Overview

Key messages:

• Climate change and health systems have a bidirectional relationship. Changes in climate are putting more pressure on health systems, but at the same time the health system fuels climate change, accounting for around 5% of global greenhouse gas emissions.
• Greening the health care sector has multiple co-benefits. Shifting from hospital-centred and curative care towards prevention and health promotion; reducing low-value care and treating people locally; and investing in greener infrastructure, all benefit the environment, and can also improve quality and access to care and population health.
• Change is needed at the level of the health system and of the health care facility with mobilization across the whole sector offering the best chance of decarbonizing.
• Seizing windows of opportunity is key and country experience suggests that action to reduce the environmental footprint of health care facilities is often the most feasible, but even bottom-up initiatives must be supported by a legal and strategic framework, technical expertise and funding.
• Health care facilities can make a difference through
  • Green procurement and making environmental criteria part of purchasing medical technologies, food and catering services.
  • Investing in energy-efficient infrastructure both actively upgrading existing facilities and applying high environmental standards to new construction.
  • Promoting environmentally friendly travel to the facility using zero-emission vehicles and encouraging staff and patients to make green choices.
  • Managing waste better rethinking processes and daily practices based on the 6Rs concept (Reduce, Reuse, Recycle, Refuse, Rethink and Repair).
  • Giving the health workforce green skills ensuring that health professionals have the time and space for training and perhaps creating dedicated professional roles to champion greening.
• Action at the health system level is crucial in enabling and encouraging greener procurement, energy efficiency and other environment-friendly action. Core steps include defining strategic direction; setting environmental standards; putting evaluation mechanisms in place; and offering technical and financial support. There are also concrete measures, such as connecting health facilities to public transport or rethinking training curricula, that can help.
• The European Union offers Member States significant opportunities to invest in greening health care facilities through a broad range of financial and technical support options, although there are challenges in making optimal use of these tools.
• The international community, and the World Health Organization in particular, offer key resources for decision-makers providing knowledge exchange and promoting collaboration at both the health system and organizational levels.