Sustainable Procurement in the Health Sector Training Report

Saving lives Sustainably SUSTAINABLE PROCUREMENT IN THE HEALTH SECTOR TRAINING REPORT

10-11 APRIL, 2017 NEW DELHI, INDIA

Cover: © Tom Pietrasik/UNDP India All rights reserved © 2017 UNDP / UNEP / HCWH June 2017

Implementing Partners United Nations Development Programme (UNDP) www.undp.org UNDP works in more than 170 countries and territories, committed to supporting developing economies and abides by the following principles: best value for money, fairness, integrity, and transparency, effective international competition, while promoting more sustainable production and consumption practices.

United Nations Environment web.unep.org UNEP is the leading global environmental authority that sets the global environmental agenda, promotes the coherent implementation of the environmental dimension of sustainable development within the United Nations system and serves as an authoritative advocate for the global environment.

Authors: Health Care Without Harm Dr. Megha Rathi, Environmental Consultant in the Health Sector The SPHS Secretariat, UNDP Istanbul Regional Hub Dr. Rosemary Kumwenda, SPHS Coordinator

Health Care Without Harm (HCWH) www.noharm.org HCWH works to transform health care worldwide so that it reduces its environmental footprint, becomes a community anchor for sustainability and a leader in the global movement for environmental health and justice.

Mr. John Macauley, HIV, Health and Development Regional Specialist

Contribution to

Ms. Mirjana Milić, SPHS Associate Coordinator

Informal Interagency Task Team on Sustainable Procurement in the Health Sector (SPHS) www.savinglivesustainably.org

UNDP India Office Mr. Hugo Barillas, Chief Procurement Officer UNDP India Communications UN Environment Mr, Farid Yaker, Programme Officer Design & Layout: Ms. Cansu Topaloglu, UNDP UNDP India Communications Freepik Disclaimer: The content, analysis, opinions and policy recommendations contained in this publication do not necessarily reflect the views of Health Care Without Harm, the United Nations Development Programme, United Nations Environment, or any of the member organizations of the SPHS Task Team.

The SPHS Task Team brings together United Nations Agencies and global health financing institutions, dedicated to lowering the environmental impact of its health procurement, with the aim of improving human health.

The 10YFP Sustainable Public Procurement Programme www.sppinitiave.org The 10YFP SPP is led by the United Nations Environment (UNEP) and co-led by ICLEI - Local Governments for Sustainability, and the Korea Environment Industry & Technology Institute (KEITI).

Sustainable United Nations (SUN) Facility www.greeningtheblue.org By 2020 all UN organizations have committed to become Climate Neutral. Coordinating this work across the UN System is the responsibility of the Sustainable United Nations (SUN) Facility.

BACKGROUND Why Focus on The Health Sector in

largest country to supply health

health sector development in India.

India?

commodities and services to UN or-

As the host agency to the Secretar-

The healthcare sector provides an

ganizations – with the total volume

iat of the informal Interagency Task

essential service to the general pub-

reaching nine hundred and nine-

Team on Sustainable Procurement

lic and, therefore, plays a crucial role

ty-nine (US$999) million in 2015.

in the Health Sector (SPHS), UNDP,

in human development. Sustainable

The pharmaceutical industry exports

together with UNEP and HCWH,

health procurement can play a sig-

drugs worth $15 billion to more

aims to leverage its knowledge of

nificant role in lowering the environ-

than 200 countries and ranks 3rd in

sustainable healthcare practices to

mental and social burden caused

the world in terms of volume and

reduce the environmental and social

by the health sector, contributing

14th in terms of value4. It is therefore

impact of health procurement. This

to inclusive green economies with

imperative that India builds an ever

will enable further uptake of sustain-

the aim of improving human health

more transparent and cost-effective

able practices within the growing

and well-being and in the context of

procurement system, particularly in

health sector in the country. UNDP

the Sustainable Development Goals

the health sector, including inte-

and UN Environment’s presence in

(SDGs).

grating environmental and social

the country offers an opportunity to

considerations into procurement

support national and state govern-

and supply chain.

ments, including the Ministry of

Healthcare has become one of India’s largest sectors, both regarding revenue and employment1, and

Sustainable Health Procurement

the total health expenditure in India

Potential

represents 4.7% GDP2.

Since 1951, UNDP has been collab-

In 2015, India accounted for 24.8 percent of the total UN health procurement, making it the largest country supplier of health commodities and services to the UN system3. More than 30 different UN organizations procured goods and services from India in 2015. India’s health sector has been growing in both revenue and employment, as evident from the fact that it is the

orating with the government, civil society and people of India to help them find their solutions to meet global and national development challenges. UNDP’s approach in India has been to develop and sustain strategic partnerships that find innovative solutions to address gaps on both the demand and supply side of development processes.

UNDP identified effective procurement practices as vital to support

Health, to develop and strengthen regulatory and policy frameworks with sustainability aspects integrated into the health systems and to monitor implementation. The UNDP-UNEP developed a comprehensive training package on SPHS, based on an initial training package developed by UN Environment, UNOPS and the International Training Centre of the International Labor Organization. The training on SPHS provides updates on procedures and best practices in sustainable public procurement in the health sector.

PROGRAMME Agenda:

Training Objective: Contribute to

The training allowed participants to

capacity building of policy makers

acquire an extensive understanding

and public procurers operating in

and practical experience of sustaina-

the health sector to develop sus-

ble public procurement practices in

tainable procurement policies and

the health sector that factor in the

Procurement and Rethinking

strategies

social, economic and environmental

Needs

OO Healthcare Procurement in India: UNDP India perspective OO Planning Sustainable Health

OO Requirement Definition with

impacts.

Sustainability in Mind

At the request of UNDP Country Of-

OO Sourcing More Sustainable Sup-

fice and their national Counterparts,

The training guided participants

UNDP, UNEP, and HCWH delivered

through various steps: from the

training on sustainable procurement

establishment of sustainable objec-

in health sector, which was attend-

tives, development of policies and

ed by the officials from the Ministry

national plans to the prioritization of

of Health and Family Welfare, Minis-

product categories, sustainability as-

Conditions and Use of KPIs

try of Railways from the Government

sessment of suppliers and manufac-

OO Applying a WLC/LCC Approach

of India, and health and procure-

turers and inclusion of sustainable

in Public Health Procurement

ment professionals from academ-

procurement criteria. Participants

OO Global Healthcare Waste Man-

ia, and international multilateral

also learned about the UNDP-UNEP

organizations. The training focused

approach of integrating sustaina-

on how to integrate sustainable

bility as the first step of the pro-

practices in healthcare procurement

curement process by working with

sons Learnt on the Engagement

processes and how to monitor the

practical cases studies and learning

with Suppliers and Manufactur-

implementation at a national level.

how to use evaluation and monitor-

The learning outcomes were aligned

ing tools to guarantee the satisfac-

with the national targets for the

tory implementation of sustainable

Policy Environment for Sustaina-

achievement of Sustainable Devel-

procurement practices in the health

ble Health Procurement

opment Goals.

sector. The workshops led to a lively exchange of experiences and knowl-

Methodology: Combined presenta-

edge between local Indian experts

tions, group work and real-case

and their international counterparts.

pliers for the Health Sector OO Evaluation with an Emphasis on Sustainability OO Contract Management, Contract

agement Project: Lessons Learnt and Next Steps OO Procurer‘s Perspective and Les-

ers of Health Commodities OO Enabling Legal, Regulatory and

OO Identifying future opportunities and entry points for action

examples

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Sustainable Public Health Procurement Training Report

Training Outline

POLICY & ACTION PLAN POLICY & ACTION PLAN PLAN POLICY & ACTION What is is sustaina What sustainable procurement? ble health procureKey concepts, ment?

Key conchallenges and cepts, challenges, opportunities.

An and actionopportunities. plan to integrate sustaiAn action plan to nable healthsustainaintegrate procurement . ble health procurement.

STEP 1

STEP 2

MONITORING & EVALUATION MONITORING & EVALUATION MONITORING & EVALUATION

GOOD PRACTICES GOOD PRACTICES GOOD PRACTICES

Sourcing more Sourcing more sustainable sustainable supsuppliers. Evalua pliers.

Evaluation tion with inno vatiwith innovative ve procurement procurement tools with emphatools sis on emphasis sustainabili- on with ty. Life cycle cost Life sustainability. assessments . cycle cost assessments.

Discussion on on Discussion good practices good practices from regional and from and global regional levels. global PracPracticallevel. exercise tical exercise on on development and implementa -and development tion of sustainable of implementation health procure sustainable health ment process. procurement process.

STEP 3

PLANNING & PLANNING & IMPLEMENTATION PLANNING & IMPLEMENTATION IMPLEMENTATION

Prioritizing action in sustainable Prioritizing action health procure in sustainable ment: assessment health procureof risks and ment: assessment opportunities.

Planning sustaiopporof risks and nable health tunities.

Planning procurement and sustainable health rethinking needs .

procurement and rethinking needs.

Sustainable Public Health Procurement Training Report

$

STEP 4

STEP 5

CONTRACT MANAGEMENT

CONTRACT MANAGEMENT CONTRACT MANAGEMENT

Development of Development of contract contract condi- of Development conditions, of tions, use ofuse KPIs contract condiKey andPerformance close collabotions, use(KPIs) of Key Indicators ration with key and close collab- IndiPerformance strategic orations with key cators (KPIs) and suppliers. strategic suppliers close collaboration with the main strategic suppliers.

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LESSONS LEARNT 1

Involvement of all stake-

go beyond legal and regulato足ry re-

procurement should be highlight-

holders in the SPP pro-

quirements. Given the high levels of

ed in training materials. Facilitators

cess is vital for success.

procurement undertaken on behalf

should ensure that at the start of the

To create a significant impact at

of Governments, the UN can sup-

training, participants have a rapid

the national level, and ensure the

port the government in setting the

understanding of the key focus are-

implementation of a sustainable

norms for sustainability in procure-

as and possible entry points in their

public procurement approach in

ment. UN agencies can, and should,

health procurement, which they can

the health sector, it is important

go beyond the legal requirements to

use easily in the implementation to

and necessary to involve all the key

lead by an example. The UN can also

ensure sustainable approaches.

stakeholders in the process. This in-

support sustainable procurement

cludes the Union Ministry of Health,

efforts undertaken by the govern-

Ministry of Finance, Environment

ment to ensure compliance with the

Ministry, Ministry of Railways and the

environmental regulations that are

state health ministries. In India, the

already in place.

curement officers to apply sustainability criteria.

the most useful sessions.

More practical exercises,

set in a local context, and a greater focus on country-specific case stud-

policy and legislative frameworks need an overhaul to incentivize pro-

5

Practical exercises among

3

Training material should

ies must be considered. Participants

be shared in advance. This

requested more examples on how

would help participants

to promote and implement sustain-

maximize their learning and time in

able public procurement. More Q&A

At a narrower level, sustainable pro足

the sessions, and allow them to con-

time to be better integrated into the

curement requires that in addition

tribute more fully to the discus足sions.

materials and sessions.

to procurement officers, programme colleagues be engaged in the pro足 cess and build sustainability criteria into their requirements.

4

Continuous improvements of the training materials is essential. Must continue

to be adapted to the peculiarities of

2 6

UN system can set an

the countries and the profiles of the

example by incorporating

registered trainees. Relevant legal

sustainability criteria that

and regulatory frameworks of public

Sustainable Public Health Procurement Training Report

Training Highlights

Support and interest in sustainable health procurement from Indian Ministry of Health and Ministry of Railways

All participants agreed that a strong legal framework is needed (i.e. national health procurement strategy with consideration of social, economic and environmental aspects) for a successful implementation of sustainable health procurement

23 specialists from key stakeholders participated in the training

Participants engaged in practical development of sustainable procurement criteria (i.e. ISO14001 criteria or equivalent, minimum 80% of packaging materials to be readily recyclable, 50% of employees should belong to minority or disadvantaged groups)

Participants gained knowledge of environmental and social impacts of health procurement

Strong interest by participants for further capacity development and support from UNDP, UNEP and HCWH in the development of sustainable healthcare procurement in the health sector

Raised awareness of the importance of the Whole Life Cycle approach, which helps to assess environmental impacts associated with all the stages of a product’s life from raw materials to disposal

Sustainable Public Health Procurement Training Report

97%

of participants rated the training as “very good” or “excellent”

Focus on practical, real case studies (i.e. green procurement of ambulances), sustainable procurement tools, methodologies and international standards

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Š 2017 UNDP India

NEXT STEPS UNDP, UNEP, other UN agencies

necessary country level support,

standards. UNDP will also ensure to

and HCWH will continue to work

methodology, and tools to ensure

follow up on incremental changes

with the Government of India, and

the implementation of sustainable

that manufacturers and suppliers

the relevant ministries, to strength-

procurement criteria in future pro-

will achieve in the application of

en national capacities on sustaina-

cesses. In addition, UNDP will work

green criteria to attain sustainability

ble health procurement, lowering

with partners to establish an en-

in their practices.

the environmental burden caused

gagement with local suppliers and

by the health sector and contrib-

manufacturers of health products

uting to creating inclusive green

and services to meet at least the

economies. UNDP will provide the

minimum social and environmental

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Sustainable Public Health Procurement Training Report

References 1. Government of India (2017) DIPP https://www.ibef.org/industry/pharmaceutical-india.aspx 2. The World Bank (2014) India Database http://databank.worldbank.org/data/reports.aspx?source=2&country=IND 3. UNOPS (2015) Annual Statistical Report on UN Procurement, p. 52 4. Government of India (2015) http://pharmaceuticals.gov.in/pharma-industry-promotion

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Sustainable Public Health Procurement Training Report