Science-based paths toward net zero emissions in the health sector

Article by Susan T. Jackson

Source: Shutterstock, Author: Natali_Mis

The latest report from the Intergovernmental Panel on Climate Change (IPCC) has laid it out in stark terms: we’re running out of time to tackle climate change and limit the rise in temperature to under 1.5°C. Yet, according to recent research, in the Covid-19-related stimulus funds committed by the world’s largest economies, only 6% has been allocated toward cutting emissions and a further 3% has been put towards areas that increase emissions, such as coal power.

The health sector’s carbon footprint jeopardizes achieving the 2030 goals

One of the most difficult aspects in addressing climate change is decarbonizing healthcare while maintaining our pursuit of just and sustainable development. At the same time, the climate crisis is a health crisis because of its effect, meaning we can’t tackle one without addressing the other. Whether direct emissions from facilities or from their supply chains for goods and services, the health sector alone is estimated to account for approximately 4.6% of the world’s annual greenhouse gas (GHG) emissions, roughly as much as annual global emissions from aviation, rail and shipping combined. At the same time, the health sector often is a large employer in countries and spending on healthcare can average up to 9% of GDP in the Organization for Economic Cooperation and Development member countries. Health sector emissions stem from facility operations, waste management, medicines, transport of patients and staff, and food service, among other things.

These figures underlie the COP26 announcement that thirteen countries (though not many of the highest emitters) will join the UK’s 2020 commitment that aims for net zero carbon emissions in their respective health sectors by or before 2050. At the same time, another 31 countries (including Germany) plan to work toward low-carbon emissions in their own health sectors. Achieving these country-level commitments presents many challenges and opportunities for the health sector.

Intersecting challenges to decarbonizing the health sector

Justifiably, people often link climate change to negative impacts on human health. However, there are climate change-related risks directly associated with the health sector’s infrastructure and supply chains as well. Here are a few examples of challenges, followed by some opportunities for achieving co-benefits that outweigh the financial costs of health sector decarbonization efforts:

Building design and operations

Hospital buildings consume twice as much energy per unit than general public buildings. Through direct use for power and other uses of energy combined with long hours of operation, hospitals and similar medical facilities consume high levels of energy.

Mismatched supply and demand

Healthcare facilities often are prepared for a variety of health issues that occur on occasion. For example, excess capacity of specialized medical devices can mean that many of these devices spend the majority of their time in stand-by mode. In terms of the human factor, work process inefficiencies also can contribute to emission issues, for example, by not tracking how patient care and related individual activities are linked to carbon emissions.

Supply chains

Healthcare facilities, as with any business, face growing responsibility for indirect emissions in their supply chains – which alone account for 62% of health sector emissions (including medicine and medical equipment). One of the biggest challenges to monitoring supply chain emissions is the lack of transparent, standardized metrics.

Decarbonizing strategies and actions

Many of the problems we face in decarbonizing the health sector can be addressed on the organizational level now while system-level solutions are in the works. Whether contributing to changing organizational structures and processes, taking action to the communities you serve, or reaching out to support more sustainable policy, there is a growing pool of examples and resources for inspiration.

Pursuing leadership

Organizations can empower their people at any level to take initiative to lead sustainably. In addition, board-approved net zero strategies that bring together a variety of stakeholders are important and can include investments in zero emission buildings and infrastructure and sourcing locally grown food are within reach already today. Individual facilities can decarbonize their energy supply systems, for example, via installing renewable energy generation or buying from energy suppliers that source electricity from renewable sources and by electrifying their transport fleets. Standardized metrics and solid data are key components of promoting and supporting sustainability along supply chains. Further, health sector professionals can share their knowledge about the links between health and climate change in ways that help members of their communities thrive.

Innovating approaches

Challenging the status quo in healthcare delivery is one area that deserves deeper exploration. Integrating services and other innovative strategies can mean lowering costs in facilities in ways that add value to patient care at the same time. Other innovations that can contribute to decarbonization of the health sector include improved diets for patients, as well as better well-being for caregivers and patients alike who benefit from improved workplace efficiencies through, for example, AI for scheduling apps. By bringing together resources and capacities, public-private partnerships can contribute to developing new ways forward as well, not least in finding ways to finance the costs of implementing decarbonization strategies.

Transforming solutions

Net zero business models are central to lowering emissions by the biggest polluters, as is working with low and middle income countries to help transition to net zero universal care delivery. The private sector can work together to decarbonize supply chains, both in ways that make health systems net zero and in ways that consider the health impact of decarbonizing the economy more broadly. Regional initiatives such as the Bavarian Green Hospital Initiative can be fruitful spaces for collaboration as well.

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