combustion burner
3. Post-combustion burner
4. Primary and secondary air
fan with automatic throttle
5. Hydraulic automatic loader
6. Automatic upturn of 770l
bin
7. Heath exchanger
8. Gas extracting fan
9. Smoke evacuation
10. Control and regulation
board
11. Neutralization and filtration
of gases
12. Dust recovering tank
13. Ashes door
14. By-pass (recover +filter)
Option flue
gas treatment

51. Reducing UPOPs and Mercury Releases from The Health Sector in Africa
Innovative, green Treatment Strategy: Steam
Treatment
►Why is steam treatment getting today popular?
 Least possible environmental impacts
 Easy operation and simple maintenance
 Safest way of treatment, as even sterilization is possible (means
one millionth survival probabiliy of pathogens!)
 Low investment and operation costs
 More than 30 years experience, easy to monitor and control

52. Technical
Advantages/D
isadvantages
⚫ Incineration:
 Advantages: Wider spectrum of waste which can be treated,
less volume of waste
 Disadvantage: High investment & operation cost, high
maintenance demand, needed solution for (fly) ash disposal
⚫ Steam treatment system:
 Advantage: Medium investment cost, low operation cost, no
hazardous by-products, more easy to operated
 Disadvantage: Can only treat bio-hazardous waste, low waste
volume reduction, high electricity & water demand
► Communication!!!

53. ⚫“Influencing” the selection
process
⚫Consideration of
environmental impact (water
and electricity consumption)
⚫Consideration of operation
cost
⚫Consideration of maintenance
requirements
⚫Consideration of available
infrastructure
⚫Requires strong technical
specifications to ensure
innovations are considered!
Technology
Selection

54. ⚫Carried out need assessment in the countries, including
infrastructure assessment
⚫Preparation of specification and infrastructure requirements for
installation sites (buildings)
⚫Including of equipment for infrastructure and maintenance
(water, electricity)
⚫Selection of equipment by countries based on standardized
items and international technical specifications
⚫Including of “minor” equipment such as PPE, waste logistic
equipment, equipment for operation of central treatment centers
⚫Challenge: International tendering under consideration of
UN requirements
Procurement
Process

55. Procurement
Process

56. Including of
infrastructure
equipment

57. Piloting of
environmental
questionaire
Available at:
https://issuu.com/informal_i
nt_task_team_sphs/docs/un
dp_environmental_question
naire_in

58. ⚫Effective communication for innovation in sustainable
procurement in the health sector requires:
►Creation of a framework to enable sustainable,
innovative procurement and communication (replication)
►Building capacity to allow beneficiaries to select right
equipment (ownership)
►Standardization of equipment and development of
acceptable, international technical specification for
procurement
►Consideration of the existing infrastructure
►Selection of equipment under consideration of BAT
aspects and affordability (operation costs, maintenance)
Lessons
learned

59. Q & A

60. GET IN TOUCH @ www.savinglivesustainably.org
Twitter: @UN_SPHS
We look forward to working with you on
a more sustainable global health sector.