Environmental sustainability for post-COVID healthcare
By Professor Jason Snape, Global Head of Environmental Protection at AstraZeneca
The COVID-19 pandemic has, in a short time, inflicted huge personal suffering and had a long-lasting economic and social impact in every country around the world. As our attention starts to shift to the future and to economic recovery, how can we begin to move forward?
Connecting healthy business, people and planet
A healthy planet is essential for promoting human health. All those with the power to make changes need to come together to act on an environmentally sustainable economic model to deliver global health. With the Lancet Commission citing climate change as the century’s greatest global health opportunity, we are taking action across all our activities to contribute toward a healthy planet and healthy people:
Greenhouse gas reduction
Greenhouse gases from human activity represent the major contributor to climate change in the past 50 years. We recognise there is a plethora of opportunities to improve global health through greenhouse gas reduction, so addressing decarbonisation in our own organisation and throughout our value chain is a business imperative. Our Ambition Zero Carbon, unveiled in January 2020, brings our plans for complete decarbonisation forward by more than a decade through a raft of initiatives, delivering a carbon negative value chain across all sites and suppliers by 2030. Our targets are verified in line with the science of climate change, working alongside internationally recognised bodies such as Science Based Targets Initiative and the Sustainable Markets Council to accelerate the transition to a global decarbonised economy.
Product environmental stewardship
Society deserves products with minimal environmental impact, without sacrificing safety or efficacy. Consequently, we evaluate all materials and processes used throughout product development, from discovery to end of life. In addition, we also address other areas including responsible R&D, sustainable supply chains, water stewardship, safe manufacturing discharges to surface waters, and waste minimisation through adopting a circular mindset. A key priority contributing to our climate agenda is switching to next-generation propellants with near-zero global warming potential in our asthma and COPD devices and transitioning to a 100% electric vehicle fleet.
With almost one third of people globally without access to clean drinking water, we are taking a broad approach to water stewardship, reducing the water used at our sites and ensuring the quality of the water we put back into the environment. We’re also looking at the impact of climate change in water-stressed areas – where the need for responsible water management is even more important – to understand the local risks in the places and communities where we operate and to future-proof our response. Together with experts from the global water stewardship team at World Wide Fund for Nature (WWF) Sweden, we have initiated a project to analyse the physical, reputational and regulatory water risks within WWF’s Water Risk Filter across our global operations, to establish how we can strengthen our water stewardship programme.
Pharmaceuticals in the environment (PIE)
Pharmaceuticals primarily enter the environment through human excretion and improper drug disposal, which has a negative impact on wildlife and human health. To help determine the risks and ensure safety throughout the product lifecycle, we've made environmental data transparent for all our products, we keep these risk assessments up to date through ecopharmacovigilance, and we are the only company to have safe discharge targets in our annual report for our own production sites and those of our suppliers. Our PIE statement outlines our industry-leading approach to ensuring the environmental safety of our medicines.
Waste can pollute and have a negative impact on the planet and people’s health. We look at waste not only in its end state, but also how it was produced – focusing first on prevention and reduction. Our approach makes sure that where waste cannot be avoided, we explore every option to ensure it can be repurposed and reused by others. Reducing waste lowers the risks to people and the environment and maximises resource efficiency, balancing the use of natural resources with what can be sustainably regenerated. In 2019, initiatives across our sites replaced over two million pieces of plastic cutlery with compostable or reusable alternatives. We signed the UK National Health Service (NHS) Plastics Pledge across all our R&D and operations sites to remove specific items of plastics.
Working with others to drive societal change
The need to connect the health of people with the planet’s health on the global agenda is key to driving more sustainable solutions for healthcare, given the vast cost to our health of air, water and soil pollution as reflected by an estimated nine million premature deaths globally. By supporting healthy environments, we contribute to a healthier ecosystem and could slow – even prevent – the incidence of disease on a global scale.
At a local and national level, proactive disease prevention takes precedence as we help to broaden access to healthcare, with screening and early diagnosis programmes to tackle high-burden non-communicable health conditions, particularly in low- and middle-income countries that currently lack the necessary healthcare infrastructure and have been further impacted by Covid-19. We are working towards a future where all people have access to sustainable healthcare solutions for life-changing treatment and prevention, through awareness and education programmes, training healthcare professionals and activating health facilities. To achieve this, all stakeholders in global health will need to review processes and resources to identify where we can innovate, where we can remove, reduce, reuse and recycle materials, and where we can ensure that need is matched to resources.
For us as a company, this means adopting an end-to-end approach to sustainable medicines development, from discovery to end of life, with circularity at every stage. It’s also why we’ve connected our company targets to the 17 Sustainable Development Goals laid down by the United Nations (UN) 2030 Agenda for Sustainable Development and to contribute directly at that level.
In practice, this means understanding the biggest issues we face as a global community and measuring business success through our contribution to healthy people and a healthy planet, whether that is sustainable management and efficient use of natural resources, reducing waste generation and promoting sustainable procurement practices, investing in disease prevention initiatives, or cutting premature death from non-communicable diseases (see Figure 1).
Figure 1: Our company approach to sustainability
It’s also why we – and other leading enterprises – are setting ambitious targets that go beyond the aim set by governments around the world to be carbon zero by 2050. Our pledge is to be carbon zero by 2025 and carbon negative across our value chain by 2030, using our voice as a purpose for good with governments and in the communities in which we operate.
Our 10-year strategy and targets for carbon, energy, water and waste, were set in 2015: decoupling economic growth from natural resource depletion for the first time. Now, Ambition Zero Carbon takes this to the next level – innovating, redesigning and rethinking our operations, our supply chain and care pathways and taking those learnings to the broader community.
Currently, pharmaceuticals are the only class of compounds that are approved irrespective of environmental hazard and risk where the societal benefit is assumed to always outweigh any environmental impact. It’s essential we identify any environmental concerns as early as possible, so we can mitigate these risks and ensure patient access to medicines does not compromise environmental protection. It’s why we are leading efforts to prioritise which legacy pharmaceuticals authorised before the current environmental testing requirements need to be evaluated for their environmental impact. We are also developing innovative approaches where environmental considerations can be integrated alongside traditional measures of safety and efficacy.
The enormity of the task at hand is without question. And the financial and regulatory hurdles can feel prohibitive. Collectively, we must collaborate and co-create to deliver the innovation, interconnectivity and infrastructure that will put societal and environmental health at the forefront of economic prosperity.
The shift to a more sustainable future requires a systems-level holistic view. Climate Week NYC 2020 presents a significant opportunity, as it allows us to collaborate beyond our own industries, co-invest rather than compete for natural resources to meet business demand, and work with governments to ensure the right infrastructure, fiscal environment and long-term vision is in place to enable transformational change.