Fifty Countries Commit to ‘greening’ their healthcare systems at COP26
Solar panels provide electricity to Mulalika Health Clinic in Zambia.

Fifty countries have committed to building sustainable, low-carbon and climate-resilient healthcare systems, and 14 of these have set net-zero carbon emission target dates from as early as 2030. 

This emerged from a health and climate change session at COP26, the United Nations climate conference in Glasgow, that was co-hosted by the World Health Organization (WHO).

“As part of a green and resilient recovery from COVID-19, we need to recognise the role of health systems as emitters accounting for 4% to 5% of global emissions,” said Dr Rachel Levine, US Assistant Secretary in the Department of Health and Human Services.

If the global health care sector were a country, it would be the fifth-largest greenhouse gas emitter on the planet, according to Health care’s climate footprint, a report produced by Health Care Without Harm.

“These emissions are predicted to increase as health systems develop, and demographic changes lead to increasing healthcare demand,” said Levine, adding that the countries that had committed to building low carbon health systems were responsible for about one-third of all health sector emissions globally.

The US has committed to decarbonizing the nation’s health systems by reducing  greenhouse gas emissions in the federal health system, as well as the private sector via  “incentives, guidance, technical assistance and regulatory approaches and partnerships”, Levine added. 

“The United States action on health system decarbonization is influential and critical. The US accounts for approximately 25% of the world’s health sector greenhouse gas emissions. This commitment to reducing greenhouse gases will also result in decreasing the negative health impacts of air pollution, such as premature death, heart disease, stroke, and more,” said Levine.

Josh Karliner, International Director of Program and Strategy at Health Care Without Harm, said that “there is a growing global movement of hospitals and health systems” that were already reducing their carbon emissions.

“There are more than 54 institutions in 21 countries representing more than 14,000 hospitals and health centres committed to race to zero,” said Karliner. “This is from Newcastle to New York. It’s from Sao Paulo to South Africa. It’s from Kerala to California.” 

Karliner explained: “We’re seeing hospitals and health systems taking action by investing in renewable energy by investing in zero-emission buildings and transport; by substituting anaesthetic gases with more sustainable alternatives; by implementing sustainable procurement programmes to purchase sustainably produced food, energy-efficient medical devices and lower carbon pharmaceuticals.” 

However, ‘greening’ health systems is a massive, expensive undertaking that requires many fundamental changes covering architecture, waste disposal, energy, and water.


A flash flood in Fiji in 2018

Small island states struggle to make health services climate-resilient

Dr Satyendra Prasad, Fiji’s permanent representative to the UN, told the meeting that his country struggled to keep health services running when faced with superstorms and other adverse weather events.

“It is quite tragic when your doctors and nurses are being evacuated when they should be providing frontline services to people who have been injured and who need care,” said Prasad. 

“This conundrum is very tough, and it is a conundrum that exists for so many countries,” said Prasad, adding that Fiji is in the process of relocating health services to higher ground and equipping facilities with renewable energy to enable them to remain operational after major cyclones of flooding.

“We losing fewer lives to extreme weather catastrophes. We are losing more lives to waterborne diseases and all the diseases that come following a major catastrophe such as flooding, and cyclone,” he added.

Similarly, the Maldives has seen the emergence of vector-borne tropical diseases such as Dengue, which it didn’t use to have, said Aminath Shauna, Minister of Environment, Climate Change and Technology in the Maldives.

“The Maldives is one of the most vulnerable island nations to climate change. We are experiencing things that we thought would happen towards the end of the century,” said Shauna.

“Our coral reefs are dying. We are running out of fresh water. Our islands are eroding, and our islands are getting more frequently flooded, which poses a significant challenge to our public health system,” she added.

To mitigate these risks, the Maldives has integrated climate risks into health policy, developed climate-sensitive disease programmes and is promoting climate-resilient healthcare facilities that are able to withstand climate events. It is also working to ensure that its essential services such as water, sanitation, waste management and electricity can still function during extreme weather events. 

“The Maldives health sector is also committed to initiating the greening of the health sector by adopting environment-friendly technologies and using energy-efficient services,” said Shauna.

Finances for adaptation

However, finances to make these changes are a challenge for countries like Fiji and the Maldives. Lack of finance has been a recurrent theme at COP26, with smaller countries with small carbon footprints appealing for reparations from large polluting countries to assist them to mitigate climate change.

Former UK prime minister Gordon Brown and WHO Ambassador for Global Health Financing told the meeting that “you cannot cut investment in health at the expense of climate change – and you cannot cut investment in climate finance at the expense of health”.

“We really have to recognise that we’re dealing with global public goods – the control of infectious diseases, a clean environment, clean air and a clean environment,” said Brown.

“And we need to have a system of global burden-sharing where the richest countries that are responsible for the historic emissions and have the wealth and the capacity to pay, make good the funding that is necessary for mitigation and adaptation, and that includes the adaptation of healthcare systems, particularly in the poorest parts of the world,” said Brown.

Despite the global commitment made at Paris COP to ensure $100 billion a year in financing to mitigate climate change by the end of this year, it looks like this target will only be reached in 2023.

However, Brown stressed that if this target was not reached, it would deprive developing countries “of the opportunity not only to build coastal defences and renewable industries, but to build the healthcare systems that are necessary for resistance to droughts and famine, and also to pollution in the air”.

Addressing the meeting via a recorded message, WHO Director-General Dr Tedros Adhanom Ghebreyesus said that the changes the world needed to make to energy, transport and food systems to meet the Paris climate goals “would bring massive health gains”.

He added that the WHO is committed to working with the countries that had committed to building greener health systems “for a healthier and more sustainable future”.

Image Credits: UNDP/Karin Schermbrucker for Slingshot , World Meterological Organisation.

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