The reality of failure is a reality physicians must face. There’s failure in the unnecessary death of a patient, in their suffering, and in their loss. But the taste of failure becomes even bitter when it is because of things we cannot control, like poverty, pollution, and gender inequality.

But why do we think that way? Are we really powerless or ill-equipped to control these systemic factors? No! Of course not.

As the healthcare community (and as citizens), we have the ability to not only cure disease, but also to actively combat the social and environmental factors that contribute to it. We can all help create a world which not only saves individual lives at present, but prevents future harm to the community in the future. This is a world of sustainability.

Here comes “Saving Lives Sustainably Asia Forum 2018: Sustainable Production in the Health Sector“, an innovative multi-sectoral conversation for more responsible and comprehensive healthcare. The forum is hosted by ADB, UN SPHS, and other collaborators. I am incredibly happy to have been a small part of it.

Crossing health and environment

I am drafting this blog post while listening to a day 2 presentation on eco-innovative packaging. Ms. Lena Stig, from PVCfreeBloogBag in Sweden, is discussing how her company removes the need for harmful PVC in blood bag production. Mr. Sourav Mitra, from Mylan Laboratories Limited in India, is talking about pharmaceutical packaging solutions: non-halogen films, paper-based laminates, reusable plastic pallets, and more.

It is easy to think: okay, reducing waste is great for the environment. How is that good for health too?

In some ways, nobody really cared about sustainability when it was just about the environment alone. People and countries started caring when we quantified the cost of people dying because of the environment, with charts on the economic costs of morbidity and mortality.

This is because health and environment are inextricably linked. Climate change directly and indirectly impacts health –it exposes the shelterless to harsh and unliveable conditions; it drives energy prices up and further traps people in health poverty. Outdated waste management solutions, including filling crowded landfills and incinerating waste, only contribute to the cycle. We overburden the earth and the people with our current “solutions”. Environmental failures drive people sick, poor, and unhappy.

“If we actually quantified, if we actually invest in sustainable procurement, how many lives can we save?” was the provocative question of Dr. Eduardo P. Barzon (Principal Health Specialist, ADB) during the closing plenary.

Health, industry, and public policy

One of my favorite panel discussions for the whole forum was Day 2’s “The Circular Economy and the Cradle-to-Cradle Approach.”

Imagine, for a moment, the antiretrovirals delivered en masse to low income and isolated areas by foundations like UNDP. These drugs, like TDF/3TC/EFV, are taken as long-term courses. Have you ever thought of the waste associated with pill bottles? How much money is lost and how much is created due to the irresponsible disposal of pharmaceutical packaging products?

Companies like Mylan Laboratories Limited are working on three-month instead of one-month bottles to prolong the use life of packaging products. NHS Scotland is a pioneer in studying polymers of choice in healthcare packaging for easier materials recovery.

…but not all organizations take these kinds of initiative. This is where public policy comes in.

Governments and big buyers can use the power of procurement to influence responsible production. Instead of just demanding for quality medicines, agencies like the FDA and WHO can demand for sustainability as well. If you’re not sustainable, you’re out.

This is the standing call of Mr. Sanjay Kumar (General Manager, DFCCIL, Ministry of Railway, India). This is the “transformative quality of the procurement system“, as Mr. Ramon San Pascual (HCWH-Asia Director) puts it. This is just one of the many ways the public sector can work with the private.

Demand drives change. That demand needs to come from all stakeholders: governments who have the power to require transitions to circular economy, corporations which see the business value of change, and end users like us who suffer the consequences of the unsustainable linear economy.

Management in health – it’s not a mystery

“What is the role of regional and developmental banks in financing these innovations?” in one panel, and “what is a viable alternative to direct on-the-ground auditing to ensure adherence to sustainability standards?” in another.

I cannot imagine the mindset of people who believe management and business have no place in health. Health is “universal” also because it permeates every aspect of our life, and it is affected by all imaginable systems in return. A health app launched in Cameroon gave women access to critical health information, targeting multiple Sustainable Development Goals in one intervention.

We need management not to earn from health, but to earn for it –by influencing and organizing private industries, consumer behavior, public policy, poverty solutions and more.

First-time forum-goer! #Me #AsiaForum2018

 

The last health forum I went to was Forum 2015: Global Forum for Research and Innovation for Heath hosted by the Council on Health Research for Development, Department of Science and Technology, and Department of Health. I don’t think that counts, though, since I was too busy with the Global Health Debates.

This is the section where I give generous and much-deserved thanks to the Innovation Management & Business Association (i.e. Kuya Dex and Ate Via) for the opportunity to serve and to participate. I cannot stress enough how happy I am that the Ateneo School of Management and Public Health is playing a role in leading the next generation of systemic change for health.

Thank you as well to my fellow IMBA volunteers, and the volunteers from 2030 Youth Force in the Philippines. Everyone was so chill that I barely felt my social anxiety.

Lastly, thank you to ADB and the organizers… for the awesome crinkles, the cheaper Starbucks drinks, and the random book sale. The food was really great too.

I definitely enjoyed the experience and the insights I gained. I look forward to attending more fora, summits and conference.

Signing off
Jari Monteagudo
Rapporteur, #AsiaForum2018