Reducing the environmental impact of medicines from procurement to disposal
22 November 2022
Ensuring the environmental sustainability of health services and medicines is necessary to safeguard the health of future generations and ensure continuous access to effective medicine. Health managers are key to leading on the green transition and reducing the direct and indirect environmental impacts resulting from emissions and waste within the healthcare sector. They play a crucial role in bringing different actors together to guarantee a joined up, single systems approach. As we strive for excellence in health management and to share best management practices, our White Paper ‘Reducing the environmental impact from procurement to disposal‘ presents strategies, recommendations and case studies that health managers can implement at the various stages of the medicine’s lifecycle.
Medicines are crucial to save human lives and improve wellbeing. However, when prescribed, used, or disposed inappropriately, they can impact human health and severely impact wildlife and ecosystems. There are various ways in which pharmaceuticals impact the environment. Firstly, the medicines and medical equipment supply chain releases large amounts of greenhouse gas emissions. Secondly, wastewater from the production and usage of medicines can be detrimental to wildlife and expedite the emergence and spread of antimicrobial resistance (AMR). It is estimated that there are 33,000 human deaths linked to antibiotic-resistant bacteria in the EU/EEA each year .
Multi-stakeholder and multi-sectoral engagement with the One Health approach across the medicine’s lifecycle is urgently needed to address this issue. So far, existing recommendations and strategies to reduce the environmental impact of medicines have primarily been focusing on the actions that can be taken by industries, community pharmacists, and practitioners. Yet, targeted recommendations for health managers are lacking.
Our White Paper is written from a health management perspective and focuses on the stages of the medicines’ lifecycle that can be influenced by health managers. These include: procurement, logistic planning and distribution, prescription, consumption and use, and disposal. The White Paper exhibits case studies and associated recommendations and best practices that health managers can put in place to help reduce the environmental impact of medicines in these five stages.
 Organisation for Economic Co-operation and Development (2019). Antimicrobial Resistance – Tackling the Burden in the European Union.
The White Paper
Our White Paper presents recommendations that health managers can implement at the various stages of the medicine’s lifecycle:
- Incentivise a standardised data collection at European level about healthcare emissions.
- Establish an EU database of good practices to minimise the environmental impact of medicines.
- Adopt a multistakeholder approach.
- Leverage digital technology to monitor prescription, adherence, procurement and disposal.
- Increase environmental health literacy and green skills of healthcare professionals, patients and citizens.
- Centralise processes in procurement, supply chain, and logistics to favour the purchase of medicines with low environmental impact.
The White Paper also contains 13 case studies highlighting best practices from across the European region.
Management, operations and practice – Discover the #EHMA2023 Tracks
Human capital, professionalism and people management – Discover the #EHMA 2023 Tracks
Human capital, professionalism and people management – Discover the #EHMA 2023 Tracks
31 January 2023
Health systems rely on their workforce. An optimal staff planning, stimulating remunerations and incentives, and appropriate competence building are crucial to staff wellbeing and organisations’ fun...
Strengthening the European vaccine ecosystem: managing the digital transition
What our Members say
I have been active in EHMA since the first years of the '90s and I have seen its evolution from a small association of members interested in sharing knowledge on health management practices to the current status of reference and advisory key player for EU, health systems and organisations, stakeholders associations, industry and universities. EHMA is now a unique knowledge hub, policy advisor, community of practice and network of best in class organisations involved in health policy and management. A place where health managers can build their competences, policy-makers and stakeholder associations envision how to implement and sustain change through health management, industry leaders understand how to engage more effectively with health organisations and systems. The right place to nurture and grow health management capabilities and capacity for every stakeholder of health systems.
Prof. Federico Lega, University of Milan, Italy
Health management has a crucial function in shaping public health and health system challenges. The Medical University of Varna, Bulgaria had success in collaborating with EHMA on EU-funded projects that has resourced us to create new health management competencies for the future workforce. In addition to all classical definitions, health management is a science dealing with individuals, groups, and society at large. It is an art contributing to the beauty of our lives and an interactive communication process at all levels of institutions and human energy. I have also had the pleasure to chair the South Eastern European Special Interest Group which gives members a space to discuss and tools to address how health systems are managed in our regions.
Prof. Todorka Kostadinova, Medical University of Varna, Bulgaria
I enjoy the high level of interaction and engagement in EHMA’s activities, in particular during the annual conference where the panel discussions are rich and well prepared. As a hospital manager and professor of health management, EHMA motivates and inspires me to be creative. You go back home feeling energised from seeing old friends and making new connections, as well as being convinced of serving as EHMA’s ambassador. It’s a strong feeling of interdisciplinary engagement, but it also feels like being part of family-like community.
Prof. Sandra C. Buttigieg, University of Malta, Malta
EHMA is a pre-eminent organisation for everyone working in planning, managing and delivering health services across Europe. As a long standing member of EHMA I have always been impressed by the vibrant community of managers, researchers and academics it has created and by the many opportunities for sharing knowledge and funding opportunities it has brought to its members. Its international scope is impressive and its impact is often felt in management and research across European and national health systems.
Prof. Axel Kaehne, Edge Hill University, UK
Health workforce has become more essential in operating, managing and maintaining health systems lately, particularly in crisis and emergency situations. European healthcare professions and the workforce need to be high on the agenda of managers and decision makers. The Health Services Management Training Centre, Semmelweis University in Hungary is a longstanding EHMA member, because it connects us with collaborators and experts, with whom we can have complex debates, from whom we can learn and at the end find solutions in various challenging fields of healthcare management.
Dr Eszter Kovács, Health Services Management Training Centre, Semmelweis University, Hungary
As a hospital administrator and health management professor, I see on a daily basis that the healthcare challenges require talented and skilled managers to transform it. the EHMA membership has been beneficial to bring healthcare management research and education to the demanding healthcare services world, promoting healthcare management competencies and knowledge creation.
Dr Alexandre Lourenco, APAH - Association of Portuguese Hospital Managers, Portugal
Many healthcare systems in Europe and beyond are facing similar challenges which require innovative and creative solutions. EHMA’s annual conference, webinars, Programme Directors’ group and other activities and resources provide incredible opportunities for networking, connecting and sharing experiences. A distinct feature of EHMA is the diversity of members with representation from many countries, sectors and different communities of practice – academic, policy-makers, practitioners, managers, leaders and students. The annual conference is a highlight in the calendar year, offering a friendly, fun and learningful environment for emerging and established members to engage, collaborate and meet up with old and new friends. I am proud to be a member of the EHMA Board.
Prof. Ann Mahon, University of Manchester, UK
Society evolution, pandemics and ageing modify health needs. So, health policies and services are to change dramatically. EHMA, through webinars, workshops and annual conference provides an excellent insight to a professional changing world, favouring closeness to management innovation and the protagonists of these changes. As a primary care services’ manager, participating in EHMA activities is really worth it and allows to involve oneself in the innovation processes.
Dr Antoni Peris Grao, Consorci Castelldefels Agents de Salut (CASAP), Spain