Public purchasing of food is a basic political instrument. It has the capacity to drive consumption and production towards agroecology, generating social, economic, environmental and health benefits. 14% of the total monetary value of goods and services in the European Union is spent on public procurement. This economic potential would directly affect the transformation of current production and consumption patterns through public purchasing of sustainable food.

Hospitals, such as "anchor organizations", should strategically use their position to influence beyond the hospital, promote citizens' health and contribute to the community and local economy. Thus, public purchasing of sustainable food should be the basis of its functioning. In Navarre, steps have been taken, since the Ekoalde producers association offers supply services to the University Hospital of Navarra, incorporating nearby and seasonal organic products in the patient menus. In Osakidetza, however, small and symbolic steps have been taken.

The Basque Government presented the Green Procurement and Procurement Programme, a strategy to promote green purchasing by 2030. Food is identified as a priority category and we hope that significant progress will be made in the coming years.

The Renascence study, developed by the University of the Basque Country, put in dialogue the staff of Osakidetza and different agents of the food system to reflect on this issue. A report on the content of these working sessions and a scientific article have recently been submitted. This seed to promote a sustainable food system in the Basque health system has yielded 13 challenges and 30 actions.

To make a leap of scale in the food system from the agri-ecological point of view, the main challenges to be highlighted, both from the sector and from the public institutions, are three: the shared supply service – so that small producers can cope with the demand and distribution of products – the adequacy of the criteria for the valuation of public tenders to local production and to the agro-ecological model, today adapted to large companies and to the agri-ecological sector, and, the possible Once again there is a need to review the direction of public investment.

Serve this article to publicize this research we call "grow" and spark the transition to sustainable food systems in our hospitals.