Firstly, the rationale and urgency behind the Circular Economy (CE) are described by providing evidence of the environmental degradation caused by a linear economy as the extensive use of natural resources threatens to exceed the carrying capacity of the Earth. A clear definition of CE is given as well as the key principles behind the concept: 1. Minimize resource extraction and material use; 2. Keep products in use as long as possible; 3. Close material cycles; 4. Prevent pollution and regenerate ecosystems; 5. Create economic and social value.

In the second part, the operational strategies (9R Framework) that are necessary to implement the CE principles in practice are presented. These include, amongst others, Rethink, Reduce, Reuse, Repair, Refurbish, Remanufacture and Recycle. Also, the main areas of action are shortly described, ranging from innovative business models to circular design and reverse logistics (take-back systems).

Inspiring examples are given of concrete initiatives that have been implemented by institutions in the healthcare sector (or other public sectors), actively contributing to a circular economy. E.g. substituting single-use by reusable materials & products; prevention of food waste in hospitals; circular textiles; a performance-based model for lighting; repair, remanufacturing and reuse of medical equipment. There is a lot of potential for healthcare institutions to implement circular principles in their own operations.

Reducing the use of primary resources, maintaining the highest value of materials and products and moving towards renewable energy (& energy-efficiency) have many positive health implications as well as economic benefits. There is also potential for significant (health) benefits from circular business models that design out waste & pollution and focus on performance & quality in the procurement of equipment.