Climate change mitigation: Perspectives from the healthcare sector

The global health sector has a responsibility to reduce its carbon footprint by adopting a decarbonisation pathway and to prepare itself for the increased disease burden

Glasgow as a lookup to Paris 

The Paris Agreement, although not perfect, symbolises an achievement for global collective action on climate change. This year, governments have been expected to ratchet up their Nationally Determined Contributions (NDCs), hoping that this will lead to greater climate ambition. While NDCs seem to be inadequate to achieve this goal, the buzzword at the ongoing COP26 is ‘raising ambition’. 

Emerging from the global pandemic, the COP this year has taken on new dimensions, with hard lessons on crisis response still fresh in memory. The pandemic not just put the spotlight on the centrality of the health sector, it also drew attention to the sector’s, often neglected, environmental footprint. The sector is estimated to contribute around 4.4% (2 gigatonnes of CO₂ equivalent) of global net emissions and is growing. About 71% of emissions come from its supply chain through production, transport, and disposal of goods and services. The sector’s carbon footprint is likely to triple between now and 2050, if it is business as usual. 

Health sector, a key area to consider 

Clearly, the health sector has a responsibility to take climate actions—to reduce its carbon footprint by adopting a decarbonisation pathway and to prepare itself for the increased disease burden. Wider societal decarbonisation is crucial for the health sector to reach net-zero emissions, which includes every aspect associated with healthcare—buildings, energy, pharmaceuticals, transport, food and nutrition, medical waste management, and supply chains. Its delivery is reliant on several industries to provide and enable the functioning of healthcare infrastructure. For the health sector to fully decarbonise, it must do so in tandem with many other sectors of the economy and society.

Differential but merged responsibilities 

The pandemic exposed the wide inequalities prevalent in health and healthcare access within and between the countries of the world. Countries’ health sectors have common, but differentiated responsibilities, and respective capabilities, to get to net-zero emissions. This demonstrates that both developed and developing countries have multiple responsibilities and obligations for curbing health sector emissions. Wealthier nations have to undertake healthcare reform that is cross-cutting, while low- and middle-income countries may have the opportunity to establish a new model altogether. Transformation must also occur in conjunction with health, equity, and climate priorities.

Countries with larger, resource-intensive healthcare networks must work towards reducing their carbon footprints rapidly and steeply. Simultaneously, those whose emissions are less must adopt climate-smart sustainable solutions to develop their respective health infrastructure. Low- and middle-income countries, in particular, will often require support from financing mechanisms, like the Green Climate Fund, the Global Environment Facility, multilateral development banks, and bilateral aid to make their healthcare systems climate-smart. To facilitate this very important support, climate financing mechanisms must recognise and prioritise the requirements of the health sector. 

Where India stands 

India has not yet developed a GHG inventory for its health sector. At present, the best estimates come from Healthcare without Harm, an international non-governmental organisation, which estimates India’s health sector to account for about 1.5% of its total GHG emissions. This share of GHG contribution might look low at the moment, but it could easily rise steeply in future projections. This, however, also means that there is an opportunity for both public and private healthcare systems to develop in a more sustainable manner, which would enable avoiding these future emissions increases. Decarbonising healthcare in both the government and private sector in India, and improving its efficiency, is a step forward in this direction, but it cannot be achieved without the participation of the state governments. 

The first step is to estimate this sector’s emissions at national and state levels and put forth coherent strategies to decarbonise it. While doing so, the health sector will not only contribute in achieving the national mitigation targets, but will also increase resilience of the sector. 

Amidst uncertainties associated with climate change, strengthening and transforming India’s health systems and its paraphernalia is of paramount importance in order to prepare for the worst emergencies, while at the same time continuing India’s aggressive agenda in support of health, environmental and climate priorities on global platforms.

Abhijit Basu is senior programme coordinator (climate) for the Centre for Chronic Disease Control

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Abhijit Basu

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