WHO/Europe brings environmental sustainability to forefront of health systems at meeting in Bonn, Germany


On November 11 and 12, WHO/Europe convened a strategic meeting on environmentally sustainable health systems (ESHS) in Bonn, Germany. Attendees included representatives of 19 European Region Member States, medical and environmental experts, nongovernmental organization leaders and WHO staff. They met to discuss the main elements of a strategic approach towards environmentally sustainable health systems.

The meeting served as a setting to present and debate a draft proposed strategic approach, elaborated jointly by the Division of Communicable Diseases, Health Security and Environment, and the Division of Health Systems and Public Health. The meeting also included an evidence summary, several case studies and field expert presentations.

Essential role of health systems in promoting resilient communities and healthy environments

Setting the tone for the purpose of the meeting, Srdan Matic, Unit Head, Noncommunicable Diseases and Environment at WHO/Europe explained, "Health systems play an essential role in promoting resilient communities and healthy environments."

Participants discussed the importance of ESHS and deemed the strategic direction positive, relevant and timely. Furthermore, representatives of Member State and experts approved the proposed vision, which highlights the relationship between environment and health, and the need to strengthen and improve both simultaneously.

Strategic actions in stewardship, service delivery, resource generation and financing were also approved during the meeting, and consisted of:

  • developing a national environmental sustainability policy for health systems
  • promoting environment and social local assets
  • engaging the health workforce as agents of sustainability
  • strengthening public health, environmental and occupational health services
  • promoting innovative models of care
  • creating incentives
  • promoting sustainable procurement
  • promoting access, management, efficiency and security in the use of resources
  • managing and minimizing waste
  • reducing greenhouse gas emissions
  • minimizing the use and disposal of hazardous chemicals.

Participants suggested an enhancement to the proposed document to provide more evidence, and measurable outputs and outcomes.

Environmental sustainability actions in health systems

Representatives of Member States presented a variety of national examples of environmental sustainability actions in health systems, including:

  • healthcare waste management (hazardous and conventional)
  • intersectoral action
  • environmentally sustainable design, planning and construction of new health care facilities, and renovation of existing ones
  • energy – efficiency and conservation, renewable sources, and combined heat and power
  • water and wastewater
  • radioactive waste
  • sustainable procurement
  • reduction of pharmaceutical waste
  • telemedicine, e-health, mobile health (m-health) and health information systems
  • anaesthetic gases
  • minimization of hazardous chemicals
  • mobility management and low carbon transportation
  • health care workforce capacity building and training
  • a national health systems strategy on environmental sustainability.

Feedback on the event was generally positive and supportive. Tanya Li, Head of Department of Information System of Ecology and Public Health, Republican Centre of State Sanitary and Epidemiological Surveillance of the Ministry of Health of Uzbekistan explained, "The proposed strategy is both inspirational and useful. I will bring it back to my colleagues in Uzbekistan in order to determine how we could integrate it to the programme on health care reform for the period 2016–2020."

Echoing Member States' approval, Kia Salin, Environmental Strategist, External Relations and Innovation Support, Swedish Medical Products Agency said, "The environmental sustainability of health systems is a very important issue, and Sweden would be particularly interested in working with other countries to move forward in the area of sustainable procurement of pharmaceuticals and medical technologies."

Hans Kluge, Director, Division of Health Systems and Public Health said, "Environmental sustainability is a strategic opportunity to further the objectives of health systems, and the concern for the environment is entirely aligned with the values of equity and solidarity that drive WHO/Europe's efforts to promote people-centred health systems."

Future efforts

Participants highlighted their willingness to share information on these and other existing case studies in future efforts. They also called for a continuation of technical work by WHO, specifically the analysis and dissemination of good practices by areas, the identification of knowledge gaps and research priorities, and the facilitation of the exchange of information and experiences among Member States.

Participants also agreed to provide further inputs to the strategic document and evidence basis. They wish to raise the profile of the topic and promote it in the relevant policy processes, including the 66th session of the WHO Regional Committee for Europe and the sixth Environment and Health Ministerial Conference, both to be held in 2016.

Almaty, Kazakhstan, was proposed as the venue for the next meeting on the topic, to be held in 2016. A meeting report reflecting the main discussion, agreements and next steps is in preparation and will be circulated and published shortly.