Climate change is a global health threat—contributing to heat waves, storms, floods, droughts and fires, altered infectious disease patterns, food shortages, and air pollution.  It adds an increased burden on  healthcare systems across the world. But less is known about the reverse: the environmental footprints of the healthcare sector have not been traced enough. 

Healthcare’s Climate Footprint

The Healthcare sector is responsible for a substantial share of the world’s emission of greenhouse gases and air pollutants: 4.4% of greenhouse gases, 2.8% of harmful particulate matter (air particles), 3.4% of nitrogen oxides, and 3.6% of sulphur dioxide. The top three emitters, USA, China, and collectively the countries of the European Union, comprise more than half the world’s total healthcare climate footprint (56%).

While vastly differing in scale, each nation’s health sector directly and indirectly releases greenhouse gases and air pollutants while delivering care and procuring products, services, and technologies from a carbon-intensive supply chain. The most relevant share of emissions (71%) is primarily derived from the health care supply chain through the production, transport, and disposal of goods and services, such as pharmaceuticals and other chemicals, medical devices, hospital equipment, and instruments. Emissions from health care facilities and health care owned vehicles comprise 17% of the sector’s worldwide footprint. In addition to that, indirect emissions from purchased energy sources such as electricity, steam, cooling, and heating comprise another 12%. Three-quarters of all health care emissions, including from its supply chain, are generated domestically which implies that roughly one-quarter of all health care emissions are generated outside of the country where the health care product is ultimately consumed.  

Healthcare’s Footprint Linkage to Health Spending

There is a strong but not a causal correlation between a country’s health spending and the country’s healthcare sector climate footprint. Generally, the higher the spending, the higher the per capita healthcare emissions are in that country.|Nevertheless, other factors are also critically important to consider, particularly the energy intensity of a country’s economy and the emissions intensity of its energy systems.

An increase in investment around healthcare would potentially translate into an increasing harm to health from pollution and environmental damage. However, if we manage to couple the health sector’s growth and investment with a new trajectory to zero emissions, health care’s climate footprint can decrease significantly in spite of the growth in health spending. 

Reducing Health Care’s Climate Footprint 

Health care must respond to the growing climate crisis urgently not only by treating those affected by the climate crisis, but also by radically reducing its own emissions. The healthcare sector must understand its impact on the environment while simultaneously meeting global health goals such as Universal Health Coverage and working to achieve the Sustainable  Development Goals. The health care climate action that aligns with the ambitions of the Paris Agreement will require health sector facilities, systems, and ministries to work with manufacturers and suppliers of health care goods and services to achieve net zero emissions by 2050 or before. Several countries have already led the way by remodelling their health systems toward decarbonization. For example, in South Korea emissions of greenhouse gases, sulphur dioxide, nitrogen oxide, and particulate matter from health care decreased by between 27% and 60% during 2000 and 2015.

Healthcare sector leaders have an ethical responsibility to measure, monitor, and address the environmental footprints of health care. Actors at all levels in the health sector should take immediate action to reduce health care facility emissions. The health sector — individual health facilities, health systems, ministries of health, international and bilateral development agencies, and private health care organizations — all need to make health investments and policy changes to decarbonize their health systems, make a transition to a more renewable energy, and improve health outcomes. Further research is needed to better understand trends in the interlinkage between health care and climate change, including an in-depth analysis of the supply chain and its climate impact, national and subnational health care climate footprinting, economic and health analysis of the costs and benefits of transitioning to climate-smart healthcare, and more.  Now more than ever, there is a pressing need to understand the environmental footprints of health care and its impact on health. The pandemic has brought attention to waste from single-use personal protective equipment. The problem of medical waste may not yet be at the top of the healthcare agenda, but it is high time that healthcare leaders realize that it is pertinent to consider the detrimental environmental and climatic implications of the healthcare sector and enact novel laws and regulations towards that measure.

Dr. Preeti Shakya
Dr. Preeti Shakya

Preeti Shakya is a medical doctor from Nepal. She is passionate about advocating for the health of women and minority populations, bringing the undeserved community closer to health equity, and disrupting health systems via advocacy, technology, and innovation. She is also a freelance writer/blogger and mostly writes on issues surrounding girls/women, health, human rights, and social justice. Her other areas of interest include clinical research, evidence-based medicine, humanitarian health aid, public health, and social entrepreneurship.

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