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When more than 200 medical journals published an article declaring that climate change poses the single greatest to public health, the move was both widely viewed as unprecedented and followed by numerous cries for world leaders to take action at the then-upcoming UN Climate Change Conference (COP26).   

“Health care’s emissions footprint has been largely ignored by those addressing climate change over the past quarter century,” explained the authors of a report titled Healthcare’s Climate Footprint from Health Care Without Harm. “The health sector itself has paid scant attention until recently.”  

Early steps to change that commenced this week when more than 40 countries committed to work toward climate-smart health care at COP26 in Glasgow, Scotland. And while the commitments at this point are to essentially undertake the necessary research to chart roadmaps, thus few details are currently available, here are five things to know about the initiative and why it’s critical right now. 

1. Which countries have committed to climate smart health care? 
Nations participating in the initiative range from the United States, Britain and Germany to Bangladesh, Ethiopia, the Maldives and the Netherlands. “The governments of these countries, which include some of those most vulnerable to the health harms caused by climate change, as well as some of the world’s biggest carbon emitters, have committed to take concrete steps toward creating climate-resilient health systems,” the World Health Organization (WHO) said. Most countries have yet to set a target date, including the U.S., according to WHO’s list. The United Kingdom, however, set 2040 while Nigeria and Sierra Leone set 2035 and the most aggressive countries, Indonesia, Kenya and Malawi, committed to net zero emissions for their health systems by 2030.

Related: How climate change poses a threat to health equity

2. Health care as an industry creates a considerable amount of pollution.
The report from Health Care Without Harm states that health care organizations on a global scale produce 4.4-4.6 percent of greenhouse gases and other toxic pollutants that result from product manufacturing, use and disposal as well as transportation and energy consumption. In the U.S. specifically, health care organizations contribute 9 percent of non-greenhouse pollution that is harmful and 10 percent of carbon emissions, research in JAMA Network found. Health care as an industry, in fact, has increased greenhouse gas emissions by 6 percent between 2010 and 2018, according to a research article in Health Affairs. “The health care sector’s outsize environmental footprint can be reduced without compromising quality,” the authors wrote. 

3. Initiatives are underway but not enough progress has been achieved to date.
As part of the climate-smart effort, WHO conducted a survey that showed 85 percent of countries have appointed someone to be in charge or climate change with health care agencies and more than half have established related committees or task forces. The WHO survey determined that 70 percent of countries cite financial resources are the top obstacle to fully implementing plans for improving health and climate change, which is up from 56 percent in 2019. Not surprisingly, half of the countries responded that the COVID-19 pandemic has inhibited work to address climate change. 

4. The Department Health and Human Services (HHS) offered hints about its intentions.
While details of how exactly HHS will achieve the changes necessary to adhere to the new commitments, early reports indicate that Assistant Secretary Admiral Rachel Levine, MD, said it will focus on emission reduction at federal health facilities and provide “incentives, guidance and assistance,” to the private sector. And in late August 2021, HHS created the Office of Climate Change and Health Equity to identify communities with exposure to climate hazards, address disparities, promote research on how climate actions benefit public health. In the private sector, health care organizations publicly agreed in 2017 to maintain commitment to the Paris Agreement after the Trump Administration withdrew. That initial group has since expanded to 44 health care entities signing on to the “We Are Still In” declaration. 

5. Participating countries have the option to commit to two similar but distinct initiatives. The initiative aims to create both climate resilient health systems and sustainable low-carbon health systems.  

WHO describes climate resilient systems as committing to: undertake climate change and health vulnerability assessments by a stated target date, use that assessment to inform a national plan, use that plan as the foundation with which to secure funding for health.  

Organizations committing to become sustainable low carbon health systems will: Select a target date by which to produce net zero emissions with the recommendation of 2050, conduct an assessment of greenhouse gases being emitted by the health system including related supply chains, develop a roadmap to enabling a sustainable low carbon health system with considerations for reducing air pollution and human exposure to it.  

WHO noted that 45 countries have committed to both focus on climate resiliency and become low-carbon emitters and 14 of those set 2050 as a target date for net zero emissions.  

Tom Sullivan

Tom Sullivan brings more than two decades in editing and journalism experience to Health Evolution. Sullivan most recently served as Editor-in-Chief at HIMSS, leading Healthcare IT News, Health Finance, MobiHealthNews. Prior to HIMSS Media, Sullivan was News Editor of IDG’s InfoWorld, directing a dozen reporters’ coverage for the weekly print publication and daily website.