Why health care can only be achieved through climate action

Earth Day 2020 is coming up next week and I felt its theme, ‘climate action,’ was the perfect occasion to shed light on how tightly our own health and the health of our planet are intertwined through the contributions of the health care sector to the ongoing climate emergency.

While there is an increasing awareness of the amount of greenhouse gases generated by things such as consuming certain foods, flights, or even by buying a new pair of shoes, never have I met anyone who considered how the medical care we use impacts our personal climate footprint. It is indeed a paradox to think of the healthcare sector -whose ultimate goal is to promote and protect human health, treat illnesses and save lives- as a major contributor to what is one of the biggest global health threats.

The health care sector contributes 4.4 % of the global net emission

Each year, two gigatons of greenhouse gas emissions are attributable to the health care sector. That equals to 4.4 % of the global net emission. Does this not seem like much? Let me try put it in other words: If the health care sector was a country, it would rank fifth among the largest carbon dioxide emitters in the world, right behind what some of the most populated countries like China, the United States, India and Russia, contribute to the global climate footprint.

Unfortunately, the world is not the most just place in the universe, and this is particularly true when it comes to climate change. Direct health consequences of climate change, such as extreme weather events and the increased spread of vector-borne diseases, disproportionally affect low- and middle-income countries with resource constrained healthcare sectors. Not only are the people living in places mostly affected by the climate crisis often the ones that contribute the least to the global carbon dioxide emission, but they also marginally benefit from the services provided by the healthcare sector.

Carbon-intensive supply chains of medical goods are the lion’s share

Now, where does all this carbon emission in health care come from? Differing in scale, indirect emissions of purchased energy for heating, cooling and electricity; transportation; product manufacture and disposal, collectively make up the healthcare sector’s climate footprint. The biggest share, however, derives from carbon-intensive production and transportation of medical instruments, technical equipment, vehicles, pharmaceuticals and other chemicals as well as agricultural products, such as food and cotton.

Next time you are at the doctor’s to get a blood check, pay attention to how much equipment is needed for that simple task, not to mention the technical equipment needed and ultimately the health care facility itself. It is not hard to imagine then how much more material is required for complex medical interventions, such as surgeries. That leads us to another problem; most of the material are disposable products with short life cycles. What is necessary on the one hand to perform medical procedures safely and hygienically, on the other hand, ends up generating a large amount of waste, often hazardous material, with significant environmental and climate impacts.

At the end of the day, it all comes back to the massive amounts of energy necessary to keep the different wheels inside the giant, complex machine of the healthcare sector running – energy, that is primarily generated by the combustion of fossil fuels. That means a rapid phase out of coal and a society-wide transition to renewable and clean energy sources would already cut down half the healthcare’s climate footprint.

“First, do no harm”

I believe that one of the most important things I was taught during my time in medical school is one of the principles of the Hippocratic Oath; “First, do no harm.” I think this principle not only applies to doctors, but for the sector as a whole and makes it an imperative responsibility of the health care sector to take on a double mission in the climate emergency.

First, responding at the frontline by treating those who fall ill or get injured due to climate change and its health consequences. Second, practice primary prevention of what ultimately causes the crisis by drastically cutting down its own greenhouse gas contributions and influencing others to do the same. Actors at all levels in the health care sector need to acknowledge that climate action ultimately is health action and that it is their particular responsibility to support decarbonization in every possible way.

Climate-smart health care can become reality

A healthcare sector that aligns with the Paris Agreement and reduces its carbon emissions to zero by 2050 without compromising the quality of care while at the same time working towards global health goals like universal health coverage– This is a scenario that might sound utopic and will by no means be easy to achieve.

But the news isn’t all bad, several health institutions all over the world have already taken on their responsibility by joining initiatives like the Health Care Climate Challenge that was launched during the Paris Climate Conference in 2015. To date, over 200 institutions in 31 countries have committed to reducing 34 million metric tons of carbon emissions and their example proves that sustainability in health care can become reality. What is needed though is immediate action and many more to follow their lead.

Every single one of us can take climate action to protect our planet and health, but we may face difficulties in doing so. Let’s learn from our experiences and help one another to deal with personal struggles in the climate movement. Share your story and participate in our Live Discussion with Klimatföreningen and ZeroWasteUppsala on Earth Day, April 22^nd, at 2pm!