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Healthcare’s climate footprint is equivalent to 4.4% of global net emissions. Lindström’s Aniruddha Banerjee is concerned with the current development and shares insights on how to change the direction for the better.
Humanity is living beyond the means of Planet Earth. Our use of finite resources continues to spiral upward and greenhouse gas (GHG) emissions continue to disperse into the air. The earth continues to heat up. It is becoming clear that we’re running out of time to course-correct. However, in consideration of the rapid global change that has occurred since the covid-19 pandemic struck in March 2020, the world is finally waking up. Covid-19 has disrupted business-as-usual. Climate breakdown, resource scarcity, and ecological collapse have moved from the horizon to the forefront, as shocks and crisis have exposed the fragility of our current, linear system. Calls to ‘build back better’ with a green recovery – thereby mending the impacts of the pandemic in a way that also addresses climate breakdown – are strong.
Healthcare, we can do better
Although the health impacts of pollution and environmental change are well recognised, the environmental impacts of healthcare have received less attention. Healthcare evaluation traditionally focuses on direct health outcomes and financial costs. However, the environmental footprint of healthcare provision, which includes a wide variety of air, water, and soil pollutants, also has an unintended and negative impact on health.
Healthcare is a large economic sector and employer in many countries. The average spending on healthcare among member countries of the Organisation for Economic Co-operation and Development is about 9% of gross domestic product (GDP).
There is a pressing need to understand the health impact of the environmental footprint of healthcare because, as investment in healthcare increases around the world, there is considerable potential for increasing harm to health at the hands of pollution and environmental change. People who are harmed by the environmental footprint of healthcare often live far away from those who benefit from the healthcare provided. Hence, doctors and other health sector leaders have a practical and ethical responsibility to measure, monitor, and address the environmental footprint of healthcare.
Healthcare’s global climate footprint
- The health sector, whose mission is protecting and promoting health, makes a major contribution to the climate crisis — the greatest health threat of the 21st century — and therefore has an important role to play in resolving it.
- Healthcare’s climate footprint is equivalent to 4.4% of global net emissions (the equivalent of two gigatons of carbon dioxide).
- The global health care climate footprint is equivalent to the annual greenhouse gas emissions of 514 coal-fired power plants.
- If the health sector were a country, it would be the fifth-largest emitter on the planet.
Top healthcare emitters
- The top three emitters, the United States, China, and collectively, the countries of the European Union, comprise more than half the world’s total healthcare climate footprint (56%). The top 10 healthcare emitters make up 75% of the global healthcare climate footprint.
- The United States health sector, the world’s number one emitter in both absolute and per capita terms, produces 57 times more emissions per person than does India.
- While India has the seventh-largest absolute health sector climate footprint, it has the lowest health-related emissions per capita of all 43 nations considered in detail in this study.
- China’s health sector produces six times more greenhouse gases per person than India’s does. But China’s health system also emits one-seventh the volume of greenhouse gases per capita as the United States, one-third of that of South Korea and just under one-half the per capita volume of the European Union.
Sources of healthcare’s climate footprint
While vastly differing in scale, each nation’s health sector directly and indirectly releases greenhouse gases while delivering care and procuring products, services, and technologies from a carbon-intensive supply chain. Healthcare contributes to greenhouse gas emissions through energy consumption, transport, and product manufacture, use, and disposal.
- Emissions emanating directly from healthcare facilities and healthcare-owned vehicles make up 17% of the sector’s worldwide footprint.
- Indirect emissions from purchased energy sources such as electricity, steam, cooling, and heating comprise another 12%
- The lion’s share of emissions — 71% are primarily derived from the healthcare supply chain through the production, transport, and disposal of goods and services, such as pharmaceuticals and other chemicals, food and agricultural products, medical devices, hospital equipment, and instruments.
- Three-quarters of all healthcare emissions, including from its supply chain, are generated domestically. This means roughly one-quarter of all healthcare emissions are generated outside the country where the healthcare product is ultimately consumed.
- Fossil fuel consumption is at the heart of healthcare’s emissions. Energy — primarily the combustion of fossil fuels — makes up well over half of healthcare’s climate footprint when measured across all three scopes.
The finding that 71% of healthcare’s climate footprint is attributable to the healthcare supply chain is significant. While further study is needed, it is highly likely that the vast majority of these emissions emanate from the production, packaging, transport, and disposal of goods and services that health care purchases. These include pharmaceuticals and other chemicals, medical devices, hospital equipment, instruments, textiles, and more.
Climate change is a health issue
Climate change is damaging human health today and will have a greater impact on it in the future. Direct climate impacts, such as the spread of vector-borne disease, increased heat, drought, severe storms, and flooding as well as the mass migration of climate refugees, all have health consequences. These will disproportionately affect the most vulnerable and marginalised populations and increase in intensity over time.
All countries will experience significant and growing health impacts from climate change. Low- and middle-income countries will see the worst effects as they are the most vulnerable to climate shifts and least able to adapt given their weak healthcare systems and poor infrastructure. Climate change could drag more than 100 million people back into extreme poverty by 2030 with much of this reversal attributable to negative impacts on health.
The health sector must take responsibility for its climate footprint
Healthcare must respond to the growing climate emergency not only by treating those made ill, injured, or dying from the climate crisis and its causes, but also by practicing primary prevention and radically reducing its own emissions.
Healthcare climate action that aligns with the ambition of the Paris Agreement will require health sector facilities, systems, and ministries to work with manufacturers and suppliers of healthcare goods and services to achieve net zero emissions by 2050 or before.
The sector must undertake this effort while simultaneously meeting global health goals such as universal health coverage and working to achieve the Sustainable Development Goals. Several health systems in multiple countries are already leading the way toward decarbonisation, serving as models for the sector.
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