Josh Karliner: A prescription for a healthy planet

Every year, human civilization churns out ever more dangerous quantities of greenhouse gases. Every day we see and feel the increasing effects of a growing climate crisis that impacts on people’s health, the economy, and the environment.   

There is a direct connection between the climate crisis and civilization’s dependence on the combustion of fossil fuelscoal, oil, and gas. The solution is clear. We must break our addiction to these toxic 20th century energy sources, and build a 21st century economy nourished by clean, renewable, healthy energy.  

The role of healthcare in this dynamic is little recognised. Not only are doctors, nurses, and health facilities all first responders to the impacts of climate change, but hospitals and healthcare systems all make a major contribution to the climate crisis, paradoxically burning fossil fuels to save lives.  

In the first ever comprehensive global study of its sort, Health Care Without Harm together with the global engineering firm Arup have found that healthcare’s climate footprint is equivalent to 4.4 percent of global greenhouse gas emissions. To put this in context, the global healthcare climate footprint is equivalent to the annual greenhouse gas emissions from 514 coal-fired power plants. Seen another way, if the health sector were a country, it would be the fifth largest emitter on the planet. 

Hospitals, health systems, and their supply chains in the United States, China, and collectively the countries of the European Union, comprise more than half of healthcare’s worldwide emissions. While vastly differing in scale, every nation’s health sector directly and indirectly releases greenhouse gases as it delivers care.

In October 2018, the Intergovernmental Panel on Climate Change issued an alarming report which found that staving off the worst impacts of the climate crisis by limiting global warming to 1.5°C, the ambition of the Paris Agreement, would “require rapid, far-reaching, and unprecedented changes in all aspects of society.” In other words, we need to fundamentally change course over the next decade or risk making the planet uninhabitable for human beings.

Healthcare organisations, whose mission is to protect and promote health, must do their part. There is no other choice. Healthcare, the only part of our global economy that has healing as its mission, 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 to zero by 2050. The sector must make this systemic change while simultaneously meeting global health goals such as universal coverage. 

This is a massive challenge. It should not be underestimated. It will require a visionary transformation that retools how care is delivered, along with a seismic shift in policy, aid and investment. The good news is that several health systems in multiple countries are already leading the way toward decarbonization, serving as models for the sector.  

For instance, nearly 200 institutions representing the interests of over 18,000 hospitals and health centers from 31 countries, have joined the Health Care Climate Challenge. They are taking action and measuring progress. So far, together they have committed to reducing emissions by 30 million metric tons. Several leading hospitals on every continent are charting a course to zero emissions. This is not enough. But it is a promising start.

The healthcare sector must help forge a prescription for a healthy planet that breaks our addiction to fossil fuels. It must begin by taking responsibility for its own climate footprint, thereby implementing the Hippocratic Oath to “first, do no harm.” Health professionals and major health institutions must become advocates for protecting the intimately intertwined health of people and planet from the ravages of climate change. Both climate justice and health equity depend on it.

Josh Karliner is international director, program and strategy for Health Care Without Harm.  

Competing interests: None declared