Evaluating the environmental impact of personal protective equipment (PPE) in the COVID-19 pandemic

This Footprint Evaluation case study explores the feasibility and value of considering environmental sustainability in the evaluation of personal protective equipment (PPE) provisioning during the COVID-19 pandemic.

This case study is not a comprehensive evaluation of PPE provisioning but a scoping of how it might be done.

About this case study

The Footprint Evaluation Initiative proposes that environmental sustainability should be addressed in all evaluations. However, environmental harm is often viewed as a necessary trade-off to protect human systems in urgent crises with severe negative impacts on people, such as the COVID-19 pandemic. Because of this, some might question whether it is technically feasible, or even of value,  to include environmental sustainability in evaluations of PPE provisioning.

This report demonstrates that the answer to both questions is a resounding yes. Including environmental sustainability in the evaluation of PPE provisioning during the COVID-19 pandemic is technically feasible. Furthermore, not only is it feasible to do this, the inclusion of environmental considerations adds significant value to these evaluations.

Ignoring environmental sustainability in the evaluation of COVID-19 responses would result in invalid conclusions, erring towards the positive impacts of PPE provisioning while ignoring the negative environmental impacts that could themselves have negative impacts on human health. Furthermore, including environmental impacts in the evaluation of PPE provisioning during the COVID-19 pandemic can inform decision-making to go beyond framing choices in terms of trade-offs that permit environmental harm to ensure human health in the short-term. Instead, it can lead to identifying better solutions and better outcomes for human health, equity, and the environment.

The case study demonstrates how to broaden the evaluation frame by:

  • Using a PPE provisioning life cycle framework to understand and map the nexus between human and natural systems for each intervention element.
  • Identifying factors that need to be considered in constructing a theory of change that takes both human and natural systems into account
  • How to formulate key evaluation questions and evaluation criteria such as the OECD DAC that consider both human and natural systems
  • The value of engaging with other knowledge domains that utilise specific methods for articulating and estimating environmental effects, effects that may be new and important to evaluators seeking to include sustainability in evaluations
  • How evidence from media can usefully complement formal research evidence, especially in rapidly changing areas
  • How applying a footprint evaluation approach would generate knowledge about options for the equitable achievement of important health outcomes in ways that do not impair environmental sustainability.

The case study is informed by the understanding that:

  • Human and natural systems are intertwined in the provisioning of PPE; decisions that affect human health and the provision of PPE also affect the environment and equity.
  • It is important to strive for win-win solutions that benefit both human and natural systems.
  • In the case of PPE provisioning, improved pandemic preparedness could have reduced the risk that human health was prioritised over the health of the environment.
  • Harm to the environment has negative effects on human health - permitting environmental harm as a trade-off necessary for ensuring human health is based on a false either/or dichotomy.

Using a typology matrix and rubrics that consider both natural system and equity effects is a useful way of synthesising and communicating evaluation findings. The nexus between equity and environmental sustainability is clear. The matrix below illustrates that both need to be considered rather than considered in terms of trade-offs. As the evaluation field has well-developed methods and approaches for evaluating human systems, this case study focuses on how natural systems could be integrated into an evaluation of PPE provisioning.

'Evaluating the environmental impact of personal protective equipment (PPE) in the COVID-19 pandemic' is referenced in: