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January 2017

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Safer Chemicals
Progress update

A progress update from HCWH Europe on EU chemicals regulation and legislation, and a look forward to 2017 for EU Mercury Regulation, Medical Devices Regulation, EDC criteria, and CETA.

EU Mercury Regulation

The European Commission presented its proposal for a regulation in February 2016, and on 6th December 2016 the presidency of the Council and the European Parliament reached an agreement on a compromised text. On 16th December 2016, the Permanent Representatives Committee (Coreper), endorsed the text on behalf of the Council.

For HCWH Europe, the main area of interest was on dental amalgam - Article 10. The Regulation proposes a phase out of mercury use in dentistry, initially by prohibiting its use for pregnant women and children patients, and after this phase out period, the dental amalgam should only be allowed in specific, very restricted cases. Ultimately the use of dental amalgam shall be phased out by 31st December 2022.

Note that dental practitioners will be responsible for the conditioning and disposal of their waste and they shall make sure that these stages are carried out in an environmentally sound manner...

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Medical Devices Regulation

The European Commission recently said that it expects to adopt its Regulation on medical devices by the end of May 2017. Annex I.2.7.4, of the medical devices Regulation includes a 0.1% concentration limit for category 1A and 1B carcinogenic, mutagenic, and reprotoxic (CMR) substances and endocrine disrupting chemicals (EDCs) in devices that are invasive and come into direct contact with the body. This includes devices that (re)administer, transport, or store medicines, body liquids, or other substances, including gases, to/from the body. Devices would only be permitted to contain such substances at a level above this limit if a justification is provided.

Importantly, within a year of the Regulation’s entry into force, the Commission will provide a mandate for the relevant scientific committee to prepare guidelines on phthalates. This would include a benefit-risk assessment of their presence, as they are CMRs or EDCs, and such assessments would have to be updated within five years. The Commission would also issue similar mandates for the preparation of guidelines on other CMRs.

Annex II of the Regulations also includes labelling provisions: a label on the device and the packaging would have to say if the device(s), their parts or materials contain CMRs or EDCs above the concentration limit. A list of such substances must be included...

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European Commission postpones vote on criteria for Endocrine Disrupting Chemicals (EDCs)

Vote on EDCs postponed

On the 21st December 2016, after years of debate and delay, EU Member States’ experts met in Brussels to discuss and potentially approve the drafts on identification criteria and a derogation allowing use of Endocrine Disrupting pesticides. However, the Commission eventually decided not to put their most recent proposals to an official vote, because they would not have obtained the sufficient qualified majority from Member States (read the 8th December version of the EDC criteria for Biocidal Products, the Pesticides Regulation, and the revised Pesticides amendment draft).

The next discussion and meeting on EDC criteria is likely to take place on the 15th February when EU Member States are to meet at the relevant expert committees. 

ECHA publishes draft guidance for identifying EDCs

On the 20th December 2016, the European Chemical Agency (ECHA) and the European Food Safety Authority (EFSA) published an outline of the draft guidance for identifying endocrine disrupting chemicals (EDCs).

This document explains what will be in the final guidance, covering areas such the type of data and information that may be considered sufficient to conclude on the endocrine disrupting properties of a substance in accordance with the criteria. 

Once completed, the draft guidance will be subject to a public consultation, which is expected to launch in June 2017 and run for two months. Following the consultation, a workshop will be held with Member State representatives who are experts in evaluating endocrine disruption to assess the applicability of the guidance. The outcomes will be published in a report.


The Unhealthy Side Effects of CETA

On the 28th October 2016, the Council adopted a package of decisions on the comprehensive economic and trade agreement with Canada (CETA). CETA is often billed as the most sophisticated trade agreement to date signed by the EU - it is ambitious and is presented as holding promises of economic growth.

CETA will remove more than 99% of tariffs that are currently imposed on trade between the EU and Canada; it claims to set high standards for consumer, environmental, and labour protection.

But a recent series of case studies: The Unhealthy Side Effects of CETA published by EPHA, highlighted the undesirable side effects for people and public policy making. They stress the negative effect CETA will have on public health by opening the door for businesses to challenge public health laws, limiting policy choices for Services of General Interest.

On the 12th January, the Environment Committee (ENVI) of the European Parliament (EP) voted in support of CETA, paving the way for a final EP vote in February 2017. HCWH Europe will again contact Members of the European Parliament to ask them to vote against CETA.

Read full article

Pharmaceuticals

Pharmaceuticals in the environment workshop report now available



On the 6th September 2016, HCWH Europe hosted a one day workshop concerning pharmaceuticals in the environment. Taking place in Brussels, we welcomed over 60 participants from 8 countries and heard from 16 speakers on a range of topics relating to pharmaceuticals in the environment, including: the European legislation perspective, the scientific evidence, national policies, and local experiences.

A report from the workshop is now available, featuring a detailed account of the presentations, pictures from the day and the results of a questionnaire that was distributed at the workshop.

The workshop agenda, HCWH Europe's position paper, and featured presentations from the workshop are also available on the HCWH Europe website.
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The European Commission must fulfil their obligation to reduce pharmaceutical pollution

Representing hundreds of environmental and health organisations in all 28 European Union Member States and further afield, 14 NGOs are calling for immediate action and answers as to why the Commission have not yet published a strategic approach to address the pharmaceutical pollution of water.

The strategic approach was promised by September 2015 in a 2013 EC Directive 2013/39/EU. Article 8c of the 2013 directive states: “…the Commission shall, as far as possible within two years from 13 September 2013 develop a strategic approach to pollution of water by pharmaceutical substances”.


Over 16 months since this missed deadline, HCWH Europe, on behalf of concerned cosignatories, sent a joint letter to European Commission (EC) President Jean-Claude Junker, Vice-President Frans Timmermans, Commissioner for Environment, Maritime Affairs, and Fisheries Karmenu Vella, and Director General for Environment Daniel Calleja Crespo – expressing concern at the delay of the strategic approach, and calling upon the European Commission to protect human and environmental health.

The letter sent on behalf of civil society is the basis of a new petition as part of the Safer Pharma campaign (www.saferpharma.org), organised by HCWH Europe, to address the delay of the strategic approach which is putting the health of EU citizens and the European environment at risk.






Speaking about the delay, Anja Leetz, Executive Director of HCWH Europe said:

“All experts (including the UN), agree that we are facing a global pharmaceutical pollution problem and we need to minimise the release of medicine into the environment throughout their life cycle: production, use, and disposal. It is unacceptable that the Commission is delaying any action to protect human health and the environment and allowing pollution to continue. It is unacceptable that the Commission delays the process laid down by EU law and we expect the Commission to publish the roadmap swiftly, so we can begin to address the problem of pharmaceutical pollution".

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Sustainable Food

Sustainable and Healthy Food in Healthcare workshop report now available

As part of CleanMed Europe 2016 - Europe’s leading conference on sustainable healthcare, on Tuesday 18th October, Health Care Without Harm (HCWH) Europe organised a workshop entitled Sustainable and Healthy Food in Healthcare. The report from the workshop is now available here.

The workshop was hosted by Gentofte Hospital in Copenhagen, a very progressive hospital in procurement of fresh, seasonal, and organic food, and food waste management and reduction.

The day’s events started with a delicious and organic meal for all participants at the hospital sta canteen. In addition to cold and hot dishes and to a salad bar, homemade rye bread, fruit and tap water is also available.

 After lunch, HCWH Europe’s Deputy Director, Grazia Cioci, presented HCWH Europe’s work on sustainable food in the past few years, and the more recent work on food waste prevention and reduction strategies through a survey of European hospitals prioritising sustainable and healthy food policies.

Over 30 experts from hospitals, academia, non-profit organisations, and municipalities gathered at Gentofte Hospital to share their best practices and experiences from their countries on the two main topics of the workshop: sustainable and healthy food and food waste.

Food in public institutions, particularly in hospitals, should be seen as a pleasant experience, however, there are still many challenges in providing sustainable and tasty food in hospitals. Therefore, opportunities for the healthcare sector to improve food served in healthcare facilities were discussed throughout the workshop and recommendations were sought.

Read the report here

HCWH Europe’s comments on the EC Platform on Food Losses and Food Waste

Health Care Without Harm (HCWH) Europe, as invited stakeholder of the European Platform on Food Losses and Food Waste (FLW), would like to recognise the importance of this process to define a methodology for preventing and reducing food losses and food waste across the EU. HCWH Europe would also like to highlight the important role that the European Union can play in combating food waste, and its commitment to the Sustainable Development Goal (SDG) 12.3:

“[…] by 2030, halve per capita global food waste at the retail and consumer levels and reduce food losses along production and supply chains, including post-harvest losses”.

HCWH Europe would like to provide general comments for the European Commission to contribute to the process of defining a European methodology for preventing and reducing food losses and food waste.  After having attended the first meeting of the FLW Platform that took place in Brussels on 29th November 2016, HCWH Europe provides some key recommendations to be considered in this process....

Read the comments here

Waste & Resources

HCWH Europe tentatively welcomes ENVI Committee
vote on food waste


On January 24th, the European Parliament (EP) Environment (ENVI) Committee voted on the EP’s report and amendments to the European Commission’s (EC) proposal - COM(215) 595 final - to revise the Waste Framework Directive (2008/98/EC).

HCWH Europe generally welcomes the ENVI Committee’s support for the amendments on food waste - such as a new food waste definition, a food waste hierarchy, and food waste reduction targets.

No common definition of “food waste” currently exists in the EU, which forces Member States to work with different national definitions and, as a consequence, different methodologies to prevent and reduce food waste. Therefore, a harmonised, legally binding, European definition of food waste is necessary in order to better regulate food waste and improve efforts to prevent and reduce food waste across all Member States.

The new proposal is to define food waste as “food intended for human consumption, either in edible or inedible status, removed from the production or supply chain to be discarded including at primary production, processing, manufacturing, transportation, storage, retail and consumer levels, with the exception of primary production losses”1.

HCWH Europe welcomes the important addition of a definition of food waste, but regrets the exclusion of losses at the primary production stage from it. By excluding this stage, a considerable amount of food waste will not fall under this definition, and therefore there will be no obligation on Member States to reduce it. 

HCWH Europe also applauds the adoption of a food waste hierarchy. This is a key instrument that will play a major role in the management of food waste, as food has specific priorities and potential for re-use that are not applicable to the waste management of other products. For example, there are particular recovery processes that can only be applied to food, such as the donation of unused food to charities and social organisations, or its use for animal feed or composting. Now approved by the ENVI Committee of the EP, these resourceful stages of food waste management are one step closer to being officially recognised by the EU and legally binding for Member States.

“In relation to food waste, we feel optimistic about the progress made by the ENVI Committee and we hope that the amendments adopted today will be supported by the vote in plenary. However, the establishment of loose objectives rather than strict targets for food waste reduction is regrettable, as they might not necessarily lead to significantly reducing food waste in Europe” 

Ana-Christina Gaeta, Resources Policy Officer, HCWH Europe. 

Today’s vote was in favour of Member States working towards the objective of a 30% reduction in food waste by 2025 and a 50% reduction by 2030. As welcome as these reduction targets are, the wording of the targets means that they are not legally binding and therefore may not have the desired effect...

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European Commission plastics roadmap not leading anywhere

The European Commission’s newly released Roadmap for the EU Strategy on Plastics in a Circular Economy [1] fails to get to the root of the problem of plastics, according to the Break Free From Plastic Movement.

The Commission outlines the problems Europe is facing with plastics and gives an overview of the focus areas which the full Plastics Strategy will address later this year: (1) decoupling plastics production from virgin fossil feedstock and reducing its life-cycle greenhouse gas impacts, (2) improving the economics, quality and uptake of plastic recycling and reuse, and (3) reducing plastic leakage into the environment. 

However, the NGO coalition argues that to make a significant contribution towards the circular economy, the Roadmap needs to focus on reducing and optimising the use of plastics. With a massive decrease in the use of single-use plastics and a sharp increase in reuse and recycling, as proposed by the Break Free From Plastic Movement, the attention on the source of the alternative materials would be secondary.

While the Commission highlights the many problems of plastic pollution for the marine environment, the coalition regrets that it does not propose adequate measures to tackle the issue. What’s more, for packaging and its role in littering, the Commission points at the lack of consumer awareness, rather than addressing the producer’s responsibility and the full range of confusion introduced by biodegradable plastics [2]. In addition, the Commission does not expand on the need to move away from the use of hazardous chemicals in plastics which can harm public health.

“Instead of acting during the product design stage and instigating prevention of plastic waste, the Commission has chosen to emphasise better recycling technologies and substitution with ‘renewable’ feedstock. These responses will not lead to a meaningful adoption of Circular Economy principles, nor will it necessarily reduce health-harming plastic pollution.” said Delphine Lévi Alvarès, European coordinator of the Break Free From Plastic Movement.

“It is crucial that we reframe the debate around real solutions, take action to dramatically reduce throwaway plastics and acknowledge producer responsibility for a product’s end of life in the design process, rather than focusing on (unsustainable) replacement and recycling”, she added.

All over the world, NGOs have come together to work together to stop plastic pollution. The Break Free From Plastic Movement believes that the EU Strategy on Plastics – which is expected to be released by the end of 2017 – needs to face up to the scale of the plastics problem and set an ambitious cross-cutting action framework for Europe to fulfil global expectations and become the frontrunner of the battle against plastic pollution...

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Member Update

Sustainable Development in Health and Care – Health Check 2017

The UK Department of Health and eight major health organisations have stated their commitments to a social and environmental sustainability. NHS England, Public Health England (PHE), NHS Improvement, the Care Quality Commission, Health Education England, the National Institute for Health and Care Excellence (NICE), NHS Digital and NHS Property Services – in partnership with the Department of Health have all made commitments.

The commitments are part of annual health check for the sector produced by HCWH Europe member - NHS England and Public Health England’s Sustainable Development Unit (SDU). The Sustainable Development in Health and Care – Health check 2017 report looks at progress across England.

Overall organisations are cutting their carbon footprint and saving money through reducing energy use, but having less success in addressing water use and the increased costs from waste disposal.  Sustainable development is increasingly becoming a core part of work shown by more organisations having board approved Sustainable Development Management Plans (SDMPs) and are reporting annually on their work.


“The commitment shown by these national organisations can be commended as an important first step in the journey. The next of which is to increasingly look outwards to understand how they are able to embed sustainable development into their core roles as regulators, funders, investors in infrastructure and system leaders.”   -  David Pencheon, Director, Sustainable Development Unit

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PVC-free Blood Bag project published in Vox Sanguinis

The article: Storage of red blood cells in a novel polyolefin blood container: A pilot in vitro study has been published in Vox Sanguinis, the haematology journal of the International Society of Blood Transfusion. The authors, Hans Gulliksson, Stephan Meinke, Alice Ravizza, Linda Larsson, and Petter Höglund are all members working within the project.

The article  concludes:

"This is a first preliminary study of RBC storage in a new type of blood bags. PAGGG-M gave encouraging results except for its inability to prevent increased haemolysis. There will be room for further development of RBC additive solutions to address the haemolysis problems. Plasma should also be tested regarding the stability of coagulation and activation pathway variables. There may also be a potential for future use of the bag for preparation of pooled buffy-coat-derived platelets."

This is just one of several promising achievements of the PVC-free Blood Bag project that has has been up and running for almost five years and now successfully entering its final stage. The project has two objectives: demonstrate that it is possible to make a PVC-free blood bag that fulfils requirements specification, and increase demand from healthcare organisations through dissemination of information. The article in Vox Sanguinis meets both those objectives.

Later this spring the project will have a final webinar presenting all results including the CE labelling of the bags and launch a Layman report.

Link to article (behind paywall)

PVC-free blood bag project newsletter

Antibiotic Resistance Coalition welcomes new members

Five leading environmental and public health organisations have joined the Antibiotic Resistance Coalition (of which HCWH Europe is an existing member). The Antibiotic Resistance Coalition (ARC), is an independent coalition of members from six continents working in health, agriculture, consumer, and development sectors. ARC advocates for policy change and action to prevent the post-antibiotic era from becoming a bleak reality.

One new member is MedAct, a UK-based organisation and HCWH Europe member, working to mobilise and organise health professionals to be “more effective social agents for social change”. They achieve this through strategic research analysis, education, and campaigns across a number of issues, including antimicrobial resistance. During World Antibiotic Awareness Week, MedAct partnered with the Alliance to Save Our Antibiotics, (an ARC member) to mobilise 12 medical UK professional societies to call on the government to set regulations curbing overuse and misuse of antibiotics in food animal production. 

Other new members of the Coalition, further expanding the strategic drive on AMR, are:

“The skyrocketing rates of resistant infections are a major cause for concern worldwide. AMR is borderless and will require cooperation at all levels if we are to fight it effectively. We welcome these five organisations whose diverse expertise will certainly help us step up the fight against this global threat to public health and the environment.”
- Dr Adela Maghear - Pharmaceuticals Policy Officer, HCWH Europe
 
About the Antibiotic Resistance Coalition

Since its formation in 2014, ahead of the 67th World Health Assembly when the initial resolution to draft the global action plan on antimicrobial resistance (AMR) was adopted, the ARC has amplified the voice of civil society across countries and sectors at various policy fora. Through coordinated efforts, the Coalition engages intergovernmental organisations and national governments on the development and implementation of the global action plan on AMR. The ARC has briefed United Nations agencies, country missions, and other stakeholders in advance of the High-level Meeting on AMR; and called on stakeholders including food retailers and health facilities to change their sourcing practices towards curbing drug resistance.

This week, at the World Health Organization (WHO) Executive Board Meeting, ARC members delivered an intervention calling on the agency to “demonstrate strength in leadership”, ensuring that their efforts both globally and nationally are aligned with public health interests and inclusive of all stakeholders, including civil society...

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Other News

HCWH Europe attending Ministerial Conference
on Environment and Health

In June 2017, Health Care Without Harm Europe will actively participate in the Sixth Ministerial Conference on Environment and Health in Ostrava, Czech Republic. The conference expects to bring together health and environment ministers and high-level representatives of Member States in the WHO European Region, partner organisations, academia and civil society. Member States are expected to adopt a ministerial declaration, an implementation plan for its commitments and a reformed governance mechanism for the European Environment and Health Process.

The ministerial draft declaration to be signed by all 53 health and environment ministers will include the building of environmental sustainability of health systems.

This means there is a recognition that greening health systems can enhance efficiency for energy and resources, and that savings can be made (which could be used to address other health priorities set by countries).

This is a great development that HCWH Europe fully supports and we are looking forward to collaborating with Member States and sharing our knowledge and experience. Our engagement with the health sector over the last 20 years shows clearly the benefit of environmental sustainable health systems.

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