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22nd July 2024
A toolkit has been launched by the Royal College of Physicians (RCP) suggesting a range of everyday steps physicians can take to help the NHS reach its net zero goal and mitigate the risks of climate change.
The Green Physician Toolkit also brings together the evidence showing the impact of climate change on health, in order to educate and raise awareness of the issue among physicians. Case studies from across the NHS showcase how physicians can adopt these actions into their day-to-day practice.
‘Changes to clinical practice and how care is delivered, whether large or small, will make an important contribution to reducing the environmental impact of the health service‘, the RCP said.
The measures suggested by the RCP that physicians can take to help mitigate and adapt to the impacts of climate change include:
The NHS is responsible for around 40% of the UK’s public sector emissions and 4% of total emissions and the health service in England has committed to reaching net zero on all direct emissions by 2040.
The RCP said that all physicians have a vital role to play in helping the NHS reach this goal – and that changes to clinical practice and how care is delivered, whether large or small, will contribute to reducing the environmental impact of the health service.
It added that supporting patients to understand how climate change will affect their health is particularly important for older patients, young children, pregnant women and those with long-term health conditions like cardiovascular diseases and asthma.
Professor Ramesh Arasaradnam, RCP academic vice president, said: ‘Those working in the NHS will be some of the first to see the health effects of climate change, if they have not done so already. The need to act has never been more urgent and we hope that our Green Physician Toolkit will support the physician community with small steps that can make a difference.
‘It can of course be challenging to prioritise sustainability at a time when there is very high demand for clinical care, but we have to keep in mind that reducing climate change and its health impacts is part of reduced pressure on the NHS in the long-term.’
RCP special adviser on sustainability and consultant nephrologist, Dr Mark Harber, reiterated this point and added: ‘The priority for NHS staff will always be giving patients the best possible care – especially in the current context of high pressure and growing waiting lists. But the health impacts of climate change are increasingly visible, and as healthcare professionals, it would be irresponsible to ignore the increasing impact that climate change will have on patient health. It is important to support patients in mitigating the risk to their health.’
Earlier this year, a sustainability project aiming to reduce the waste being incinerated in operating theatres by 215kg a year was launched by University College London Hospitals NHS Foundation Trust, along with an initiative to replace single-use hats with named reusable fabric hats for staff working in operating theatres.
9th May 2024
The European Congress of Clinical Microbiology and Infectious Diseases is one of the largest annual global gatherings of experts focused on a single topic. This year it has rebranded, emerging as the European Society for Clinical Microbiology and Infectious Diseases (ESCMID) Global congress. Here, Gerry Hughes reports on the key themes and highlights from the congress such as AI, climate change and AMR.
With hundreds of invited speakers, the ESCMID Global 2024 gathering in Barcelona, Spain (27-30 April), welcomed approximately 16,000 delegates for five days of knowledge exchange, collaboration and innovation.
As in previous years, antimicrobial resistance (AMR) was a topic of concern among speakers and delegates alike, with issues such as artificial intelligence (AI) and climate change also high on the congress agenda.
During ESCMID Global, an entire study day was dedicated to exploring the intersection of data science, machine learning and infection management. While AI is not a new concept, several presentations explored the use of large language models (LLMs) in clinical practice, which is showing increasing promise.
Dr Raksha K. Bhat, head of department – central laboratory and consultant microbiologist and infection control officer at St Martha’s Hospital, Bengaluru, India, showcased her work with ChatGPT in the clinical microbiology laboratory.
By evaluating Gram stain reports from over 7,200 retrospective sputum samples, ChatGPT was tasked with providing clinical management recommendations. Measuring five qualitative aspects – including accuracy and clinical relevance – of ChatGPT’s performance against human evaluation of these samples, it achieved an overall assessment score of 3.5 out of 5.
Although promising, there are challenges—such as the need for specific prompts during the training of the model and the absence of guidelines for integrating emerging AI technologies into clinical practice.
Dr Bhat posed a question at the beginning of her ESCMID talk: ‘Should clinical microbiologists pack their bags?’ The results of this study suggest not yet, and that AI is currently best placed to complement, rather than replace, clinical expertise.
The 2024 ESCMID Lifetime Achievement Award winner, Professor Evelina Tacconelli, director of the Infectious Diseases Section at Verona University Hospital, Italy, introduced a brand new innovation in the Value-Dx Clinical Algorithm.
This collaborative effort between clinical, academic and industry stakeholders aims to curb inappropriate antibiotic use for community-acquired lower respiratory tract infections.
Leveraging machine learning and a meta-analysis of point-of-care tests, the algorithm assists clinicians in managing common respiratory infections. Professor Tacconelli envisions a future where this process is automated, seamlessly integrating evidence collation and infection surveillance data.
Her vision aligns with ESCMIDs aspiration for high-quality studies to inform clinical practice, and she anticipates AI reducing the time between study publication and guideline integration in the future.
A presentation from Professor Ilan Schwartz, associate professor of medicine in the department of medicine at Duke University School of Medicine, US, took a sobering turn, highlighting AI’s potential for harm.
Opening his talk on LLMs, he noted that according to the World Economic Forum, misinformation and disinformation are currently the top short-term global risks, ahead of extreme weather events.
In a recent publication on this topic, Jin and others argue that more engagement is required between the medical, scientific and local communities, addressing issues such as trust, stigma and scientific literacy to tackle misinformation and disinformation.
Professor Schwartz highlighted the destructive capabilities of AI as reported recently in the BMJ. In that study, LLMs were successfully prompted to generate health disinformation on two topics: sunscreen as a cause of skin cancer and the alkaline diet as a cancer cure.
He also demonstrated the ease with which he could generate a ‘deep-fake’ video for free and with no training on how to use the software.
One perhaps unexpected aspect of climate change is the increasing release of ancient pathogens to the environment. Professor Jean-Michel Claverie, emeritus professor at the School of Medicine of Aix-Marseille University, France, described his research in isolating ancient viruses from Siberian and Russian permafrost.
This frozen soil acts as an ideal preservation medium for infectious pathogens because it lacks light and oxygen. However, as the planet warms, the permafrost thaws, releasing these ancient viruses into the atmosphere.
In 2014 and 2015 Professor Claverie’s team revived a 30,000-year-old virus, leading to media attention about so-called ‘zombie viruses’. A recent publication by this team describes isolation and characterisation of 13 new viruses isolated from seven different ancient Siberian permafrost samples.
Professor Claverie advised that large-scale industrial projects near thawing permafrost areas should have on-site medical surveillance to detect any emerging pathogens. Indigenous populations in these regions should also be involved in monitoring, he said.
In another talk at ESCMID Global on the interplay between land degradation and climate change, Professor Kris Murray, professor of environmental change and health, and co-director of the centre on climate change and planetary health at the London School of Hygiene and Tropical Medicine’s Medical Research Council Unit The Gambia, UK, described how climate change and biodiversity loss impact the spread of zoonotic diseases.
He showed how even small changes in temperature and rainfall can affect disease ecology, altering incubation periods and growth rates. For instance, zoonotic viruses such as dengue are finding increasingly suitable breeding and survival conditions due to climatic shifts.
Land use also plays a significant role. In south-east Asia, people working in agricultural land are more likely to be infected with disease-causing pathogens. Murray welcomed mitigating measures addressing land degradation. However, he warned that impact of these efforts varies substantially, and evidence remains scarce regarding their direct effect on reversing disease spread.
In times of global crisis, like the threat of AMR or the Covid-19 pandemic, scientists and healthcare professionals play a crucial role in communicating trusted and relevant information to the public. But translating complex medical and scientific advice into friendly and easy-to-understand content is a challenge.
Professor Siouxsie Wiles, a microbiologist from the Bioluminescent Superbugs Lab at the University of Auckland, New Zealand, took up that challenge.
In her session at ESCMID Global, Professor Wiles discussed innovative ways to engage with the public beyond traditional media responses. One impactful approach of hers was teaming up with illustrators and local communities to produce messaging in graphic interchange formats (GIFs).
Joining forces with cartoonist Toby Morris, they produced GIFs on topics such as flattening the curve and the power of individual actions in infection control. Over 70 graphics, including alternatives to handshakes and explanations of mRNA vaccines, were then created and published online by The Spinoff, a New Zealand news outlet. Dr Wiles also made sure these visuals were accessible to all by sharing them under a Creative Commons license.
However, not all experiences have been positive. Dr Wiles faced abusive messages and even death threats arising from her media presence and contribution to the public debate. She highlighted the SafeScience (WetenschapVeilig) initiative, which was set up in the Netherlands to support researchers facing harassment. This sector-wide initiative allows scientists to log abuse incidents and access supportive resources.
During the five-day ESCMID Global congress, a central theme emerged: the urgency to safeguard public health. This was a theme that particularly resonated with one of the keynote speakers, the British economist Lord Jim O’Neill.
Lord O’ Neill chaired the widely cited ‘Review on Antimicrobial Resistance: Tackling drug-resistant infections globally’ in 2016, which made strong recommendations on actions that need to be taken to avoid an AMR-driven public health and financial disaster by 2050.
While he lauded achievements in areas such as reductions in the antimicrobial use in certain agricultural sectors, he warned ESCMID delegates that much is still left to achieve. In particular, he underscored the integration of emerging technologies, such as AI, as a pivotal driver for AMR mitigation.
Recent data from the European Centre for Disease Prevention and Control (ECDC) stresses the magnitude of the challenge at hand. Earlier this month, the ECDC released a report based on a point prevalence survey (PPS) conducted in European acute care hospitals in 2022/23.
The survey revealed that approximately 4.3 million patients experience at least one healthcare-associated infection (HAI) annually. In microbiologically documented HAIs, 32% of microorganisms were resistant to antimicrobials. Furthermore, the prevalence of patients receiving antimicrobials in the EU/EEA sample had risen to 35.5% (with a country range of 20.8% to 56.5%), compared to the previous PPS conducted in 2016/17 (prevalence of 32.9%).
This continued threat of AMR, as highlighted by Lord O’Neill and in the ECDC report, is a stark reminder of the urgent need for action.
The ECDC report was published in the same week that the UK Government released its new policy paper ’Confronting antimicrobial resistance 2024 to 2029’, which sets out its latest five-year national action plan to support its 20-year vision for AMR.
Following ESCMID Global 2024, the infectious diseases community will now look towards the United Nations General Assembly, due to convene this September in New York, which will further address the pressing topic of AMR. Hopes are high for accelerated international action.
9th November 2023
A new operational framework for building climate-resilient, low-carbon and sustainable health systems across the world has been launched by the World Health Organization (WHO).
Published to coincide with the upcoming United Nations Framework Convention on Climate (COP-28), the framework includes a guide for healthcare professionals in addressing climate-related health risks to help safeguard the health of local and global communities.
It is ‘an opportunity for the health sector to lead by example by reducing its own greenhouse gas emissions while continuing to enhance quality of care’, the WHO said.
Greenhouse gas emissions from the health sector are now responsible for almost 5% of the global total. And if the sector were a country, it would be the fifth-largest emitter on the planet.
Dr Tedros Adhanom Ghebreyesus, WHO director-general, commented: ‘Around the world, health systems are vulnerable to the impacts of climate change, but they also contribute to it.
‘We therefore have a dual responsibility to build health systems that can withstand climate-related shocks, while at the same time reducing their carbon footprint. This framework gives countries a roadmap for doing just that.’
Consisting of 10 key components, the framework outlines the various actions health organisations, authorities and programmes can take to better anticipate, prevent, prepare for and manage climate-related health risks and therefore decrease the burden of associated climate-sensitive health outcomes.
Of particular note is the second component, which details the need for countries to have a ‘climate-smart health workforce’ centred on three objectives: health workforce capacity; organisational capacity development; and information, awareness and communication.
Sample measurable outputs and indicators are listed for each objective, including up-to-date training for existing staff, the integration of climate-related curricula for new trainees, contingency plans for acute shocks such as extreme weather events, the sharing of best practice on reducing greenhouse gas emissions, and establishing solid communication between internal and external stakeholders.
With continuing themes of collaboration, additional components outlined in the framework relate to climate-transformative leadership and governance; research to provide an evidence-base for the development of policy and innovations; and a focus on infrastructure, technologies and supply chain, among others.
The WHO concludes that the ‘application of this framework would result in an important contribution to universal health coverage, global health security and specific targets within the UN Sustainable Development Goals’.
11th September 2023
Guidance on how global warming can be addressed in clinical practice has been outlined by the European Respiratory Society (ERS) in its latest consensus statement on climate change and respiratory health.
Published in the European Respiratory Journal, the statement describes climate change as ‘an unfolding major planetary and health crisis’, and a major threat to those with common lung conditions.
This, it says, is linked to the frequent and extreme weather events, prolonged aeroallergen seasons and poorer air quality associated with climate change, which can lead directly to a worsening of health and an increased risk of death.
Traditionally, clinicians have been involved in climate change adaptation strategies such as identifying vulnerable groups and providing advice on how they can protect themselves during heatwaves, for example.
However, the ERS says this clinical role has now expanded to focus on both human and planetary health, which includes contributing to the reduction in greenhouse gas emissions.
According to the ERS, subsequent changes to clinical practice could therefore include promoting green prescriptions such as inhalers; focusing efforts on smoking eradication; and encouraging patients, where appropriate, to engage with nature, take active modes of transport and make more sustainable food choices.
Professor Zorana Jovanovic Andersen, chair of the ERS Environment and Health Committee and professor of environmental epidemiology at the University of Copenhagen, who was one of the authors, said: ‘As respiratory doctors and nurses, we need to be aware of these new risks and do all we can to help alleviate patients’ suffering. We also need to explain the risks to our patients so they can protect themselves from adverse effects of climate change.‘
The consensus statement also highlights that climate change will have a disproportionately greater adverse effect on individuals living with respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD).
It outlines some of the health risks of climate change such as a decline in lung function, increases in allergic responses and/or new cases of chronic (asthma, COPD, lung cancer) or infectious (pneumonia, influenza, tuberculosis, Covid-19) respiratory diseases.
It also identifies a higher risk of exacerbations for existing respiratory diseases, increased use of medication, emergency department visits, hospitalisations and death.
The fact that children are more susceptible to the impact of climate change on lung health is also highlighted, including the fact that the prevention of chronic respiratory disease should start as early as possible as many chronic lung diseases in adults have childhood origins.
Several previous reviews have provided extensive summaries of the different mechanisms by which climate change affects respiratory health, as well as outlining adaptation strategies. The latest statement provides an overview of all major pathways linking climate change with lung health.
While it summarises all of the available evidence, the authors also recognise some gaps in current knowledge. For instance, there is the need for further research to fully map the burden of climate change on respiratory diseases under different global warming scenarios and to understand underlying biological mechanisms, as well as identifying pathways of adaptation that can be translated into public health policies.
Professor Jovanovic Andersen, added: ‘Climate change affects everyone’s health, but arguably, respiratory patients are among the most vulnerable. These are people who already experience breathing difficulties and they are far more sensitive to our changing climate. Their symptoms will become worse, and for some this will be fatal.
‘Air pollution is already damaging our lungs. Now the effects of climate change are becoming a major threat to respiratory patients.’
Indeed, the deleterious respiratory effects of the particulate matter contained within air pollution, are already known to provide a mechanism through which lung cancer can develop among individuals who have never smoked.
29th April 2021
Experts discuss the need for the health care sector to be included in the EU’s move toward a circular economy.
The healthcare industry creates more than double the amount of greenhouse gas emissions than the entire aviation industry. Yet few are holding the sector accountable.
A recent webinar entitled ’Towards a More Circular, Sustainable and Economic Health Care System in Europe’, offered an expert panel of key stakeholders, including representatives of the European Commission, European Parliament, European Committee of Regions, environmentalists, researchers, and industry to assess the health care waste problem, EU efforts to promote a circular economy, and offer a path forward for solutions.
The discussion is timely, as the EU’s Medical Device Regulation can have a profound impact on the way that hospitals across Europe can lower their carbon footprint while simultaneously reducing costs.
The following article includes edited versions of comments made by the authors at the 11 March 2020 webinar. The edits were made with permission of the authors to make the comments more suitable for printed format.
Dorota Napierska, chemicals policy and project officer, Health Care Without Harm Europe:
If the healthcare sector were a country, it would be the fifth largest emitter of global emissions on the planet. The healthcare sector within the European Union is one of the most polluting after the US and China. Evidence shows that more than 70% of emissions are driven by the supply chain, and it is not really such a surprise if we realise how the healthcare is currently dependent on the use of disposables.
The production, use, and disposal of healthcare products is emblematic of the linear economy. Alternatives to counter these unsustainable practices will be shifting more to a circular healthcare economy model built on principles of resource conservation.
A change to more sustainable and very often reusable products and services brings not only environmental, but also significant financial benefits for hospitals, and medical device reprocessing and remanufacturing have proven to play an important role here.
Napierska: The real success and scaling up of reprocessing in the US started with strong regulation and strict guidelines. So, we are incredibly pleased with the adoption of the medical device regulation in Europe as it offers a path for hospitals to access environmentally preferable, more circular and lower cost reprocessed and remanufactured products.
In line with our global strategy, we believe that reprocessing and remanufacturing of medical devices can support hospitals on their way to maximise reuse, minimise waste, and save money. But this obviously needs support from national authorities, who must first make reprocessing and remanufacturing legal and possible.
Anna Schulte, lead researcher of a detailed life cycle analysis study published recently in the journal, Sustainability, Fraunhofer Institute for Environmental Safety, and Energy Technology UMSICHT:
Medical device remanufacturing might be the most promising circular economy strategy for single-use medical devices because they cannot be easily just reused directly by hospitals and cannot simply be recycled.
Our research team proved environmental benefits associated with remanufactured electrophysiology catheters in 13 out of 16 impact categories evaluated. We found hospitals save more than 20% from the use of remanufactured EP devices compared to exclusive use of virgin devices. Global warming emissions were cut in half when using remanufactured catheters compared to the virgin product. For abiotic resource use, a saving of 28.8% was calculated.
Our study provides information for policy and other decision-makers as it shows the transformative potential from linear to circular use of catheters by applying a remanufacturing system. In a fully circular production system, the carbon footprint could be reduced about 34.5% compared to linear production.
If 750,000 electrophysiological catheters are used in Germany every year, for example, complete collection of catheters for remanufacturing would save about 450 tonnes of CO2 equivalents per-year, in contrast to linear manufacturing.
Schulte: A legal obligation to remanufacture medical devices with high remanufacturing potential could be a key to achieving the circular economy and lead to more sustainability in the healthcare system.
Circular value creation is both environmentally and economically beneficial compared to linear value creation. Remanufacturing of single-use medical devices is an excellent example because it has the potential to preserve the product at the highest value, to be circular and reduce environmental impacts compared to virgin production, and to reduce environmental impacts on a systemic level.
Erik Hansson, Deputy Head of Unit of Medical Devices and Health Technology Assessment, DG SANTE (Health and Food Safety), European Commission:
EU Member States may decide to allow reprocessing of single-use devices. If Member States permit reprocessing of single-use devices (SUDs), those devices must, like any other device, comply with the requirements of the EU Medical Device Regulation. Member States can however choose to derogate from these requirements with regard to devices that are reprocessed and used within a health institution provided the reprocessing is performed in accordance with Common Specifications adopted in August 2020.
Compliance with either of the above paths aims at ensuring that the safety and performance of the reprocessed device is equivalent to that of the original device.
Hansson: They could also decide whether they want to introduce even stricter conditions or requirements than what we have in the Common Specifications. So, Member States have a few options to decide what they wish to do with this new legal framework. The Member States have the obligation to notify us whether they will permit reprocessing of single-use devices, and how they want to do so – whether they wish to use the Common Specifications, whether to allow outsourcing to external reprocessors, and so on.
The Common Specifications contain requirements for organisation and risk management, for instance when contracting an external reprocessor; staff, premises, and equipment; monitoring of changes made by manufacturers; determination of the reprocessing process; technical documentation and so forth. The Common specifications also include requirements for the procedures and steps of the reprocessing cycle; the quality management system, annual audits and reporting of incidents; and traceability, for instance, tracking reprocessing cycles and keeping records.
What is the Circular Economy Action Plan, and what else should healthcare entities know about the path toward a more circular economy?
Paola Migliorini, Deputy Head of Unit, DG ENV, the European Commission:
The Circular Economy Action Plan announces a set of initiatives for 2021 to ensure that all products on the EU market, including those used in the health sector, are sustainable by design, so that sustainability becomes the norm. And for that we need a product policy framework.
Many products break down too quickly, or cannot be easily reused, repaired, recycled, remanufactured, or refurbished. In healthcare, many are made for single use only. At least 80% of the products’ environmental impacts are determined at the design phase, so it is especially important to ensure that the design is optimal and allows for refurbishment and remanufacturing. We also need to address false green claims to ensure that there is no confusion when a product can claim to be “green”, and that there are clear lines of information for producers and consumers alike.
Currently there is no comprehensive set of requirements that ensures sustainability and the circularity in products, and we need to clearly act on that.
Under the Circular Economy Action Plan, we also want to take the lead on global efforts towards a circular economy. In February, we launched the Global Alliance on Circular Economy and Resource Efficiency to mobilise partners across the globe towards the development of a circular economy going beyond EU borders.
Sirpa Pietikäinen, Finnish Member of the European Parliament, representing the European People’s Party. She is a member of the Economic and Monetary Affairs Committee and a substitute member of the Environment, and the Public Health and Food Safety (ENVI) Committee:
We would need four planets’ worth of resources by 2050 if we do not make drastic changes. So, the first and most important signal from the EU Parliament is that you need to have the right ambition level.
If you do not remember anything else that I have said, please remember that by 2050, all sectors, including the health sector, would need to produce the same or better welfare, the same or better income for your company, and the same or better quality for the customers and patients than today, but with one-tenth of the resources.
We must do this to stay within planetary boundaries that are absolute and non-negotiable. All products marketed in the EU should be durable, upgradable, reusable, repairable, and then recyclable at the highest level as parts of an equipment or as materials.
Tjisse Stelpstra, Regional Minister, Province of Drenthe NL, Member, European Committee of Regions:
The COVID crisis is very urgent, and we must act on it without hesitation. Those working in healthcare know, maybe better than others, that this crisis is about health, it is about life. Let us hope it is a temporary crisis. There is no doubt that this crisis has had great effects on the world economy, and a recovery from this crisis is needed. But there is also another crisis, and it is also about health, and it is also about life, and that is the climate crisis. Where covid seems like an acute illness, the climate crisis is an insidious disease which more and more manifests itself as acute.
Tjisse: Local and regional authorities have an important role. They can help us to not only build a circular economy, but to intensify a circular society more broadly. I think that is what we need. Let us use this reality as a great opportunity for cooperation. There will also be skepticism and ignorance, and that is why we all – especially governments – have a lot of work to do. We must convince our citizens, our companies, our industries, and our clients about the importance of this transition to a circular economy and show them it is not only making the world better environmentally, but it is also the next step to more welfare.
So, I am an optimist, I am hopeful. COVID has shown us that we are resilient – in no time, we made a change to a digital economy, so I hope that we can in no time make the change to a circular society.
Alan Wain, Chief Operating Officer for NHS Supply Chain Coordination, National Health System, England:
Remanufacturing is quite sophisticated. Most of these devices cannot simply be put through a sterilizer; you have got to take them apart; you have got to reprocess them put them back together and make sure they are clinically safe to use again.
Just to put remanufacturing into context, if we examine our strategy to net-zero carbon emissions, the NHS needs to take out something like 16.5 million tonnes of carbon dioxide equivalent per year just from the supply chains.
One of the biggest contributors [of emissions in the NHS] is down our supply chains, our suppliers’ own carbon footprints, and that that accounts for about 4.5 million tonnes. Of that, 157,000 tonnes could be removed by using remanufactured or reprocessed devices, and another 202,000 tonnes from reused and refurbished devices.
To achieve our objectives, the NHS needs to be working with our strategic suppliers to achieve a major, seismic shift in carbon footprint reduction. We have been working with Vanguard as a strategic supplier, and we are doing a lot of engagement around the NHS for uptake of remanufactured devices.
It starts with the collection of the original device and sending it off to Vanguard’s remanufacturing unit to remanufacture them for reuse by the NHS. The next step is to get a bigger uptake of these devices within the NHS. There is, now, a small amount of uptake, but the ambition is to get to a much larger footprint wherein 40–50% of the devices being used are remanufactured.
Remanufacturing is an important part of our strategy – though it is not the only part of our strategy – and we are looking forward to working with our strategic suppliers to drive down the carbon footprint across the whole NHS.
Dan Vukelich, President and CEO, Association of Medical Device Reprocessors:
The provisions in Article 17 of the MDR represent one of the greatest opportunities for hospitals in Europe to lower costs, reduce waste, and reduce greenhouse gas emissions.
Unfortunately, medical device remanufacturing is currently not available in most EU Member States. So AMDR is urging Member States to act quickly to promote this circular economy solution for health. The practice has grown substantially in many countries. In 2019, our members served over 7600 hospitals and surgical centres worldwide, enabling them to participate in a circular economy for hundreds of types of medical devices labelled for single use.
As confirmed by the science presented, devices that are remanufactured have a substantially lower carbon footprint and use less resources.
Additionally, remanufacturing eliminated nearly 7 million kilos of medical waste from landfills and incinerators. This environmental contribution comes at no extra cost. In fact, medical remanufacturing has enabled healthcare systems to save over 446 million euros in 2019. This will potentially change when the MDR comes into force.
Vukelich: So far, the Netherlands and Belgium have allowed remanufactured products and notified the commission. I expect Germany soon, and I would hope before the May deadline that we are going to have some others that will report favourably towards allowing these products.
So, I hope each of us, from our individual standpoints, will encourage the European Commission and the European Parliament to continue down that path of promoting a circular economy and including healthcare within their scope. As we have learned from Anna Schulte’s research and from the example that Alan Wain and others have brought up, reprocessed and remanufactured medical devices are an immediate solution.
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