Health Care Without Harm (HCWH) is an international nongovernmental organization (NGO) that works to transform health care worldwide so that it reduces its environmental footprint, becomes a community anchor for sustainability, and a leader in the global movement for environmental health and justice.
With regional offices on four continents, partners around the world, and global and regional initiatives, HCWH is leading the global sustainable health care movement.
HCWH’s areas of work include sustainable healthcare waste management, green building, the substitution of hazardous chemicals used in hospitals with safer alternatives, reducing health care’s climate footprint and working with the health sector to advocate for a healthy climate.
Health Care Without Harm comprises:
- Four regional offices (based in Buenos Aires, Brussels, Manila, and Washington, DC) that develop regional work and initiatives in Latin America, Europe, South East Asia, and the United States, respectively. A Global staff also facilitate programs with global impact, including (but not limited to) Global Green and Healthy Hospitals - a worldwide network of hospitals and health systems acting together for environmental health.
- Strategic partners that represent our interests and lead the development and implementation of HCWH-related work in Australia, Brazil, China, India, Nepal, and South Africa. Practice Greenhealth, a nonprofit health care sustainability membership organization, and Greenhealth Exchange, a green purchasing cooperative, both based in the United States.
"First Do No Harm" ... Together with our partners around the world, Health Care Without Harm shares a vision of a health care sector that does no harm, and instead promotes the health of people and the environment. To that end, we are working to implement ecologically sound and healthy alternatives to health care practices that pollute the environment and contribute to disease.
For example, the incineration of medical waste is a leading source of dangerous air pollutants such as dioxin and mercury, and the use of hazardous chemicals indoors may contribute to the high rates of asthma among health care workers. The huge scale of the health care sector worldwide means that unhealthy practices — such as poor waste management, use of toxic chemicals, unhealthy food choices and reliance on polluting technologies — have a major negative impact on the health of humans and the environment.
The good news is that the health care sector can play a leading role in solving these problems. Due to its massive buying power, and its mission-driven interest in preventing disease, the health care sector can help shift the entire economy toward sustainable, safer products and practices.
Health Care Without Harm is at the center of this work to transform the health care sector worldwide, without compromising patient safety or care, so that it is ecologically sustainable and no longer a source of harm to public health and the environment.
Health Care Without Harm began in 1996 after the U.S. Environmental Protection Agency identified medical waste incineration as the leading source of dioxin, one of the most potent carcinogens.
In response to this serious problem, 28 organizations came together in Bolinas, California to form the coalition Health Care Without Harm (HCWH). Since then, HCWH has grown into a broad-based international coalition of hundreds of organizations in 52 countries, with offices in Arlington, VA, Brussels, Buenos Aires and Manila.
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Over the last two decades, Health Care Without Harm has had a significant impact on the health sector by working with health professionals, hospitals, major health systems, ministries of health and UN organizations to reduce the sector’s environmental footprint and mobilize it as an advocate for environmental health and justice. Our successes include:
- Starting with one hospital in Boston in 1996, and scaling the effort across the globe years, HCWH and its partners waged a successful 15 year campaign to phase out mercury based-medical devices and substitute them with safe, affordable, accurate alternatives. As a result, we have virtually eliminated the market for mercury-based medical devices in the United States, achieved a ban mercury thermometers and blood pressure devices in the European Union, and secured national or provincial phase in countries such as Argentina, Chile and Brazil to the Philippines, South Africa and Nepal, while working with thousands of other hospitals across the world to switch to safer alternatives. This global organizing, undertaken in collaboration with the World Health Organization and others, succeeded in securing language in an international treaty, the Mimamata Convention, mandates the phase-out of mercury containing thermometers and blood pressure devices by 2020. For more information, visit: https://noharm-global.org/issues/global/mercury-health-care.
Health Care Waste Management
- HCWH is partnering with the United Nations Development Program (UNDP) and the World Health Organization in a project funded by the Global Environment Facility to disseminate sustainable healthcare waste management in four African countries: Ghana, Madagascar, Tanzania and Zambia. Starting in early 2018, project hospitals will treat their waste with autoclaves manufactured in South Africa and designed specifically for the African situation. Hospitals will also substitute mercury-containing medical devices, develop recycling programs and one will establish a biodigester to dispose of food waste and pathological waste. The project builds on the success of a previous one which improved healthcare waste management in eight countries in Africa, Asia and South America
- HCWH has created a database of non-incineration healthcare waste management technology suppliers and products around the world. This provides healthcare professionals with an overview of the options available to them and includes technologies including heat-based disinfection, needle destroyers and tissue digesters.
- HCWH and Nepali strategic partners, HECAF, have been piloting the use of biodigestion as a method of treating organic wastes, particularly food and pathological waste. They are mixed with water in underground concrete domes seeded with cow dung, where bacteria break them down and generate methane-containing biogas, which can be used for cooking or water heating. The digesters are low-maintenance, and by capturing the methane that would be generated as these materials rot for use as a fuel, they reduce the greenhouse gas emissions of the waste stream.
- HCWH contributed to key international reports such as the UN Special Rapporteur’s report on hazardous waste and human rights, UN Environment’s compendium of health care waste treatment and destruction technologies and co-authored the ‘Blue Book’, WHO’s guidance for all governments on health care waste management. Our experts serve as leading authorities on sustainable health care waste management in international policy fora.
Sustainable procurement of health products and services
- As the UN was adopting the Sustainable Development Goals (SDGs) in 2015, UNDP and Health Care Without Harm (HCWH) began a joint project to integrate sustainable criteria into UN health sector procurement with the support of the UN Foundation and the Skoll Foundation. Among the highlights of our joint work to date, are a supplier engagement strategy, and systematic evidence reviews to develop a list of chemicals of concern that will guide GGHH members and Ministries of Health to substitute hazardous substances when these chemicals appear in healthcare products and materials. We are also producing guidance documents and training for procurement officers on how to integrate sustainability into the procurement of products that the UN and HCWH member hospitals buy for health programmes.
- These efforts are just the beginning. UNDP holds the secretariat of the UN Sustainable Procurement in the Health Sector (SPHS) initiative. This initiative brings together UN agencies and global health funding institutions to promote sustainable procurement in the health sector and evaluate criteria for procurement to reduce greenhouse gases, conserve resources, select less toxic products and publish tools and resources. Through SPHS, the outcomes and outputs of the UNDP-HCWH project have the potential to scale across the UN system health purchasing practices, which exceed $5 billion every year.
- The results of the UNDP-HCWH project are also set to synergize with sustainable procurement work HCWH has been developing in the health sector in the United States and Europe for the past 20 years, and scale across HCWH’s Global Green and Healthy Hospitals network.
- In recent years, HCWH has established itself as a world leader on climate change and health. We organized the first Global Climate and Health Summit at COP17 in Durban, South Africa; helped establish an international coalition of health organizations, the Global Climate and Health Alliance; and co-authored with WHO a ground breaking discussion document on how health care can become more climate smart—all in 2011. Since then, HCWH has focused on embedding a low carbon framework based on mitigation, resilience and leadership strategies in hospitals, health systems and international health organizations and financial institutions around the world. We have developed measurement tools, case studies and a framework -the 2020 Challenge- that can help hospitals and health systems measurably more toward low-carbon health care delivery. And we have convened health care leaders to develop shared strategies at several global fora, including the Paris Climate Conference.
- HCWH’s Healthy Energy Initiative has helped educate and mobilize Health sector leaders in seven countries to advocate for a move away from fossil-fuel based energy development, particularly coal, and towards clean, renewable energy options.
Building a Global Organization and Network
- While HCWH started in the U.S. in 1996, it quickly spread around the world. Over the last twenty years, we have created a deep well of expertise and helped generate a worldwide health care movement for environmental sustainability. We now have offices in four continents, strategic partner organizations in several other countries, and a global coordination team- all brimming with committed staff people dedicated to achieving our mission.
- It is not only staff people and strategic partners that make up HCWH. Since 2011, we have been building a worldwide network of hospitals, health systems, health care facilities and health organization called Global Green and Healthy Hospitals (GGHH). In 2017, the GGHH network experienced record growth with both the number of institutional members and the hospitals and health centers represented by them increasing by over 30%. GGHH has now 1,005 members in 51 countries on 6 continents who represent the interests of over 32,100 hospitals and health centers. Members are using innovation, ingenuity, and investment to transform the health sector and foster a healthy future for people and the planet.
- GGHH is based on a comprehensive framework for moving the sector toward more environmentally sustainable healthcare and fostering leadership for environmental health. GGHH has published a series of guidance documents and dozens of case studies from around the world, while building global online collaboration platform that allows members to collaborate, crowd source solutions and measure progress as we all move together to help make this planet a healthier place to live.
GGHH is also challenging its network to commit to reducing their environmental footprint via a new initiative: the Green Health Challenges, a data-driven initiative, designed to help healthcare organizations commit to sustainability goals and track their own environmental projects and efforts.