Climate Summit 2017

Principle of equity must guide Bonn talks, says member of Indian PM’s climate change council

Excerpts from an interview with JM Mauskar on India’s expectations from the Bonn climate change negotiations.

The two-week climate change conference that started in the German city of Bonn on Monday will lay down the roadmap for the implementation of the Paris Agreement from 2020. But when the agreement was stitched up in 2015, countries had deferred answering some of the most difficult questions.

How countries define and operationalise the principle of equity in the Paris Agreement is one such question. The parent United Nations Framework Convention on Climate Change requires the responsibility for acting against climate change to be divided between countries on the basis of equity. Each set of countries, based on their current economic situation and projection of future growth, defines equity using different parameters. This makes it difficult to find common ground at the negotiations, which are driven by consensus.

India has already committed to reducing the greenhouse gas emission intensity of its gross domestic product by 30%-35% below 2005 levels by 2030. (The emissions intensity of the economy refers to the amount of greenhouse gases a country emits per unit of national income.) Has India taken on its fair share? Does it need to do more? The discussions in Bonn will consider if and how targets provided by all the countries under the Paris Agreement should be reviewed.

The Indian Prime Minister’s Council on Climate Change is the apex body overseeing the implementation of these national targets. JM Mauskar is a member of the council and has led several Indian delegations at earlier climate change negotiations. He spoke to about the expectations from the Bonn round of talks and India’s priorities from the meeting. He spoke in his personal capacity.

Excerpts from the interview:

What do we expect out of the Conference of Parties in Bonn?
Each Conference of Parties obviously cannot lead to a landmark agreement or outcome. The host government would, of course, like to have a landmark decision under its stewardship or presidency but it is not practically possible. In Bonn, the task is to continue settling the implementation arrangements for the legal treaty, the Paris Agreement. It was already decided last year in Marrakech that these rules, arrangements and guidelines would be finalised at the end of the Climate Conference in 2018. By that measure, both the Marrakech meeting last year and the Bonn meeting this year are intermediary stages.

However, since Fiji, a Small Island Developing State, holds the presidency in Bonn, it would be justified and appropriate if some declaration could be issued on time-bound action regarding the vexed matter of loss and damage as a result of climate change, which is close to the heart of low-lying countries. Other desirable outcomes in Bonn could relate to issues such as deciding on enhancing pre-2020 climate actions during the coming three years of 2018-2020 and starting concrete discussions on putting in place arrangements for before and after 2020.

So we will not see the rules actually being framed this year?
As always, some parties would like to freeze decisions on some elements of interest to them in advance of others. But in the negotiations, there is an important axiom: “Nothing is decided till everything is decided.” In Bonn, one hopes the negotiators and their political leaderships will take time to understand each other’s red lines and try accordingly to work towards finalising the implementation arrangements in entirety during the conference in 2018. The second commitment of the Kyoto Protocol and the Cancun Pledges ends in 2020 after which the implementation of climate action under the Paris Agreement, called the Nationally Determined Contributions, commences from January 1, 2021. So we surely have time to flesh out these implementation arrangements in a manner that does not upset the balance achieved in the Paris Agreement.

What are your concerns about countries being asked to ratchet up their new emission reduction targets through the Facilitative Dialogue 2018 and even before 2020 from when the Paris Agreement is to be implemented?
Negotiations for the Paris Agreement had an Alice in Wonderland kind of atmosphere. After approval from the highest levels within respective governments, various parties stated what they were willing to offer as their climate actions much before they knew what the treaty governing those actions was going to contain. These were called Intended Nationally Determined Contributions; the word Intended would be removed after a country ratified the Paris Agreement. This was done to provide mutual reassurances between developed and developing countries to end the atmosphere of mistrust. It was then thought that after the treaty was decided in Paris, the parties could take another look at their promises to refine or clarify their Contributions, if necessary.

There was also a provision for a “Facilitative Dialogue 2018” in the Paris Decisions, which were taken along with the Paris Agreement, to discuss long-term goals and to inform preparations of the Nationally Determined Contributions. The latter clause at this juncture applies only to those parties that have not submitted their Intended Nationally Determined Contributions before ratifying the Agreement. The word facilitative was chosen specifically; it is to understand each other better. Nowhere does the Paris Agreement or the other decisions taken in Paris ask that the Facilitative Dialogue become a process of compulsorily enhancing or ratcheting up the Nationally Determined Contributions, specifically emission reduction obligations, before 2020. The parties can obviously amend their contributions voluntarily if they feel so after the consultations, but this enhancement cannot be imposed through this process.

But what is the argument over it in Bonn?
We hear from some parties that this exercise for greater understanding and clarity among parties, in light of the latest scientific evidence, should become an exercise for re-submission and ratcheting up of greenhouse gas emission reduction contributions.

If you recall, the climate actions of developing countries are to be enabled and supported by means of implementation – finance, technology and capacity-building – to be provided by developed countries. The mitigation actions of countries are to be undertaken without violating the principle of equity and the principle of common but differentiated responsibility. The enhancement of obligations in any case needs to be informed by new and fresh scientific inputs from the United Nations’ intergovernmental panel on the science of climate change – their sixth report will come after 2018. Then, there is the pre-2020 period when developed countries have substantial commitments against which they are yet to be assessed. What needs to be done after 2020 and who needs to do it is linked to what developed country parties did on the front of emission reduction, finance and technology before 2020.

So, if developing countries are at some stage required to enhance their emission reduction obligations, this could only be done after assessing if developed countries have provided the finance and technology they were obligated to pre- and post-2020 and if these transfers of means of implementation were adequate.

To the best of my understanding, any enhancement of contributions from countries should take place after the first Global Stocktake exercise has been completed in 2022-2023. This exercise will review both mitigation and adaption actions contained in the Nationally Determined Contributions of all countries as well as enablement and support provided by the developed countries on finance, technology and capacity-building.

What should India’s focus in Bonn be? And what should it not give away at these negotiations?
It is not unknown that rule-making and fleshing out of various treaties have departed from the original principles and objectives. Sometimes, the prioritisation of issues went awry and sometimes new elements crept in that were not envisaged in the treaty. Keeping in mind the magnitude of the global challenge posed by climate change, we should not let that happen in Bonn. I am quite clear the Paris Agreement is an agreement under the United Nations Framework Convention on Climate Change – implying that the latter is the parent treaty. That being so, the central and key role of equity and the principle of common but differentiated responsibility cannot be wished away or diluted in deciding the implementation arrangements for the Paris Agreement. The distinction between developing and developed countries has not been abolished in the Paris Agreement, nor has a new classification, a mezzanine floor, been created between developing countries.

The Agreement contains a fine and delicate balance between what the vision of the parties is in the long term, when present inequalities lessen significantly and poverty is eradicated, and what the parties target in the medium term through their Nationally Determined Contributions. The Agreement contains a balance between what developed countries would do and what developing countries would do. It contains a balance between the needs of mitigation and adaptation and the provision of enablement and support through the means of implementation – finance, technology and capacity-building. The decisions in Bonn should not be of a nature that upsets this hard-won balance or goes against what is provided in the Paris Agreement. India demonstrated leadership and flexibility in Paris and even later but in Bonn, there surely would be an inviolability of fundamental climate change principles and provisions.

What would the role of the United States be in Bonn? Would it be a casual observer or a keen participant?
In Bonn, we are not starting from scratch. For one, the United States continues to be party to the UN Framework Convention on Climate Change. Whatever President Donald Trump has said or done has not changed that. Since the Paris Agreement is under the Convention, the United States as a member of the Convention has a right to attend and participate, even after quitting the Agreement. From what I have read and understood, Trump’s overall approach is that of a deal-maker. Which is perhaps why he did not opt to walk out of the UN Framework Convention on Climate Change, which would have taken only one year. Then, the United States would not have to wait till November 2019 to give the formal quit notice and a further one year till November 2020 to walk out of the Paris Agreement.

It is indeed interesting that President Trump did not also send the Paris Agreement to the United States Senate, thus keeping the quit decision in his hands. From its recent submission to the United Nations, it appears the United States has not taken an uncompromising stance but has stated clearly that its walking out of the Paris Agreement is conditioned upon it finding suitable terms of re-engagement. This seems to imply that if the Paris Agreement rules are made to their satisfaction, then the United States would not quit.

Normally, in all multilateral negotiations, countries form groups. A statement from any group gives it the weight of all its members. And besides saving time, the chances of arriving at a consensus are more between a few groups than between numerous countries. That is why all developing countries are members of the G77+China and also of other smaller groups of converging interests. Similarly, developed countries are organised in various groups. The United States is part of the Umbrella group, comprising other developed countries like Australia, Japan and Russia. Sometimes, when there is no consensus within a group or for the sake of emphasising a key point, individual countries also make their submissions.

I do not, therefore, know what is going to happen in Bonn vis-a-vis the United States’ participation. This is a unique situation that has arisen. But I do not suppose the United States will be speaking on each and every issue. Most likely, it will speak as a member of the Umbrella group. Only where it diverges or departs from the Umbrella group stance would the American representative speak separately. We will thus need to see what kind of new balance the United States seeks at the Bonn negotiations. One would come to know by listening to both the Umbrella group and the United States individually.

If what the United States wants is not against the principles of the Convention and does not violate the delicate balance achieved in the Paris Agreement, then whether it is India or any other country, there should be no problem in being positive, pragmatic and flexible. We have so far achieved real results in international negotiations not only by adhering to our red lines but by being flexible and innovative at the same time. We need to wait and watch how the United States ultimately projects its new position in Bonn.

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Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the marketing team and not by the editorial staff.