Health and the Supply Chain Have Their Day at COP28

Just over 11 years ago, Superstorm Sandy hit the New York City and New Jersey coastlines. I still recall the awe and the pride I felt as my friend Christopher O’Connor, then president of Greater New York Hospital Association Ventures and Nexera, provided a firsthand account of the measures taken to evaluate patients in the wake of the historic weather event.  In the past decade, weather- and climate-related hospital evacuations have become more commonplace as a result of more frequent and severe hurricanes and wildfires. Healthcare workers are to be commended for their emergency preparations and effective responses when evacuations are required; hospital administrators, meanwhile, are investing in mitigation measures, such as installing iron and steel flood barriers and purchasing high water trucks that can move people and products in the event of severe flooding.

Given the rise in disasters and the not so insignificant steps being taken to respond, it is surprising that this year’s COP28 climate conference was the first time there was a day dedicated to the relationship between climate and health. While the international forum focused considerable attention on the developing world, where resources are far more limited, there is no shortage of challenges in developed countries like the United States. According to Science Daily, in 2022 researchers at the Harvard T.H. Chan School of Public Health found that many hospitals along the Atlantic and Gulf Coasts are at risk of flooding, even from relatively weak storms. Despite the precautions taken, such as building flood barriers and moving sensitive equipment to higher floors, hospital operations are at the mercy of the surrounding infrastructure. The researchers identified 18 metropolitan areas where roads leading to hospitals are at risk of flooding, making it difficult, if not impossible, for patients, healthcare workers, and supplies to reach the facilities.

Ironically, while climate-related weather events are threatening hospital operations, they are also increasing the demand for services. As an example, according to an article from CBS News, 2023 was declared the hottest year on record; just ask those living in Phoenix, where temperatures topped 110° on 54 days, breaking a previous record set in 2020. Beyond the usual health impacts, such as heat exhaustion, Phoenix area hospitals saw a significant increase in the number and severity of burns from individuals -- often the elderly with medical conditions --  who fell on extremely hot asphalt.

Those attending Health Day at COP 28 noted other health-related consequences of climate change, including a higher potential for infectious diseases and other diseases attributed to worsening water and air pollution. Climate change can also threaten access to the social determinants of health, such as employment and housing, disproportionately impacting the poor and more marginalized communities.

Sadly, just as the demand for healthcare services increases with climate change, the use of more healthcare operations also contributes to climate change. Globally, hospitals and other healthcare facilities account for about 5% of the world’s carbon footprint, with some estimates as high as 10% in the U.S.

While fighting climate change is a multi-stakeholder battle, supply chain professionals are once again on the cutting edge, with 70% of healthcare related greenhouse gas (GHG) emissions linked to the supply chain.  Given the severity and urgency of the issue and its ties to supply chain, here are some steps supply chain professionals can take today:

1.  Ask your suppliers what they are doing to reduce the greenhouse gas (GHG) emissions and other negative environmental impacts, such as plastic use, in their product lifecycle.  Consider all aspects, including production, shipment, use, and disposal.  
2. When data is available, choose more environmentally friendly products. Anesthesia gases are a great place to start, given the significant difference in GHG emissions between different products.
3. Consider how changes in business practices between you and your suppliers can reduce GHG emissions, such as consolidating orders to reduce shipments.  
4. Work with finance to understand the total lifecycle costs of products to justify higher per unit acquisition prices that can have a lower total cost of ownership. Also, remember that more environmentally friendly products are not always more expensive.
5. Collaborate with clinicians to:
   
   1. Identify opportunities to use fewer disposable and single use products without sacrificing clinical quality. Help clinicians by providing peer-reviewed and other substantiated evidence to support decision making. 
   2. Capture actual product utilization using unique device identifiers (UDIs) to:
      
      1. Optimize inventory levels to reduce expired inventory.
      2. Clean up procedure cards and eliminate waste from products opened but not used.  
      3. Support real world evidence generation to help identify and reduce use of medical procedures and products that deliver no value.  
6. Ask senior leadership about what their environmental priorities are (e.g. investing in climate mitigating strategies) and offer to provide procurement and logistics expertise where applicable.

At COP28, more than 120 countries, including the United States, signed the Climate and Health Declaration, which supports a two-pronged approach to transform “health systems to be climate-resilient, low-carbon, sustainable and equitable and to better prepare communities and the most vulnerable populations for the impacts of climate change.”  Once again, the world will turn to supply chain professionals to help lead this charge, further reinforcing the power of procurement and effective resource management in fostering the resiliency of the health system as a whole and the populations served.