Third Saving Lives Sustainably: Sustainable Production in ...€¦ · 1 Tird Savin Lives...
38
Report A CALL FOR UNITED ACTION TO RECOVER BETTER AFTER COVID-19 WITH SUSTAINABLE PRODUCTION AND PROCUREMENT OF HEALTH COMMODITIES Supported by Third Saving Lives Sustainably: Sustainable Production in the Health Sector Global Forum 2020
Transcript of Third Saving Lives Sustainably: Sustainable Production in ...€¦ · 1 Tird Savin Lives...
-
Rep
ort
A CALL FOR UNITED ACTION TO RECOVER BETTER AFTER COVID-19 WITH SUSTAINABLE PRODUCTION AND PROCUREMENT OF HEALTH COMMODITIES
Supported by
Third Saving Lives Sustainably: Sustainable Production in the Health Sector Global Forum 2020
-
All rights reserved © UNDP December 2020
SPHS SecretariatDr. Rosemary Kumwenda, Team Leader, HIV, Health and Development, UNDP Eastern Europe and Central Asia and SPHS Coordinator John Macauley, Regional HIV, Health and Development Programme Specialist, UNDP Eastern Europe and Central AsiaIan Milmo, Project Manager, Sustainable Health in Procurement Project (SHiPP), UNDPMirjana Milic, Associate SPHS Coordinator, UNDPNevra Gomdeniz, Communications Specialist, UNDPAmanda Lindstrom, Sustainability Consultant and Global Forum 2020 Rapporteur, UNDP
DisclaimerThis document is produced to inform discussions around strengthening sustainable production, procurement and disposal in the health sector. The content, analysis, opinions and policy recommendations contained in this publication do not necessarily reflect the views of the United Nations Development Programme or any other organizing agency of the Global Forum 2020. Any omissions, inaccuracies and mistakes are responsibility solely of the authors.
About the UN informal Interagency Task Team on Sustainable Procurement in the Health Sector (SPHS)The SPHS brings together seven United Nations agencies (UNDP, UNEP, UNFPA, UNHCR, UNICEF, UNOPS, WHO) and three global health financial institutions (Gavi, The Global Fund, Unitaid) who are committed to introduction sustainable procurement in the global health sector. Through a transparent and inclusive engagement process and by leveraging its normative and market power, the SPHS is dedicated to lowering the environmental impact of its procurement, with the aim of improving human health and welling.
Cover: © UNICEF Ethiopia
https://savinglivesustainably.org/
-
1
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
Abbreviations and AcronymsADE Acceptable Daily ExposureAE Adverse eventAIDS AcquiredImmunodeficiencySyndromeAMR Anti-Microbial ResistanceARV AntiretroviralAPI Active Pharmaceutical Ingredient CCC Command and Control CenterCO2 Carbon DioxideCDC Disease Prevention and Control EHS EnvironmentalHealthandSafetyEU European UnioneVIN Electronic Vaccine Intelligence NetworkFAO Food and Agriculture Organization oftheUnitedNationsFDA Food and Drug Administration GAVI GlobalAllianceforVaccines and ImmunizationGEF Global Environment FacilityGGHH Global Green and Healthy HospitalsGHG Greenhouse Gas EmissionsGF The Global FundGMP GoodManufacturingPracticesGPIH Green Procurement Index HealthHCW Health Care WasteHCWH Health Care Without HarmHCWM Health Care Waste ManagementHIV HumanimmunodeficiencyvirusILO International Labour OrganizationITC International Trade OrganizationICCM InternationalConferenceon Chemicals ManagementLCA LifeCycleAssessmentLGBTI Lesbian, Gay, Bisexual, Transgender and IntersexMERS-CoV Middle East Respiratory SyndromeCoronavirusMRL Maximum Residue LimitsNCD Non-Communicable DiseasesNRA National Regulatory Authority
OECD OrganisationforEconomic Cooperation and Development PPE Personal Protective EquipmentOHS OccupationalHealthandSafetyPSM ProcurementandSupplyManagementPV Pharmacovigilance QA Quality AssuranceRBC Responsible Business ConductSES SocialandEnvironmentalStandardsSDG SustainableDevelopmentGoalsSFDA SaudiFoodandDrugAuthoritySHiPP SustainableHealthinProcurement ProjectSIWI StockholmInternationalWaterInstituteSPHS SustainableProcurement intheHealthSectorSPP SustainablePublicProcurementSRA StringentRegulatoryAuthoritiesSHC SustainableHealthcareCoalitionTCO TotalCostofOwnershipUN United NationsUNDP United Nations Development ProgrammeUNEP United Nations Environment ProgrammeUNFPA United Nations Population FundUNHCR United Nations High Commissioner forRefugeesUNICEF United Nations International Children’s Emergency FundUNOPS UnitedNationsOfficeforProject ServicesUPOPS Unintentional Persistent Organic PollutantsWB World BankWTO World Trade OrganizationWHO World Health OrganizationZPBF Zambia Pharmaceutical Business ForumZPPA Zambia Public Procurement Authority
-
2
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
Table of ContentsExecutive Summary ........................................................................................................................................3Key Results at a Glance ...................................................................................................................................6
Official Opening of the Global Forum 2020 ......................................................................................................8Keynote Address: Climate Crisis and Health ................................................................................................10Panel Discussion: Sustainable Health Supply Chains in the Context of COVID-19 and Beyond ....................11Parallel Sessions ..........................................................................................................................................14
A.FoodSafety—RiskAssessment .......................................................................................................................14B. Responsible Business Practices ....................................................................................................................16C.MedicalDevicesandSafety .............................................................................................................................18D.SustainableProcurementIndexforHealthClinic .........................................................................................20
Global Forum 2020 Day Two ..........................................................................................................................20Opening Panel Discussion: How Can We Better Prepare for the Next Public Health Crisis? ........................20Parallel Sessions: .........................................................................................................................................23
A.DrugSafetyandSupplyChains .......................................................................................................................23B.SupplyChainsandGender ..............................................................................................................................25C.InnovatorsfromtheField ................................................................................................................................27
Closing Panel: Enabling Leadership for Sustainability in the Health Sector: Moving Towards 2021 ............30Final Remarks and Closing of the Global Forum ...........................................................................................32Provided Guidance, Reference Materials and Tools ......................................................................................33
Annex: Forum speakers, rapporteurs and organizers ..................................................................................34
-
3
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
The 3rd Saving Lives Sustainably: Sustainable Pro-duction in the Health Sector Global Forum 2020 took place on the 18–19thofNovemberaspartof In-ternational Conferences Program, honouring G20 Saudi Presidency Year 2020. The event was co- organized by Saudi Food and Drug Authority (SFDA), G20 Saudi Secretariat, United Nations Development Programme (UNDP), Secretariat of the UN informal Interagency Task Team on Sustainable Procurement in the Health Sector (SPHS) and Health Care Without Harm (HCWH),andwithsupportfromtheSwedish In-ternational Development Cooperation Agency (Sida). TheGlobalForumisanopportunity forglobalhealthsector stakeholders that consist ofUN agencies, in-ternational organisations, governments, policymakers, multilateralfinancial intuitions,manufacturers, tech-nical experts, academia, civil society organisations and others to explore the current sustainable consump-tion and production patterns and the latest public and private innovations on sustainable procurement and manufacturingofhealthcommodities.
ThethemeoftheGlobalForum2020istitled—A Call for United Action to Recover Better After COVID-19 with Sustainable Production and Procurement of Health Commodities.TheoutbreakoftheCOVID-19pandem-ic is a not only a global health crisis, but also has been definedasasevereeconomic,political,environmen-talandsocialcrisis.Withtheimmensepressurefortheprovisionofadequatehealthcareservices,manycountrieshavebeenunabletorespondeffectivelytothis emergency. This also includes with the adherence to the social, environmental and ethical dimensions in publichealthprocurementandinthemanagementofglobalhealthsupplychains.Therefore,amongstwiththe COVID-19 pandemic crisis, the environmental and social issues in the health supply chain have escalat-ed that include the respectofhumanrights, labourand gender in the supply chain, the use and disposal ofhealthcareproducts,handlingoftoxicchemicalsinindustrial processes, natural resource depletion and air pollution—which ultimately contributes towardsthe climate and biodiversity crisis.
In light of these interconnected issues,Sustainable Production and Consumption (SDG12), as highlight-ed in the inaugural WHO Global Strategy on Health, Environment and Climate Change, is the essential
Executive Summarytransformationneededtoimprovethelivesandwell-being sustainability through healthy environments andtopreventfuturepandemicsanddiseasesbeforetheyoccur.Therefore,giventhemissionoftheSPHSto improve human health and the environment by le-veraginghealth supply chains—globalhealth sectorstakeholders in partnership with suppliers and manu-facturersholdthekeypotentialtotransitiontheglob-al economy towards a healthier and more sustainable world. Also, it is important to recognize that in light ofthepandemiccrisis,despitetheongoingchalleng-esintheprovisionofhealthcareandwithregardtohuman health and the environment, there has been identifiedopportunitiesforpositivechange.Hence,inlightofthesecurrentobservations,theopeningses-sionoftheGlobalForumaskedthemainquestiontothedelegates—How can the world prepare for the next upcoming health crisis and how can we recover better from COVID-19?
The Global Forum 2020 was initiated by a high-level openingstatementdelivered from theSwedishAm-bassadortotheKingdomofSaudiArabia,WHOandUNDP Resident Representatives, Founder and Pres-identofHealthCareWithoutHarm(HCWH)andtheCEOoftheSaudiFoodandDrugAuthority(SFDA). The opening session highlighted intersections between climate change and global health, and the necessary transitionsneededforarecoveryfromtheCOVID-19pandemic. This message was further highlightedthrough the keynote address where Dr. Mandeep Dhaliwal, Director of UNDP’s HIV, Health and De-velopment Group, raised the need to strengthen the resilience of the health sector through strong anddedicated actions towards environmental sustain-ability. She urged the global community to supporteffortsaimedatreversingplanetarydamagethatcanbe done through scaling up smart climate actions, to decouplenaturalresourceusefromeconomicactivity,andtolookintonewwaysandopportunitiesforglobalpartnerships and collaborations.
Throughout the course of the two days, the Glob-al Forum 2020 explored several interdisciplinary themes that included medical devices and safety,responsible business practices, food safety risksassessments, drug safety and sustainable supplychains, supply chains and gender and innovations
https://savinglivesustainably.org/global-virtual-forumhttps://savinglivesustainably.org/global-virtual-forumhttps://www.sfda.gov.sa/enhttps://www.undp.org/https://www.undp.org/https://savinglivesustainably.org/https://savinglivesustainably.org/https://savinglivesustainably.org/https://savinglivesustainably.org/https://www.sida.se/English/https://www.sida.se/English/https://www.un.org/sustainabledevelopment/sustainable-consumption-production/https://www.un.org/sustainabledevelopment/sustainable-consumption-production/https://www.who.int/phe/publications/global-strategy/en/https://www.who.int/phe/publications/global-strategy/en/
-
4
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
from thefield. The Global Forum 2020 also hosted a practical discussion on the SustainableProcure-ment Index forHealth (SPIH) which is an environ-mental andsocialmeasurement tool andplatformcurrently under development by UNDP, HCWH and Arup. The event concluded with a bold closing panel onenablingleadershipforsustainabilityinthehealthsector where distinguished speakers raised the need forurgentpoliciesthatspeaktotherequiredactionson the ground that encompass preventative health care, systematic leadership and an enhanced global collaboration.
Insummaryofthediscussionsandevent,theGlobal Forum2020reinforcedtheinternationaleffortsledbytheKingdomofSaudiArabiaduringtheG20Summitto ensure a continuous sustainable development as wellastoenhancethefocusonthehumanandhu-manneedsineveryandallaspectsoflife. A synopsis ofthekeymaintakeawaysfromthediscussionsoftheGlobalForum2020havebeenprovidedasfollows:
\ A One Health response is needed to prevent future pandemics—aOneHealth response is acollaborative, multisectoral and transdisciplinary approach with the goal of achieving optimalhealth outcomes by recognizing the intercon-nection between human health and the natural environment. This requires collaboration effortsfrom local, regional, national and global levels with multiple sectors and stakeholders working
together to achieve better public health outcomes and toprevent futurepandemics, amongstwithemerging environmental health issues and dis-eases.Thisalsoincludestheneedforasystem-atic and interdisciplinary leadership that compli-ments the One Health response and for a future investment in health care infrastructure as pre-ventativemeasureforbothpublichealthandtheenvironment.
\ The health sector urgently needs to innovate towards sustainable consumption and produc-tion—thehealthsectorneedstoinnovate in order togainefficienciestoachievebetterhealthcareoutcomes and not to contribute toward furtherharm to public health and the environment. The COVID-19 pandemic has demonstrated how med-ical devices, health products and supply chains needtobemoreresourceefficient to guarantee access and security to health care supply and not to contribute toward themisuse of naturalresources and generating harmful waste. This showcases the needforbetterregulatorypoliciesforresponsibleproduction and amongst with the available market opportunities in circular design forhealthcareproducts,energyefficientclinicalequipment, health care waste management and in industrial optimization.
\ COVID-19 has escalated the need for an im-proved science, digitization and technology in the health sector and supply chain—theGlobal
Third Saving Lives Sustainably: Sustainable Production in the Health Sector Global Forum 2020 (© SFDA)
-
5
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
Forum has demonstrated how real-world evi-dence and dataareessentialtoensurethesafety,efficacyandqualityinthedeliveryofhealthcare.Thisalsoincludestheimportanceofcentralized management systems, regulations, harmonized standards, guidelines and data in the health sup-ply chain. The COVID-19 pandemic has created a historic acceleration towards the digitization ofoperations and by providing innovative technolo-gies as health care solutions. Digitizing the health supply chain has demonstrated to provide sub-stantial cost savings, transparency and account-abilityasafundamentalpartofaresilienthealthsystem.Blockchaintechnologiescanalsofurthersupport evidence-baseddecisionmakingforreg-ulators, procurers and health care providers, with further opportunities for data generation, opti-mization and transparency in environmental and social responsibility.
\ There is a need for better gender responses to ensure optimal health care and supply chain se-curity—Women, girls and marginalized groupshavesufferedthemostfromCOVID-19andspe-cial policy measures are urgently needed fromboth governments and the private sector as a resolution to this issue. It is also recognized that there is a strong business case to invest in wom-en’s health as they represent as a majority in both ofthefrontlinesofhealthcareworkandinlabourintensivejobsinhealthcaremanufacturingsec-
tors. Access to digital technology and the inter-net hasalsobeen identifiedasamajorgap forwomen and girls, which has been a key resource used during the pandemic. There also needs to be moreemphasisinfocusingonLGBTIQ and in-clusionofamorediversifiedgenderdatagenera-tionforbetterhealthoutcomes.
\ There is a need for an enhanced global, region-al and local collaboration and diversification in the health supply chain—COVID-19isacollectivechallenge that is borderless and demonstrated the needforstrongerpartnershipsandcollabora-tions amongst multiple sectors and stakeholders. International, regional and local organisations need to work together and not to compete in the deliveryofhealth careas lessons learned fromthepandemic.Also,withtheidentifiedneedandactions for thediversification and localization of supply chains to ensure the supply chain security in agriculture and health care, this demonstrates as a major health supply chain transformation andbringsnewareasofopportunitiesandchal-lenges whether through global trade, regulations and/or sustainable development. This also show-cases positive prospects for the incorporation of sustainability and for governments and newhealthcareindustriestostart-offtheirpracticeson theright footbyembedding social and envi-ronmental policies, standards, tools and technol-ogies that are readily available.
Third Saving Lives Sustainably: Sustainable Production in the Health Sector Global Forum 2020 Official Opening (© SFDA)
-
6
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
Key Results at a Glance
GLOBAL PARTICIPATION OF KEY STAKEHOLDERS
times the sessionswere viewed
women
men
social media reach
registrants
MinistryofHealth,RegulatoryAuthoritiesandPublicProcurement
UN Agencies
Government, Embassies and Municipalities
NGOsandCivilSociety
Pharmaceuticals,HealthProductsandManufacture
Academia,ResearchandStudents
Hospitals, Pharmacies and Clinics
Other
Businesses
HealthSciences,TechnologyandResearch
Management Consulting
Transport, Freight and Logistics
International Financial Institutions
registrants
countries
Organization Types
-
7
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
KEY HIGHLIGHTS IN GLOBAL FORUM 2020 CONTENT
Training and Capacity Building
Academic Research,Literature and Studies
Best Practices, Lessons Learned and Recommendations
Case Studies Guidance, Standards and Tools
Gender Equality
Packaging
Water
Pubic Health
Procurement
Medical Products
ResourceEfficiency
Standardization
Digitization and Data
Transportation
Human and Labour Rights
Waste Management
Energy
Chemicals
GOAL1:NoPoverty
GOAL2:ZeroHunger
GOAL3:GoodHealthandWell-being
GOAL4:QualityEducation
GOAL5:GenderEquality
GOAL6:CleanWaterandSanitation
GOAL7:AffordableandCleanEnergy
GOAL8:DecentWorkandEconomicGrowth
GOAL9:Industry,InnovationandInfrastructure
GOAL10:ReducedInequality
GOAL11:SustainableCitiesandCommunities
GOAL12:ResponsibleConsumptionandProduction
GOAL13:ClimateAction
GOAL14:LifeBelowWater
GOAL15:LifeonLand
GOAL16:PeaceandJusticeStrongInstitutions
GOAL17:PartnershipstoachievetheGoal
Totaloccurrences
of SDGs
ContentAnalysis
Best Practices, Lessons Learned and Recommendations
CaseStudies
Guidance,Standardsand Tools
Training and Capacity Building
Academic Literature, ResearchandStudies
TopicsCovered
-
8
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
Day 1—November 18, 2020Global Forum 2020 Facilitator: Dr. Hamoud Al-nughaymishi, Head, Risk Communications, SaudiFoodandDrugAuthority(SFDA)
Opening Remarks: \ H.E.Prof.HishamAljadhey,CEO,SFDA \ H.E.Mr.NiclasTrouve,SwedishAmbassador to
theKingdomofSaudiArabia \ Adam C. Bouloukos, Ph.D., Resident Representa-
tive,KingdomofSaudiArabia,UNDP \ Dr. Ibrahim El-Ziq, Representative, Kingdom of
SaudiArabia,KuwaitandBahrain,WHO \ Gary Cohen, President and Co-Founder, Health
CareWithoutHarm(HCWH)
Keywords: COVID-19,ResilientHealthSystems,G20,Supply Chains, Vulnerabilities, Opportunities, Mar-ket-shaping, Procurement Strategy, Supply Short-ages,Partnerships,GoodPractices,Standards,Cli-mateChange,Environment,ToxicChemicals,SolarEnergy, Cost Savings, Health Care Waste, CarbonFootprint,SustainableProductionandConsumption,Policy and Regulations, Innovation.
Theofficialopeningsetsthesceneforthe2020Glob-al Forum to showcase the intersections between cli-mate change and global health, and the necessary transitionstorecoverbetterfromtheCOVID-19pan-demic. TheKingdomof Saudi Arabia advocates asa strong investor in the Sustainable DevelopmentGoals(SDGs)andthiswastranslatedintothevisionfor 2030 Agenda for Sustainable Development andaspartof thissideevent for theG20Summit.Thewitnessed economic and social disruption caused by the pandemic is devastating as tens ofmillionsofpeopleareriskoffallingintoextremepoverty.Thenumberofundernourishedpeopleiscurrentlyesti-mated at roughly 690 million and could increase by 132millionbytheendof2020.
Summary of Key Messages: \ InSaudiArabia,theworldleaderswillmeetfor
theG20Summitforthewell-beingofhumanity,healthoftheplanetandforabetterrecoveryaf-
Official Opening of the Global Forum 2020
ter COVID-19.ThecapitalcityofRiyadhinSaudiArabiasetsthestagefortheG20Summittodis-cussthemost importantglobal issuesforem-poweringpeople,maintaining thehealthof theplanet and creating new ways to enhance human cooperationinthefieldofinnovation.
\ The Forum will jointly explore how we can re-coverbetterafterCOVID-19throughSustainableProcurement, Consumption and Production practicesthatwilllaythefoundationsfortheG20Summit, amongst with the fundamental ques-tion—how can the world prepare for an upcoming health crisis? The pandemic has showcased the dire changed rules of life, the crippling of theeconomyandhinderedtheglobalaccesstofoodand medicines.
\ The pandemic has demonstrated vulnerabili-ties in the health supply chain. There is a need forhealthcaresystemsthatcanadaptswiftlytonew challenges and the global community needs tostepupitseffortstoensure access to quality health care for all.
\ Access to essential medical supplies such as personalproductiveequipment(PPEs),mechan-ical ventilators and diagnostics for COVID-19have been witnessed. Off-label prescriptions and stockpiling of several medicines have also hin-dered accessibility and increased the risk of the poor-quality medicines.
\ Global cooperation is needed more than ever for resilient health systems.Asanexample,SwedenandtheKingdomofSaudiArabiacollaboratedinthe coordination and planning to optimize ICU pa-tient treatments which showcases international solidarityandcooperationduringatimeofcrisis.
\ Health care supply chains need to avoid harmfulproduction processes and with the improper dis-posalofproductsthatcontributetoclimatechangeand environmental degradation. This is a growing concern witnessed during the pandemic, as the in-creaseduseofPPEshascausedunprecedentedaccumulationofhealthcarewasteglobally.
\ There isaneedtofocusonthehealth sector’s contribution to its overall carbon footprintand how we can collectively enable the health sector
https://youtu.be/ckhWYqPQnS4?t=1879
https://youtu.be/ckhWYqPQnS4?t=1879
-
9
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
to deliver services without negatively impacting people’s lives and that of the planet. There are manylessonsfromaroundtheworldthatcanbescaled up and replicated globally to decarbon-ize the health sector and the Global Forum 2020 shall provide experiences and suggestions on how this can be done.
\ Strongandresilientsupplychainsareessentialforpublichealthastheyareacriticalelementofawell-functioninghealthsystemandareavitalinput to advancing national and regional health security goals. Thus, the pandemic has chal-lenged the supply of essential medicines andhealth products which compromises each coun-try’s achievements in universal health coverage and threateningprogress towards theSustain-ableDevelopmentGoals(SDGs)by2030.
\ Sustainable consumption and production modal-ities support companies to reduce the harm to workers, communities and the environment, as well as to save energy and natural resources. The strategic procurement method provides as a vital opportunitytoachievesupplychaincosteffective-ness, as WHO has estimated that by reducing un-necessary expenditure on medicines, countries
cansaveupto5percentoftheirtotalhealthex-penditures.
\ The pandemic showcases incredible opportu-nities—there isashinedlightontheessentialrole that the health supply chain plays in global healthforthe7.8billionpeopleonourplanet.We need to think about how we redesign our supply chains through the use of health carematerials,manufacturingprocessesandprod-uct disposal with technologies and systems that can guarantee health care access that is sustainable.
\ There is a need to establishstandardsforenvi-ronmentally responsible health products. While suppliers can proactively model these innova-tions in the marketplace, regulations are likely to inevitably change soonforlowcarbonprocessesandcertaintypesoftoxicchemicalswithrestric-tionsfordifferentuses.
\ Thismeeting is a prelude for theG20Summitandhow it canmodel the kinds of values thatareneededinthehealthsectorforuniversal and equitable access, sustainable production and preventativehealthcare—itisrecognizedtheseissuesareallinfactintegrated.
Third Saving Lives Sustainably: Sustainable Production in the Health Sector Global Forum 2020 Official Opening (© SFDA)
-
10
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
Keynote Address: Climate Crisis and Health
Keynote Speaker: Dr. Mandeep Dhaliwal, Director, HIV, Health and Development, UNDP
Keywords: COVID-19,HealthSector,Action,ClimateCrisis, Countries, Sustainable Consumption andProduction, Biodiversity, Environment, Green House Gas(GHG)Emissions,EvidencedBasedPolicy,Na-tionallyDeterminedContributions(NDCs),Scalabil-ity,NaturalResourceDecoupling,Sustainability,In-novative Finance.
Dr. Mandeep Dhaliwal’s keynote speech highlighted theimportanceofcollectiveeffortsto strengthen the resilienceofhealthsystems and how sustainable pro-duction and consumption practices provide as a vital opportunity to improve thehealthofpeopleandourplanet. In order to improve public health and to reverse planetarydamages,thereisneedforboldinvestments, partnerships, policies and actionsthatworkforpeopleand the environment as COVID-19 is a stark reminder thatwearejustonepartofacomplexecosystem.
Summary of Key Messages: \ COVID-19 has shown the critical importanceof
scaling integrated development solutions which
can advance sustainability and equity. However, ifwedonot learn fromourmistakesand takedecisive action, we risk increasing the health sectors carbon footprint, escalating costs, andharmingpeopleandplanetaryhealth—we must not underestimate our collective challenge.
\ UNEP’s Emissions Gap Report of 2019 states that the world needs to reduce emissions by 7.6percenteveryyearforthenextdecadetolimitglobal warming to 1.5 degrees Celsius. Accord-ing to the UNDP-UNFCCC NDC Outlook Report: The Heat is On,almosthalfoftheworld—75 na-tions representing 37 percent of global green-house gas emissions, are planning to take more climate action than promised in their national climate pledges. Meanwhile, 71 countries are stilldeliberating,whicharesomeofthebiggestgreenhouse gas emitters, and 14 countries have indicated they have no plans to revise their na-tionally determined contributions.
\ We need to encompass newwaysforgovernmentled multi-sectoral action and to develop new ways to financeclimatesmart sustainability solutions inthehealthsector.WeknowfromthelandmarkHealth Care Climate Footprint Report by Health
© UNDP Iraq, 2020
https://youtu.be/ckhWYqPQnS4?t=4361
https://www.unenvironment.org/resources/emissions-gap-report-2019https://outlook.ndcs.undp.org/https://outlook.ndcs.undp.org/https://www.arup.com/perspectives/publications/research/section/healthcares-climate-footprinthttps://youtu.be/ckhWYqPQnS4?t=4361
-
11
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
Care Without Harm (HCWH) and Arup—healthcare contributes to 4.4 percent of net globalgreenhouse gas emissions. Asapart of this is-sue, the health sector purchases a broad range of products including chemicals, electronics, plastics, medical devices, energy generation tech-nologies, laboratory reagents, anaesthetic gases, pharmaceuticals, personal protective equipment andfood. The production packaging, transporta-tion,useanddisposaloftheseproductsthereforecontributes to chemical contamination, resource depletion, biodiversity loss, air and water pollution and ultimately contributes to the climate crisis.
\ There are three critical lessons to reflect onhow we can build forward better and recoverstronger from COVID—(1) To scale up climate smart actions that are equitable, just and aligned with the Sustainable Development Goals, (2) To decouple economic activities from environmental and social impacts and (3) To collaborate in ways that we never have before to address the climate crisis. We are all stakeholders with interlinked andinterconnectedfatesandthereisnooptingout of the climate and biodiversity crisis—we mustacttogetherforthehealthofthepeopleand planet.
Panel Discussion: Sustainable Health Supply Chains in the Context of COVID-19 and Beyond
Moderator: Dr. Rosemary Kumwenda, Team Leader, HIV, Health and Development, UNDP Eastern Europe andCentralAsiaandSPHSCoordinator
Panelists: \ H.E. Mr. Ahmed Alhakbani, Customs Governor,
KingdomofSaudiArabia \ Don Mwangana, Principle Inspector, Zambia
Medicines Regulatory Authority \ EvgheniiAlexandroviciGoloşceapov,AdvocacyDi-
rector, Positive Initiative \ RajaSharif,FounderandCEO,FarmaTrust \ Fahad Alshebel, CEO, National Unification Pro-
curement Company
Keywords: Procurement, Regulatory Authorities, Data Systems, Prevention, Challenges, COVID-19, HealthCare, Medicines, Medical Equipment and Supplies,HealthCareWorkers,Suppliers,Manufacturing,GMP,Local Production, Quality Assurance, Inspections, Digitalization.
The outbreak of COVID-19 has disrupted the provi-sion of adequate health care services andwith thispressure, many countries have been unable to re-spondeffectivelytothishealthemergency.Thisalsoincludeswiththeadherenceofsocial,environmentaland ethical dimensions in public health procurement. Therefore,thissessionexplorestheinsightsonhow
sustainability should and can be followed in healthemergencies, and with the perspectives on how this is handled through the various activities and work that has been conducted during the pandemic. The panellistswerethenaskedasinglequestionof“What challenges and opportunities were brought with the COVID-19 pandemic in concrete terms and what would you have done differently in a pandemic situation going forward?”
Overall, the panellists indicated that the pandemic brought about challenges for policymakers, regula-tors and innovators. There were also trade barriers, thehumanrightsissuesofequityofaccesstoqualityandaffordablecommoditiesandmedicines,issuesofaccess to PPE, ICU beds, ventilators and other crit-ical health supplies. The panellists highlighted key pointsofwhatthefuturelookslike,andthis includ-ed (1) ramping up of local manufacturing was rec-ognized as an essential aspect in order to secure supplies at national level, (2) digitalization of health processes is needed in order to ensure transpar-ency and accountability to sustainability standards, (3) technology is essential to safeguard human life and to safeguard global health care to ensure that all countries worldwide have access to technology (4) there has to be concerted efforts and partner-ships that are required to manage the global pan-demic.
https://youtu.be/ckhWYqPQnS4?t=8129
https://youtu.be/ckhWYqPQnS4?t=8129
-
12
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
Summary of Key Messages, Lessons Learned and Actions:H.E. Mr. Ahmed Alhakbani—Paramount to theKingdomofSaudiArabia’schallengesandopportu-nities during the pandemic was its ability to monitor and manage the health and safety of employees at the beginning of the pandemic.AsapartofSaudiArabia’s Customs, they primarily worked with the health authorities to ensure the safety of the em-ployees by facilitating digitization, accommodat-ing remoteworkandmanaging the risksof tradeandeconomicactivitiescomingfromborderareas.Their operating model was also changed in order toallowforcontinuousgoodstoflowinandoutofthe country while mitigating risk through calculated risk assessments.
TheKingdomofSaudiArabiaalsohadworkedonen-hancing the transparency in a rapidly changing envi-ronment, considering on a weekly basis there were changes in regulation, processes and procedures is-suedfromgovernment.Therefore,theyhadupdatedtheirwebsitewithacontinuousfeed,inbothinArabicandEnglish,tohelpinvestorsinSaudiArabiatodealwith the rapid change in procedures and processes. Digitization and collaboration with government enti-ties was also an imperative strategy by adding more online services that enables for customers to dealwithSaudicustomsremotely,amongstwiththelever-ageoftechnology.
Fahad Alshebel—AspartoftheSaudi Arabia Nation-al Unification Procurement Company, they worked closely with health regulatory authorities, suppliers and health care providers. They needed to respond quicklyinordertomeetthedemandsofthepandem-ic and hence, a committee was established within 24 hours. Demonstrated examples were highlighted on howthesupplierbasewasleveragedinordertofulfilaccess to PPE, ICU beds, ventilators and other critical health supplies. This also included ramping up local productionandtoimproveeconomiesofscaleinor-dertocoverthedemandwiththehelpofthehighercommission and regulatory authorities. This also had triggered the thinking on capacity and the capability ofstrategicstocks,andalsotokeepacontingencyforanyneedsinthefuture.
Evghenii Alexandrovici Goloşceapov—Moldova facedmany challenges as the public health procurement process did not use electronic systems during the COVID-19 pandemic, nor did it incorporate the integra-tion of sustainability standards. It took health authori-tiesmanydaystogettheinformationfromthestocksneededfromhealthinstitutionsandamongstwithano centralized database that had resulted in a public dis-tresswiththegovernment.Thus,theMinistryofHealthis planning to bring back the electronic system forhealthprocurementandtofulfilopencontractdatafortransparency, amongst to solve systematic issues and reportingratesofhealthinstitutions.Thisalsoincludes
© UNDP Bangladesh, 2020
-
13
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
to enhance Trade Related Intellectual Property Rights (TRIPS)flexibilitiestoincreasecompetitioninthemar-ketandalso,theneedformethodologiesforlifecyclecostsformedicinesandmedicaldevices.As highlight-ed in theofficialopening—there isaneedforapan-demic ready health system.
Don Mwangana—AsrecognizedbytheZambia Medi-cines Regulatory Authority, online systems are need-ed and this has been escalated due the pandemic to implementasystemthatallowsforanonline appli-cationof licences, certificates and payments for thedistributionofmedicinesandhealthproducts.How-ever, during the pandemic, it was recognized that con-nectivity proved as a challenge as not all clients have accesstoplatformsandtheinternet. Also, with the in-creased demand in COVID-19 related health commod-ities, there was a need to increase the market supply ofhandsanitizersandtheZambia Medicines Regula-tory Authoritycreateddifferentincentivesandmech-anismstofacilitateaproductioninthelocalmarket.Also, as a regulatory authority, they did not have the guidance documents for the registration or inspec-tion of hand sanitizer products and had conductedthe necessary groundwork in order to provide capac-ity building on the issues related to GMP. Overall, the Zambia case demonstrates interesting perspectives ofanintegratedregulatorymanagementsystemandhowtheyreducedtheimpactofprocurementduringapandemicfromaregulatoryperspective.
Raja Sharif—Thetechnicalabilitytosafeguardpeo-ple’slivesandtopreventshortagesandwastageofmedical products is currently available and accessi-bleforMinistriesofHealth,regulatorsandhospitals.This is not only inWestern countries, but also forlower-middle income countries. While blockchain technology allows for end-to-end tracking in realtimeofmedicalproducts, it also monitors the distri-butionandenvironmentalaspectsoftheproductsatagranularlevel.Thishelpstoeliminatecounterfeitmedicines by sealing the supply chain and also to enhance quality and to prevent shortages and waste by aiding with the demand side planning, as it is rec-ognized there is an estimatedUS$4billionworthofmedicinesintheUSthatarewastedeachyeardueto the expiration in warehouses. This also helps reg-ulators to fully digitize the regulatory processwithless paperwork and with trusted data and automa-tion capabilities.
Blockchain technologies are also considered cheap-er than other systems andarenot fully operationalatthispointintimeduethelackofawarenessinthemarket. Blockchain essentially can change society by digitizing the procurement process, which enhances transparency and contributes towards efficienciesand optimization. Blockchain can also help eliminate corruption and aid with the protection of the envi-ronment by monitoring GHG emissions and reducing waste.
© UNDP Bangladesh, 2020
-
14
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
A. Food Safety—Risk Assessment
Moderator: Dr. Rashed Alarfaj, Executive Director,Monitoring and Risk Assessment, Saudi Food andDrugAuthority(SFDA)
\ Mohammed Alhuthiel, Director, Risk Assess-ment,SaudiFoodandDrugAuthority(SFDA)
\ Dr. Tadesse Amera, Co-Chair, IPEN and Director, PesticideActionNexus(PAN)-Ethiopia
\ Dr.MahaAlturki,AssociateDeanofAcademicAf-fairs,CollegeofAppliedMedicalSciences,KingSaudbinAbdul-AzizUniversityforHealthScience(KSAU-HS)
\ Dr.RandahMiqbilAlqurashi,AssistantProfessor,King Faisal University
Keywords: Pesticides, Chemicals, FoodSafety, RiskAssessments, COVID-19 Pandemic, Systems, Expo-sure, Production, Immunity, Consumers, Academic Studies,Nutrition,Diet,Health,Impacts.
Foodsafety andnutrition is keyelement for agoodand sustainable health system. As per WHO, over 200 diseasesarecausedbyunsafefoodandanestimat-ed600millionpeoplegetsick fromunsafe foodev-ery year1.Accesstosafeandnutritiousfoodiskeytosustaining lifeandpromotinggoodhealth,amongsttokeepingpeoplehealthy inmidst of aglobal pan-demic.Therefore,keepingallconsumershealthyandsafeiscriticaltosurvivingapandemicandthispaneldiscussionisdesignedtoshowcasetheimportanceofscienceasacrucialcomponentforafoodsafetypar-adigm,whilehighlightingthefoodsafetychallengesand how to improve immunity through nutrition.
Thepanellistshadpresentedkeypointsforthisses-sionthatinclude:(1) There is no scientific evidence that COVID-19 can be transferred through food (2) The importance of capacity building for food risk as-sessments in the world and more specifically in de-veloping countries, (3) Governments need to ensure the sustainable supply of sufficient, safe and nutri-tious food during and after the pandemic, (4) A One Health approach is needed to confront emerging dis-eases and antimicrobial resistance, (5) There is an need for an increase the public awareness on a bal-
Parallel Sessionsanced diet that includes all food groups and to follow the WHO guidelines to protect our immune systems. Overall, creating healthy and sustainable food sys-tems are needed to produce an effective food econo-my and to deliver nutritious and safe food.
Summary of Key Messages, Lessons Learned and Actions:The Role of Risk Assessment in Food Safety systems (Mohammed Alhuthiel)—Mr.Althuthielpresentedtherisk management activities conducted at the SFDAandwhatimpactthishadonfoodsafetyandsecurityduring the pandemic. It was highlighted in a recent study conducted in multiple countries that the current framework is not enough to guarantee food safetydue to the lackof infrastructureandexpertise, lackofdata,newemergingrisksandwiththeglobalizationof foodsupply.With theSFDAlessons learned fromCOVID-19, there isaneed to focuson thedomestic foodsupplychainandmanufacturing,andtosupportlocal agriculture that is accessible, sufficient, safeandnutritiousduringandafterthepandemic.
Food production also needs to reinforce basic foodhygienepractices,tochangethelayoutanddesignoffoodproductionlines,andtouseautomationtocopewith physical distancing. Timely communication is key tomaintainingfoodsafetyandsecurity,andthereisahighimportanceofanimmediatescientificresponseto policy makers, consumers and stakeholders. Best practices include advanced coordination between government agencies in terms of food safety andsecurity, to improve the standards and guidelines to cope with the situation, and to increase consumer awareness. Overall, it is advised that we need more reliance on science and scientific capacity building,and the need to implement a One Health approach to confrontemergingdiseases.
Pesticides used for food production as a health and safety issue (Dr. Tadesse Amera)—Dr. Amera pre-sentedthechemicalrisksfrompesticidesusedforfoodproduction.All pesticides are potentially harm-ful to humanhealth and canaffect people in theirapplication when they are consumed, with impacts thatcanbeacute(immediate)orchronic(long-termexposure). There is also a recognized bioaccumu-
1 https://www.who.int/news-room/fact-sheets/detail/food-safety
https://youtu.be/Iewt96AHP6g
https://www.who.int/news-room/fact-sheets/detail/food-safetyhttps://youtu.be/Iewt96AHP6g
-
15
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
lation in the human body and biomagnification ofpesticidesinfoodsystems,whichcanleadtowardsharmful chronic impactsover time.Therearealsovoluntary standards that are managed by the Food andAgricultureOrganization(FAO)andWHOonPes-ticideManagement(JMPM)toavoidadversehealtheffects.Thesevoluntarystandardsareusedbygov-ernments and international risk managers such as the Codex Alimentarius Commission to establish Maximum Residue Limits (MRLs) for pesticides infood. There are also opportunities to reduce andeliminate pesticides, such as the resolution present-ed at the 4thmeetingontheInternationalConferenceonChemicalsManagement (ICCM) on agroecologyin crop production, integrated pest management and organicagriculture.Therefore,foodsafetyinrelationto pesticides residue is recognised as a public health and environmental priority.
How Nutrition Can Help to Fight Against COVID-19 Pandemic (Dr. Randah Miqbil Alqurashi)—Dr. Alqurashi presented the immune system, the mi-cronutrientdemandsoftheimmunesystem,thepub-licawarenessforpreventingCOVID-19(currentstudy)and guidelines to protecting our immune system. Worldwide, there is an estimated one million deaths amongchildrenunderfiveyearsoldduetodeficien-ciesofVitaminAandzinc,while250millionpreschoolchildren are Vitamin A deficient.Micronutrients areimportantastheysupportthestructureandfunction
ofmucosal cells, promote response tobacterial in-fections,stimulateageneralimmuneresponsivenessand protect against cell damage. However, nospecif-icfoodgroup,supplementornaturalhealthproductcanpreventpeoplefromcatchingCOVID-19,butWHOdoes encourage people to eat a healthy balanced diet to support the immune system. A balanced diet that includesallfoodgroupssupportsaneffectiveimmunesystemandmayprovideprotectionagainstinfections,cancers and other diseases.
Current State of Evidence: Vitamin D and Immuni-ty During COVID-19 (Dr. Maha Alturki)—Dr. Alturki presented on how the nutritional status may play animportantpart indifferentsevereinfectionsandin particular with COVID-19. Vitamin D is an essen-tial nutrient that humans obtain through exposure to sunlight, diet and dietary supplements. It plays a vitalandcomplexroleintheimmunesystemfunc-tion and could prevent the cytokine storm and sub-sequent acute respiratory distress syndrome that is commoninthecauseofmortalityinCOVID-19.Whilethere has been emerging literature and studies that showcase Vitamin D in the prevention or treatment ofviralrespiratoryinfections,theevidencehaslim-itations. Therefore, the evidence to use Vitamin DsupplementstotreatorpreventCOIVD-19is insuf-ficientanditisrecommendedtomaintainadietthatcontainsabalanceofvitaminstoobtainanoptimaland nutritional status.
© UNICEF Ethiopia, Mulugeta Ayene 2020
-
16
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
B. Responsible Business Practices
Moderator: Dorin Rotaru, Health Programme Manag-er, UNDP Ukraine
\ Dr.FionaAdshead,Chair,SustainableHealthcareCoalition
\ Hitesh Upreti, Advisory Board Member, CPhI—MiddleEast&Africa
\ Wazani Zulu, Manager, Regulatory & Compliance, SterelinMedical&DiagnosticsLtd.
Keywords: Industry Practices, Public Procurement, Services,Sustainability,Systems,HealthImpacts,Pa-tients,Pharmaceuticals,Environment,Stakeholders,PrivateSector,QualityAssurance,Research,Sustain-able Development.
The COVID-19 pandemic has created a major disrup-tion in the economy and in the operations of globalbusinesses. These disruptions have created a wide range of impacts and withmany businesses strug-glingfinancially.TheCOVID-19crisishasalsoexposedmajor vulnerabilities in health care operations and supplychainslinkedtoconditionsofworkandwithanincreased impact on the environment through the in-creaseddisposalandwasteofmedicalcommodities.
Therefore,itisrecognizedhowcompaniesrespondtoresponsible business practices will have lasting reper-
cussionsforthesakeoftheeconomy,societyandtheplanet,andhowwecanrecoverbetterfromCOVID-19.Thepanellistshadpresentedkeypointsforthisses-sionthatinclude:(1) We need to make sure that we work across the system in collaboration to encour-age innovation—how do we bring people together to solve problems and to measure impact? (2) How sustainable are we in the lifecycle of the products? Research and development, manufacturing and pro-duction, distribution, use and disposal—what mea-sures are we putting in to ensure sustainability? (3) The private sector has a significant impact on sus-tainability while digital technologies are contributing to the decrease of the health care costs and its envi-ronmental impact. Therefore,thepanelconcludedonhowsustainabilityisembeddedinallofustoensurethatweworktowardsasustainablefuture—it ises-sentialtoputinalleffortstodeliverthemessages.
Summary of Key Messages, Lessons Learned and Actions:A positive collaboration for greener health care bridging the private and public sectors (Dr. Fiona Ads-head)—TheSustainableHealthcareCoalition(SHC)isapartnershipofhealthcarecompaniesandotherhealthagencies that are drawn together to address some of the most pressing sustainability issues in globalhealthcare.Aprimaryfocushasbeeninsustainability and digital health in order to measure environmental impact and there are great opportunities for collab-
© UNDP Iraq, 2020
https://youtu.be/xhH-KUPFND0
https://youtu.be/xhH-KUPFND0
-
17
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
orations. Digital solutions are playing a larger role in healthcaredeliveryandcanbeavaluablepartofdeliv-ering sustainability towards Net Zero Health Care.
Digital interventions can also improve the “bottom line,” improve patient outcomes, reduce costs and are critical to monitoring and measuring environmental impact.TheSHCisexpandingonhowcircularecono-my principles can be applied to health care, how sup-plychainscanplayaroleforsustainablehealthcaresystems,howlifecycleassessmentscanbeembed-dedintheuseofplasticsandhowinnovationcandrivechange. Case studies were presented from multiple health care companies amongst the release of theworld’sfirstguidanceonhowtomeasurethecarbonfootprintofpharmaceuticalsandmedicaldevices.
Responsible Business Practices: Sustainability in Procurement (Wazani Zulu)—Environmentalsustain-ability involves making decisions and taking actions thatareinthebest interestofprotectingthenatureand preserving the capability of the environment tosupporthumanlife.TheMinisterofHealthofZambiahas achieved multiple milestones, which include in-troducing a bill (PublicProcurementBillof2020)thatmandates e-procurement by all spending agencies and ministries.
TheZambiaPharmaceuticalBusinessForum(ZPBF)works closely with the Zambia Public Procurement
Authority (ZPPA) to ensureall tendering processes followanopentendermodelthatenablestranspar-ency, and amongst working with the Zambia Medi-cinesRegulatoryAuthority(ZMRA)toensuredossiersubmissions are made electronically. The ZPPA is planningtocontinuetoscale-uptheuseofthee-GPSystemandtoembedissuesofsustainabilityintoso-licitation documents. The Zambia Ministry of Com-merce, Trade and Industry has also identified thepharmaceuticalsectorasaprioritysectorforlocaldevelopmentandaredevelopingafiveyearstrategicplanforlocalmanufacturing.
Responsible Business Practices: A Pharmaceutical Industry Perspective (Hitesh Upreti)—The pharma-ceutical industry is responsible for the discovery,development and production of drugs that are highquality,safeandeffective.Somechallengesandre-flectionsfortheindustryincludethefactthatinde-veloping markets, patients need to be educated to create awareness and access to latest developments across the world in health care. There is also a need to progressively shift fromprescriptiondrugstooth-er product segments and to health care delivery, and theseshiftscanbedifferentbyregion.
With regard to primary care franchises, there is aneedforaportfolioevolutiontowardsspecialtycareproductsdesignedforhighlyprofiledpatientpopula-tionsandbackedby complex scientificandmedical
© UNDP Moldova, Adriana Bîzgu
-
18
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
data. Therefore, the industryneeds to identifywhichbusinesstargetsaregenuinelyattractiveformajorornew investments. The capacity issues in relation to thesizeofthehealthneedsandmarketdemandre-quireprivate-publicpartnerships toaddress the fullspectrumofpublichealthissues,frombasicpatientaccess to care and to managing global health crises. Overall, it is advised that national strategies should be madetoreduceinequalitiesinhealth,forcountriestostandardizepricingtoenhanceaccessandforgovern-ments and the private sector to plan together on prior-ityareasfortheindustrywithaclearroadmapforsus-tainability for thenextfiveyears. It is also important nottoforgettheresponsibilityoftheindustryanditsimpactontheenvironment—itiskeytogobeyondwhatis required as legal and to do what is right.
C. Medical Devices and Safety
Moderator: Dr. Mohammed Majrashi, Executive Di-rector,SurveillanceandBiometrics,MedicalDevicesSector,SaudiFoodandDrugAuthority(SFDA)
\ Faisal Ali M. Alshehri, Head, Medical Device Reg-ulationandStandards,SaudiFoodandDrugAu-thority(SFDA)
\ BaderE.ALoufi,Head,Post-MarketClinicalEval-uation,MedicalDevicesSector, Saudi Food andDrugAuthority(SFDA)
\ Dr.Manish Pant, Chief, Health andGovernanceUnit, UNDP India
Keywords: MedicalDevices,Standards,Manufactur-ers,Challenges,Safety,MarketDynamics,Documen-tation, Requirements, Guidelines, Quality Assurance, Risk,Compliance,SupplyChain,Facilities,Vaccines,Temperature, Government, Management, Digital Supply,HealthCareProviders.
ThissessioncoveredMedicalDevicesandSafety,andthe replications of the COVID-19 pandemic. Indus-tries, markets and businesses all over the world have beenaffecteddue to thepandemic and this impacthasbeenprofoundwithinthemedicaldevicesector.Therefore,thispanelsessionlookedintotheclinicalprocesses thathave takenplace fromdifferentper-spectives, the collaborations conducted to facilitatemedical device access and also, what was done to ensuretheavailabilityandaffordabilityofmedicalde-vices in the marketplace.
Thepanellistspresentedkeypoints for this sessionthat include: (1) Harmonized standards are an im-portant tool in the medical devices regulatory cycle in order to ensure safety and performance, (2) Best available research, opinion of clinical expertise and patient voices add a significant input towards a good post-market evaluation of medical devices (3) Dig-ital supply chain systems are an essential element of building a resilient health care system and with a strong government ownership and empowerment of health care workers—the system can provide cost savings, transparency and accountability (4) En-couraging medical device innovation is essential to achieve a sustainable and high quality of health care.
Summary of Key Messages, Lessons Learned and Actions:The Utilization of Medical Device Standards to Demonstrate Safety (Faisal Ali M. Alshehri)—Thepresentationhighlightedtheimportanceofstandards,medical device lifecycles and SFDA efforts duringCOVID-19. A standard is a defined as a documentthatisestablishedbyaconsensusofsubjectmatterexperts and approved by a recognized body that pro-videsguidanceonthedesign,useorperformanceofmaterials, products, processes, services, systems or persons. Guidelines are then used to help explain and share knowledge on the processes, requirements or applicable recognizedstandards.TheSFDArecentlydevelopedguidancedocumentstocoverArtificialIn-telligence(AI)relatedtopicsasthesearenewareasthat are not regulated in the market. They are also working on new documents to include cybersecurity, software,and3Dprintingformedicaldevices.
The COVID-19 and SFDAMedical Device Efforts in-cluded temporary updates to ensure easier market-ing authorization requirements and provided sup-port to local manufacturers. They are in constant communication with local and national partners and arepleased tostate theyhaveanumberof expertsworking with international organisations to develop a numberofpublicationsinlinethewiththecharacter-izationofPPE. Case studies on how standards were used during COVID-19 (medical masks, ventilators)were presented amongst other SFDA publications.
Post Market Surveillance Activities to Ensure the Safe Use of Medical Devices (Bader E. ALoufi)—Thepresentation elaborated on pre-market and post-mar-
https://youtu.be/jzRubHG3P_U
https://youtu.be/jzRubHG3P_U
-
19
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
ketreactiveandproactiveactivities,amongsteffortsoftheSFDAduringtheCOVID-19pandemic.Accord-ing toWHO, thereare twomilliondifferentkindsofmedical devices in the world market today and these products can be classified in about 22,000 genericdevices or groups2. Therefore, the primary questionishowtoensuremedicaldevicesaresafeandusedsafely—thisrequiresarobustregulatorysystem.
ThebestpracticesandeffortsconductedbytheSFDAas a part of post market surveillance during theCOVID-19 pandemic include conducting research to ensure the safe-use of medical devices, increasingthe awareness regarding the best practices in utiliz-ingPPE,deliveringeffectivecommunicationwiththepublic and health care providers, and working closely with health care providers on issues regarding high demand devices.
Transforming the Vaccine Supply Chain in India (Dr. Manish Pant)—Indiahastheworld’slargestim-munization programme that vaccinates close to 20 million beneficiaries each year including the new-borns,pregnantwomenandchildrenunderfive.Thevaccine supply chain in India has many challenges whichmainlyconsistofthelackofrealtimevisibilityofstocksacrossallhealthfacilities,themismatchbe-tweendemandandsupply,andwiththecomplexityofthe supply chain.Hence,theGovernmentofIndiawas
interested in digitizing the vaccine supply chain and haddecidedtoaddresssomeofthemainchallengesforimplementationthatincludedlow internet access, lack of functional computers andwith the need fordata entry operators.
Therefore,inordertobypassthebroadbandchalleng-es, a smartphone technology, called Electronic Vaccine IntelligenceNetwork(eVIN),wasimplementedtodig-itize the supply chain. The eVIN system is more than justasoftware, it isahumanplatformformanagingthe health supply chain. There are over 900 workers who support the system and work with government staff to ensure the vaccine supply chain is workingproperly. The system connects the central state, district and regional store as one architecture that provides a dashboard, actionable analytics and temperature mon-itoring in real time tohelpmake informeddecisionsaboutstockandinfrastructuremanagement.
Somemajorimpactsincludethestock availability in-creasing to 90 percent across all critical control points, which means hard to reach areas have vaccine access with an 80 percent reduction in stockouts. The eVIN projecthasasaresulttransformedintoaconsump-tion-based procurement system. The project has also aided with gender equality as 50,000 health workers havebeentrainedwhichcomprisesofmorethan60percentofwomen.Theyalsohavebeenintroducedto
© UNDP Kazakhstan, Salamat Ayazbay
2 https://www.who.int/health-topics/medical-devices#tab=tab_1
https://www.who.int/health-topics/medical-devices#tab=tab_1
-
20
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
digital technology and vaccine management, which hasledtoagreaterempowermentoftheseworkers.
D. Sustainable Procurement Index
Moderator:Dr.KristianSteele,Associate,Arup \ Anna Tuddenham, Consultant, Arup \ TerryEllis,SeniorConsultant,Arup \ Callum Newman, Associate Director and Group
LeaderforInternationalDevelopment,Arup
Keywords: SustainabilityProject,MarketMeasuringTool, Supply Chain, Organisations, Suppliers, Base-lines, Health, Environment, Human Rights, Pilot Proj-ect,SustainabilityCriteria,SDGPerformance.
The SustainableProcurementIndexforHealth(SPIH) is a globally established, recognized and adaptable measurement tool for policymakers,manufactur-ers, suppliers, procurers and health care facilitiesend users. It is designed to provide as an incentive forentities to improve theirenvironmentalandso-cial sustainability record. There currently is no such measurement tool that exists to monitor greenhouse gas emissions, resource depletion, chemical/ toxic
impacts on human health and the environment and amongst human, labour rights and gender equality. Theambition of theproject is to facilitate sustain-able procurement in the health sector by supporting the decisionmakingofbuyersandcertaintyforsup-pliers, to provide a robust and transparent method thatcommunicatessupplychainperformanceandtoprovideclearpathwaysforstakeholdersto improvetheirperformance.
Baseduponfeedbackreceivedbybuyersandsuppli-ers,theindexwillfocusonacaseduringaspecificactivity (purchasingevent) rather thanasamarketmonitoring tool or supplier/contract performancetool. It aims to support in “shaping the market” by leveraging procurement events with long term po-tential to transition to a market-based labelling typeofsolutionfrombothanorganisational empha-sis (baseline) performance and product focus. Key theme areas include GreenhouseEmissions(GHGs),Resources, Toxicity and Social Aspects with indi-cator levels, criteria and weighting that provides a scorecard.TheSPIHwillbeavailableon theSPHS Platform. Buyers and suppliers who are interested inpiloting theSPIH inJanuaryandFebruary2021,to contact Ian Milimo at [email protected] and [email protected].
November 19, 2020
Moderator: Dr. Jalal Alowaisi, President, SaudiRedCrescent Authority
\ Amel Alfatih, Director General, Global Health,FederalMinistryofHealth,Sudan
\ SanjayKumar,ChiefMaterialsManager,MinistryofRailways,GovernmentofIndia
\ Dr.JonathanE.Slutzman,InstructorinEmergen-cyMedicine,HarvardMedicalSchoolandMassa-chusetts General Hospital
Global Forum 2020 Day Two
Opening Panel Discussion: How Can We Better Prepare for the Next Public Health Crisis?
\ Ramon San Pascual, MPH, Executive DirectorHealthCareWithoutHarmSEAsia
\ Dr. Fayad Dandashi, CEO, Tamer HealthcareKeywords: COVID-19, Health Care System, SupplyChain, Uncertainty, Resilience, Economy, Communi-ty, Mechanisms, Preparations, Scale, Collaboration,Equality,ResourceEfficiencies,PlanetaryHealth,Lo-calization, Digitization.
https://youtu.be/CcpDOpE0ED0?t=1220
https://youtu.be/CcpDOpE0ED0?t=2741
https://youtu.be/JAmHp0wvgLQfor Health Clinic
http://savinglivesustainably.org/http://savinglivesustainably.org/mailto:Ian.Milimo%40undp.org?subject=mailto:Anna.Tuddenham%40arup.com?subject=mailto:https://youtu.be/CcpDOpE0ED0%3Ft%3D2741?subject=mailto:https://youtu.be/CcpDOpE0ED0%3Ft%3D2741?subject=https://youtu.be/CcpDOpE0ED0?t=1220https://youtu.be/CcpDOpE0ED0?t=2741https://youtu.be/JAmHp0wvgLQ
-
21
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
The opening panel discussion started with the initial question—How can we better prepare for the next pub-lic health crisis? This was then broken down into three subsetquestions:1. What is your insight about the current strategy from
crisis management, including the whole cycle of mitigation preparedness, response, recovery and the resilience of the health care system?
2. What challenges did you face during the current pandemic crisis and what are the alternative ap-proaches used or proposed as a solution for this challenge?
3. What are your key recommendations as a decision maker in order to be prepared to handle a future crisis?
Key and common themes that were discussed amongst the panellists in order to prepare for thenext public health crisis include collaboration, envi-ronmental health, equality, digitalization, localiza-tionandresourceefficiencies. Overall, the panellists highlighted key points of what the future looks likeandthisincluded: (1) Need a proactive and not a re-active response when it comes to delivering health care (2) Health care systems need to compliment and not compete with one another via local, regional and global areas (3) There is a need for an invest-ment in public health infrastructure and for health care to be viewed as an investment, not an expen-diture (4) A need for the diversification of supply
chains, re-localization and repatriation of the sup-ply chain and sourcing (5) Sustainable health care is resilient health care—it needs to include the health of the planet and to encompass equality (6) Digi-talization, science and technology are important factors to strengthen the health care system in a post-COVID-19 era (7) There is a need to look into the reusability of medical devices and equipment in order to maintain supply security and to respect the environment.
Summary of Key Messages, Lessons Learned and Actions:Dr. Jonathan E. Slutzman:(1)Thegreatesthighlightwas on public health infrastructure and how public health has been given a lower priority as a responsive orreactivehealthsystem,andnotnecessarilyfocus-ing on the preventative side. There have also been a numberofchallengesin how health care is being de-livered and in particular with supply chain topics on the environmental footprint of health care services.Also, the just in time supplies modality that is per-ceived as an efficient use of resourceshas actuallybecome a liability and this is due to the single use dis-posable culture making things worse for maintaining medical supplies and the environment. Competing health systems are also a challenge as opposed to the needed partnerships and collectively working to-gether during a pandemic, amongst to make a better useofanationalstockpileorregionalstockpiles—the
Dr. Rosemary Kumwenda (UNDP) speaking at the opening session on Day 2 (© SFDA)
-
22
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
pandemic has certainly showcased vulnerabilities in how health care is delivered. (2) The two biggest challenging factors include thepathophysiologyandoptimaltreatmentforthenoveldiseaseandhowhealthcareworkersandtheirfam-ilieskeepsafeatthesametime.Thelimitationsofavailable PPE through single use disposables that were not available due to constant changing supply chains had led to questionsarisingfromclinicalstaff,amongstwiththeerodedconfidenceontheabilitytoprovide optimal health care. (3)Sustainablehealthcareisresilienthealthcare and ifwecanprovidehealthcare that is lessharmful toour natural environment, then it will by extension also be more resilient to the shocks that we will inevita-blyface.Thisalsoincludeswiththediversificationofsupply chains, whether global or local, and with the durabilityofequipmentthatcanbereused. There also isaneedforagreater transparency in our public and privatesectortorestoreconfidence and to showcase how health care providers not providing care in an en-vironment that could be harmful to them or their pa-tients.Thereisalsoaneedforagreater regional and international cooperativity considering future virusesand climate change do not respect borders. Sanjay Kumar:(1)Therearetwofundamentalissuesthat need to change in order to make the health care systemmoreproactiveandresponsive to failures inthefuture—a health care system needs to be viewed as an investment and not as an expenditure and we
cannot separate the health of human-beings fromthehealthoftheplanet. (2) India had faced serious challenges as they rec-ognized that they did not have the capacity to supply PPEandamongstwith theescalationofprices—thiswas the number one item health care professionalsrequired to provide vital care. As a result, the Indian government and local businesses had started working together in order to ramp up production through textile mills, which ultimately made India the second largest manufacturerofPPEwithinfourmonths.Whilethisisadvised as not the best way to handle the supply chain during a pandemic, itisrecommendedforthefuturetofocusonthedigitization,diversificationandlocalizationofthesupplychainaslessonslearnedfromCOVID-19. (3)Thereneedstobeaninvestmentintheresearch and analysis of evidence-based system and policyframework that can handle future crises. There is also a need for a communication strategy that canreachallpopulationsandtoavoidmisinformationonthescientificunderstandingofthepandemic.Lastly,thereisalsoaneedforaninvestment in sectors and industriesthatnotonlybringbenefittotheeconomy,butalsotopeopleandtheplanetasapartofthepostCOVID-19 recovery.
Amel Alfatih: (2)Theuncertaintywastheoneofthebiggest challenges which included how to conduct and follow the rapid case management, treatment protocolsandconsumptionrates—theessentialpace
H.E. Prof. Hisham Aljadhey, CEO, Saudi Food and Drug Authority at the Global Forum 2020 (© SFDA)
-
23
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
ofthepandemic.Thehumanresources,movementofcommodities during the lockdown was also a chal-lenge, and with the expenses of maintaining largestockpiles. They are now looking into scaling and rat-ifyingalegalengagementframeworkwiththeprivatesector to encourage local production, to look into a more rational use/ reusable PPE and to build capac-ityofhumanresourcesaslessonslearnedfromtheCOVID-19 pandemic. (3) Sustainability is actually about resilience thatrequires better planning at both the government, non-governmental level and across all stakeholders to build resilient action. Information sharing is also centreastheresultoftheuncertaintywhichrequires more clarity and transparency amongst stakehold-erstoensureawholeofgovernmentandsocietyap-proach. Coordination is important between regions and nations and also to have the digital platformssupport it, amongst with cleaner supply chains mech-anisms. Lastly, there isaneed forabettercapacitydevelopment across all institutional levels and with a systematic consultation, dialogue and collaboration foranearlypreparednessaction.
Ramon San Pascual: (1) There are three importantlessons gathered from the pandemic that need tobe considered which include the health care system, governance and human and environmental health. Manyof theoccupationalhealthcare systems were not prepared for the pandemic and it is important to recognize that health system resilience and equity are interrelated, which had heightened the pandem-icfailure.Intermsofgovernance,local and national governments need to compliment and not to compete with one another.Lastlyintermsofpublichealthandthe environment, the plastic pandemic has been es-calatedinSouthEastAsiaduetotheCOVID-19crisis.(3) HCWH has recently released a statement titledBeyondCOVID-19:TowardHealthyPeople,aHealthyPlanet,JusticeandEquity, which includes recommen-dations to ensure a better recovery. These recommen-
dationsincludetofocusonhealthequityandclimatejustice, health care strengthening and capacity build-ing, and health incorporation in all policies to prioritize andensureasuccessfulrecoveryforsocieties.
Dr. Fayad Dandashi: (1)Whenlookingatthecourseofthepandemic,therewasdefinitelyalackofstrategyand preparedness in the early days which required a lotofmanagementfrombusinesses, thehumandi-mensions and the supply chain. The most important factorwas to limit the transmissionof the virus, totreatthosewhowereaffectedandtoboostthemoraleofthepopulationandhealthcareworkers. From the corporate level, communication was key to colleagues and workers and this was managed by assembling a dedicated team with the authority and ability to make quick decisions. (2) As integral to health care and the supply chain,the main challenges were how to ensure an uninter-rupted supply to the health care system and solidarity acrossmanysegmentswhileprotectingthehealthoftheworkforce. As a lesson learned fromCOVID-19,the supplychainisnowbeingreviewedforalternativesolutionswhich isdefinedas therepatriation of the supply chain and with an inclination towards re-local-ization.Thisisinparticularforcriticalindustriesandsupply chain systems such as food, agriculture and health care. (3)Oneof themost important factors is toenvisagethe world and how the global landscape will look again in the post-COVID-19 era. This includes de-glo-balisationandtherepatriationofthesupplychainandsourcing.Adigitaleconomyisalsointhenearfutureand this will have a large burden on regulators and policymaking. There also needs to be more spend-ingonhealthcareinfrastructureacrosstheglobaltobeable tocopeandprepare for thenextpandemic,amongst with stress tests. Lastly, disruption in sci-ence and technology is also key to watch in areasfornew vaccines, gene therapy, regenerative medicine, personalized medicine and predictive medicine.
A. Drug Safety and Supply Chains
Moderator:Dr.AliAlShahrani,ExecutiveDirector,Phar-macovigilance,SaudiFoodandDrugAuthority(SFDA)
Parallel Sessions \ TurkiA.Al-Thunian,Bpharm,MClinPharm,MSc.
Epi,PhD,ActingDirectorof theResearch Infor-matics Department, Saudi Food and Drug Au-thority(SFDA)
https://youtu.be/luXIWLca3ZU?t=218
https://youtu.be/luXIWLca3ZU?t=218
-
24
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
\ Dr.AbudaaliAlmutairi,DrugSafetyExpert,SaudiFoodandDrugAuthority(SFDA)
\ NicolaiSchaaf,ProgrammeManager,StockholmInternationalWaterInstitute(SIWI)
Keywords: COVID-19, Health Care System, SupplyChain, Pharmacovigilance, Real World Evidence, Data Science,Stakeholders,Safety,QualityAssurance,Da-tabases,Antibiotics,AntimicrobialResistance(AMR),Transparency,GoodManufacturingPractices (GMP),Platforms.
Thisscientificpanelregardingdrugsafetyandsup-ply chains had provided an insight on the procedures fordrugsafetymonitoringandhowitmaintainsgoodpublic health outcomes. The panel also had elaborat-edonscientificdriventoolsusedfordrugsafetyandhad shared endorsements that are used to ensure the safeuseofmedication.Thepanelhadalsoprovidedadiscussiononensuring theentire supply chainofmedicine is kept intact to avoid harm to people and totheplanet.Thisis inparticularwiththeissuesofpharmaceutical pollution and antimicrobial resis-tance(AMR).
The panellists presented key points and recommen-dations for thissessionthat include: (1) Real-world evidence is essential to maintaining better health outcomes (2) Pharmacovigilance and post-market-ing activities are important to minimize the risks of medicinal and pharmaceutical products and vac-cines, and especially during pandemics (3) Respon-sible production of antibiotics are crucial to improve global health outcomes and there is a need to have a policy in place to address these issues.
Summary of Key Messages, Lessons Learned and Actions:Real World Evidence: A Saudi Regulatory Perspective (Turki A. Al-Thunian)—ThepresentationhighlightedSFDA’seffortsinbuildinganinfrastructureandreal- worldevidenceintheSaudihealthcaresystem. Nor-mally pharmaceutical companies have been respon-sibleforprovidingdataonthepostmarketingjourneyofdrugsinthemarket,butrecentlyregulators have startedtoinitiatetheirownplatformstogeneraterealworldevidenceduetothehighrelevanceofdataforthe decision-making process. Real-world evidence is notonlyrelevantfromasafetyperspective,butitsrel-evancecanbeextendedtootheraspectsofthedrug
journey that includes effectiveness, assessing drugshortagesandassessingtheriskfactorsthat ledtothe shortage in the health care system.
Therefore in2018,SaudiArabiaestablishedtheNa-tional Saudi Pharmacoepidemiology Database. Chal-lengestheSFDAhadfacedtoimplementthissysteminclude on how adopting electronic health record sys-tems are relatively new, to separate record systems withinonehospital, howdifferenthospitalsusedif-ferent codingsystemsandalgorithmsandamongstwith the validation studies and data completeness. Theyhavealsotestedtoseeiftheirelectronichealthcarerecordsarereadyforadvancedepidemiologicalanalysis amongst with real-world evidence research methodologiesincollaborationwithresearchersfromthe Netherlands and the United Kingdom.
Pharmacovigilance Department Initiatives: Recent and During COVID-19 (Dr. Abudaali Almutairi)—thepresentation highlighted the history of the SFDAPharmacovigilance(PV)department,theSFDAexpe-rience in ADE Reporting Promotion, Proactive Drug SafetyMonitoringofAEsand theSFDA-PVActionsduring COVID-19 Pandemic. In relation to lessons learnedfromCOVID-19,thishadimpacted the work-flow of different market authorization holders and theSFDAsimplifiedtherequirementsbymaintain-ing the compliance to the PV regulations as much as possible. They had accepted PV documents and dis-seminationofriskminimization measures via email, had flexibility in accepting extension requests and performed remote PV inspections for companies. Other actions included the inspection and evalua-tionofhandsanitizersthroughlabtesting, whereas updates on safetywerepublishedon theirwebsite forproductthatdidn’tmeetqualitycriteria.Also,inpreparation for the upcoming COVID-19 vaccines,the pharmacovigilance department in collaboration with the other SFDAdepartments, regulatory bod-iesandMinistryofHealthareworkingoncreatingapharmacovigilanceforthevaccine,amongstwithanactiveplanforthesurveillancetomonitorthesafetyprofilesofthevaccines.
Supply and Demand Side for Responsible Antibi-otics Manufacturing (Nicolai Schaaf)—The presen-tation looked at the environmental impactsofphar-maceuticals and active ingredients, where antibiotics materialize as a risk to human health.StockholmIn-
-
25
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
© UNDP Bangladesh, 2020
ternationalWaterInstitute(SIWI)worksintheareasofwater governance and diplomacy to raise awareness ofissuesinrelationtoaccesstowaterchallengesforinternational policy, which includes the field of wa-ter and pharmaceuticals. While clean water provides positivehealthimpactsintermsofinfectionpreven-tionandreducingthedependencyofantibiotics,itisimportant to recognize that working with antibiotics carry a built-in risk to resistance.
Therefore, the responsibility of antibiotics, drugmanufacturing,emissionsandwaterpollutionneedstobeaddressedduetotheincreasedriskofantimi-crobial resistance.SIWIisworkingwithstakeholdersfrom the pharmaceutical industry, the health caresector, the water sector, wastewater treatment and technology providers to understand who the stake-holders are and what is their responsibility. They have recently released a white paper on Reducing Emissions from Antibiotic Production (REAP) and have formed theResponsible Antibiotics Manufac-turing Platform (RAMP). Current challenges that SIWI faces inrelation to theirprojects in responsi-ble pharmaceuticals include the nature of regula-tions in the pharmaceutical market, access to data transparency, complexities in the supply chain and theconsensusintermsofmanufacturingstandardsforemissionscompliance.Thus,thereisaneedfora better access to information, transparency andcollaboration between stakeholders in order to bet-terunderstandthescale-of-riskforpharmaceutical
emissions in the environment and to conduct appro-priate risk management plans for pharmaceuticalmanufacturing.
B. Supply Chains and Gender
Moderator: LinRogerLi, SeniorManager, StrategicSourcing,SourcingandSupplyChainDepartmentattheGlobalFundtoFightAIDS,TuberculosisandMa-lariaPanelists:
\ MargauxYost,Manager,BSR(BusinessforSocialResponsibility)
\ Natalia Korchakova-Heeb, Managing Direc-tor, SDG.17 Consulting GmbH and Founder,PPPHealth4All
\ Shama Karkal, CEO, Swasti; Chair, Asia Pacif-ic Alliance on Sexual and Reproductive HealthTrustee, Catalyst Foundation
Keywords: Gender, Women, Girls, LGBTIQ, Marginal-izedGroups,HealthAccess,SupplyChains,System-ic Issues, Workers, Pandemic, Policies, Workplace, Investments, Health Access, Communities, Health Products,Businesses,DataScience,Technology,Dig-italization, Innovation.
COVID-19 represents as a fundamental threat topublic health and the health supply chain. It is also important to recognize this has a serious impact on
https://youtu.be/xQ1B9Tz5gOU?t=717
mailto:https://www.siwi.org/publications/reducing-emissions-from-antibiotic-production/?subject=mailto:https://www.siwi.org/publications/reducing-emissions-from-antibiotic-production/?subject=mailto:https://www.siwi.org/what-we-do/ramp/?subject=mailto:https://www.siwi.org/what-we-do/ramp/?subject=https://youtu.be/xQ1B9Tz5gOU?t=717
-
26
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
women, girls and marginalized groups that represent thebackboneofthecurrentandfutureglobalwork-force.Therefore,thispaneldiscussionaddressedonhow international organisations, governments, policy makers, businesses and civil society can respond to thegenderdimensionsofhealthandwell-beingandtofurthercommitintotakingonthisresponsibility.The panellists presented key points and recommen-dationsforthissessionthatinclude:(1) Women, girls and marginalized groups have suffered the most from COVID-19 and special measures are need-ed from both government and the private sector to address these issues (2) there is a strong business case for both governments and the private sector to invest in women’s health as an important part of the global economy and supply chain resilience (3) There needs to be more emphasis focusing on LGBTIQ and inclusion in gender data for better health outcomes (4) With COVID-19 and discussions on digitalization, it is important to recognize 327 million fewer wom-en than men have a smartphone and can access the mobile internet (5) SPHS members shall advocate for gender equity policy making and facilitate cre-ating space for women businesses along the health supply chain from the upstream production to the last mile delivery at the people and community level.Key Summary Messages, Lessons Learned and Ac-tion Points:
COVID-19 Impact on Women and Health Supply Chains (Natalia Korchakova-Heeb)—Thepresentation
highlightedontheimpactsofCOVID-19ongenderandwomen.Somekeyfactsincludeonhow70percentofthehealthcareworkforcearewomenworkinginthefrontlinesofCOVID-19, whereas they had risked their lives, their families and amongst having additionalworkloads to manage due to the crisis. 60percentofwomen’semploymentisintheinformaleconomy with fewprotectionsagainstdismissalandlimitedaccessto social protection. 16percentof theglobalgenderpay gap are leaving women more vulnerable to an eco-nomic downturn due to the pandemic and 84 percent of women business owners have seen a significantdecrease in sales in 2020. Domestic violence has also increased by 25 percent with limited protection mea-suresduringtheperiodofquarantine.
Thisraisesthequestion—howcanwesupportwom-en? There is a clear business case to invest in women consideringmeasuresthatsupportwomenbenefitsthe economy when women are at work. Therefore,supporting measures should be conducted by gov-ernmentstostrengthenthepoliciesandfinanceforwomen, and in particular during the COVID-19 cri-sis. Considering women are three times more like-ly tosuffer frommentalhealthproblemsthanmen,some bestpracticesforbusinesses were presented on preventing stress during COVID-19 for women.Gender smart procurement is also an avenue to sup-port women and multiple methodologies, guidelines, resources and tools were presented by the Interna-tionalTradeCentre (ITC), thePharmaceuticalSup-
© UNDP Bangladesh, 2020
-
27
Third
Sav
ing
Live
s Su
stai
nabl
y: S
usta
inab
le P
rodu
ctio
n in
the
Hea
lth S
ecto
r |
Glob
al F
orum
202
0
plyChainInitiative(PSCI),UnitedStatesAgencyforInternational Development (USAID) and amongst a casestudyexamplefromChile.
Health Supply Chains (Margaux Yost)—There areapproximately 100 to 90 million women in global sup-ply chain jobs which constitute as workspaces where consumer products are cultivated, produced, created andtraded.Also,womenmakeupof62to90percentofthelabourintensivejobsinthesupplychain.AspartoftheBSRWomenandEmpowermentPracticeTeam,thereisaprogrammefocussedonwomen’sempow-erment that specifically caters to women workerswith a low income. As this is an area overlooked by the donor community, this group is considered highly vul-nerable with limited access to health, protection and with a low financial inclusion. Therefore, there is a str
