“The 2030 Agenda” for Sustainable Development is being confronted with severe crises and is unravelling social contracts. The failure of the global economic model to account for the natural boundaries of the planet has led to environmental destruction and human precarity. The set of aspirations, norms and institutions commonly referred to as the social contract have been hollowed out by market fundamentalism and is increasingly failing both people and the planet.

Our changing climate and the rising frequency of extreme weather events have serious implications for our health systems. It affects hospitals and healthcare systems operationally, financially, and structurally but also directly impacts the health of the population affecting life and livelihood contributing to inequality.

Current climate change adaptation strategies focus primarily on enhancing the resilience of critical infrastructures, such as energy, transport, and buildings, but they overlook the healthcare sector and its dependency on those infrastructures. The healthcare sector is uniquely placed to be a catalyst for change and advocate for better practices across sectors.

Respect for the ecosystem and the regeneration of nature is essential for a balanced eco-social world to protect our mutual sustainability, Yerevan State Medical University (YSMU) acknowledges this global commons as the imperative for the collective wellbeing embedded in the economic, social and environmental dimensions.  So, YSMU endeavours to become a catalyst for effective science-policy impact pathways through going beyond “thinking differently” to ”doing differently”.

Hence, the Faculty of Public Health, YSMU with the leadership from the Professor Marine G HOVHANNISYAN, the Dean, has initiated one “Implementation Research (IR)” on the “circularity of medical wastes” involving Armenia, Georgia, Ghana, and Nepal.

Specific objectives of this IR are to

1. estimate the impacts and the externalities (impacts related with environmental and social aspects) for determining the total economic benefit from non-incineration technology for treating medical wastes from select cities / regions in the participating countries;
2. organise workshops for collaboration and interactive partnership among actors and stakeholders to mobilise expertise and competencies as well as create acceptance and alignment of the “circular economy (CE) model for the participating countries;
3. define a business model of operational innovation for responsible using of materials with accountability of costs for the respective country settings;
4. introduce digital technologies to integrate distribution and consumption of materials, segregation and disinfection of medical wastes, and disposal of medical wastes from select cities / regions in the participating countries;
5. develop human capacity with systems thinking and collaborative approaches for users of materials at select cities / regions in the participating countries to unlock circular value from medical wastes;
6. institutionalise a collaborative platform bringing together diverse actors for sustainability of CE model for medical wastes in Armenia, Georgia, Ghana, and Nepal.

The expected outcome will be acceptance and adoption of circular consumption patterns at the study settings leading to an increasing employee engagement and creating a stronger skill base. Result shall demonstrate an increased productivity with reduced medical wastes at select cities / regions in the participating countries, and establish an industrial symbiosis contributing to the local economy with reduced environmental footprints. Finally, this IR shall provide an empirical support for developing a practice model for CE in the health systems of lower -and lower middle-income countries in the world.

Our IR is designed for accelerating the pace of SDG6(Clean Water and Sanitation), SDG7(Affordable and Clean Energy), SDG8(Decent Work and Economic Growth), SDG10(Reduced Inequalities), SDG11(Sustainable Cities and Communities), SDG12(Responsible Consumption and Production), SDG13(Climate Action) while contributing to SDG3(Good Health and Wellbeing) and enhancing SDG17(Partnership for the Goals)”. Hence, this project is having the mentoring support from UN System because the Goal of the project is explicit for realising “the 2030 agenda”.

The Mentors

Dr. Mihran HAKOBYAN, MD, PhD.  UNICEF, Armenia

Sandhya BALASUBRAHMANYAM, PhD., UNSSC, Germany

The Partners and the Collaborators

Georgia: Georgian Waste Management Association, Republic of Georgia

The Team

YSMU is committed to the “Equality, Diversity and Inclusiveness (EDI)” not as an agenda alone but in all our actions and so, this project team is from different geographies representing diverse culture and bringing interdisciplinary competence having proven capabilities aligned with the deliverables of the project. We embrace EDI also to promote gender equality and to minimise effects from the opportunity gap.

Professor Marine G. HOVHANNISYAN MD; MPH; D.Sc. Project lead	Pavitra PAUL, PhD. (health economics) Principal investigator	Dilyara NURKHAMETOVA, MD; PhD. Central support and coordination
Giorgi GULIASHVILI Co-Principal investigator (Georgia)	Lawrencia OSAE-NYARKO, PhD. (Public health) Co-Principal investigator (Ghana)	Devendra P. Shrestha, PhD. (Economics) Co-Principal investigator (Nepal)
Elias Kwesi ASUMING-BREMPONG, PhD. (Clinical microbiology) Researcher (Environmental Health) (Ghana)	Karine POGHOSYAN, PhD.; MD. Master trainer – 1	Rahul SETHI, MD; MBA Master trainer – 2
Ana TSKHADADZE Coordinator, Georgia	Khachatur MARGARYAN, MD; MBA Support and coordination (Armenia)

The project status update (as on 31 January 2023)

1. finalised collaborative partners / participating country / organisation representations;
2. formal agreement documentation with the partners is in place;
3. initial data gathering from Armenia, Georgia, Ghana and Nepal is complete;
4. the full proposal including methodological approach, budget document and the “Gantt chart” is ready;
5. formal letter (s) confirming the participation with the list of deliverables from the respective municipal authorities, local chamber of commerce (s) and professional associations of the participating countries are received from Georgia and Nepal (such letters are yet to be received in Armenia and Ghana);
6. the human resource allocation by YSMU is agreed.

We are ready to submit this project proposal for funding from the potential grant funding agency(s).

Secretariat

Office of the Dean, Faculty of Public Health

Yerevan State Medical University

2 Koryun Street, 0025, Yerevan, Armenia.
Tel.: 010 301-000 (308)