Article by Paola Hernández Olivan, Food Projects and Policy Officer

Hospitals and health systems procure a broad diversity of products ranging from chemicals, electronics, and plastics to energy, pharmaceuticals, and food with significant environmental and social impacts. 

For that reason, purchasing has been defined as one of the 10 interconnected goals of the Global Green and Healthy Hospitals Agenda to address and promote greater (environmental, social, and economic) sustainability in the healthcare sector, and ensure good health and wellbeing of everyone.

Considering the healthcare sector is estimated to be responsible for 5% of global carbon emissions - sustainable procurement should be seen as a key strategic tool to:

• Fulfil hospital’s needs
• Spend public money efficiently and effectively
• Promote public environmental health
• Create new opportunities to foster quality, innovation, and equity 

To further explore sustainable procurement in the healthcare sector, Health Care Without Harm and the Global Green and Healthy Hospitals network (GGHH) recently hosted a webinar (in Spanish) to introduce the implementation of the Sustainable Health in Procurement Project (SHiPP) in Latin America. Alejandra Fernández, HCWH Project Officer for Latin America, explained that this joint initiative, developed by the United Nations Development Programme (UNDP) in collaboration with HCWH, is initially being implemented in Chile, Colombia, and Costa Rica.

The project has been investigating current purchasing practices of hospitals and health systems in the target countries: they generally use electronic platforms that allow public purchases through framework agreements (e.g. Compr@Red). Such agreements are general however, and therefore limiting as they are not specific for the healthcare sector or certain products and services. In addition, some hospitals and health systems do not use any sustainability criteria; those that do usually look for mercury-free products (in accordance with the Minamata Convention on Mercury), whose expiration date is greater than one year, and which have little toxicity to the environment.

Looking forward, the project team expect to:

• Develop more case studies
• Continue market research on prioritised products to identify available products considered environmentally-friendly and healthy alternatives
• Inform and educate the healthcare on sustainable purchases

This initiative will be upscaled and expanded to other countries in the region, facilitating an exchange of best practices and implementation.

Also presenting in the webinar was Monica Lisett Castaño Tovar, Environmental Manager of Fundación Valle del Lili in Cali, Colombia. The hospital has 514 beds, and its own procurement committee, which evaluates technologies and inputs according to specific parameters (e.g. carbon footprint, energy/water use, origin, disposal) for the best environmental and health benefits for its institution. Implementation of its sustainable procurement programme (known in Spanish as COECO) has facilitated changes in the procurement of:

• Needleless syringes,
• Bard Mesh - saving water, staples, and optimising patient's stay and skin integrity,
• LEED lamps - reducing 403,563 kWh/year and saving COP 109,000,000 a year (USD 35,199.33),
• Disposable facial masks,
• Disposable trocars - saving COP 2,880,768,000 per year (USD 930,285.3)

During the webinar, essential elements were examined to drive the shift towards more sustainable procurement in the healthcare sector for guaranteeing both human and environmental health throughout their entire supply chain. In this sense, there are still some challenges that need to be addressed:

• The provision of specific tools, methodologies, and guidelines to the healthcare sector to better measure its carbon footprint,
• Research alternative market opportunities, particularly among small and medium-sized enterprises,
• Increase use of local labels (less well-known internationally), to boost local economies and be equally efficient while including environmental and social criteria
• Communicate changes and justify them in terms of environmental and social benefits, and economic gains,
• Greater collaboration and coordination with multiple stakeholders and other sectors to advocate and raise awareness about the importance of sustainable procurement 

Procurement can be an essential strategy to achieve sustainable and healthier environments in healthcare is still a work in progress, and there is a lot of room for improvement. The healthcare sector needs to take action so that procurement may serve as a central connecting point of green, social, and innovative policies to achieve large-scale transformational change.

HCWH Europe’s upcoming factsheet Reducing the carbon footprint of healthcare through sustainable procurement, including European best practices from Iceland, Sweden, and United Kingdom, will be release shortly; meanwhile, you can read more procurement case studies from GGHH members here.