Climate change and global health: What actions are healthcare leaders taking?

This year has seen devastating floods in Pakistan, heavy wildfires in the US and severe droughts in Europe and the Horn of Africa, worsening an existing food crisis. Climate change is compounding these crises or increasing their likelihood.

People around the world are already suffering from the impact of climate change through increased respiratory and cardiovascular disease, injuries and premature deaths related to extreme weather events, changes in infectious diseases patterns, and threats to mental health.

And while air pollution currently kills 7 million people per year, the WHO predicts that climate change will cause approximately 250,000 additional deaths per year between 2030 and 2050 from malnutrition, malaria, diarrhoea and heat stress. This is why climate change has been named the biggest health threat facing humanity by the WHO.

The healthcare sector has a particular responsibility in this space, being directly affected by the climate change impacts on patients and at the same time being responsible for over 4% of greenhouse gas emissions (GHG) globally.

An increasing number of hospitals and other healthcare players have started to take action. The International Hospital Federation is launching a call for action alongside the World Hospital Congress to address climate change as an integral part of healthcare delivery.

We have asked key executives from the healthcare sector to reflect on the challenges of climate change on their business and what solutions they are already implementing.

Robert C. Garrett, Chief Executive Officer, Hackensack Meridian Health

The healthcare industry’s mission is to heal. And for us to remain committed to keeping our communities healthy, enhancing people’s quality of life, and delivering more value in healthcare, we must do everything in our power to fight climate change. To truly call ourselves healers, we must work together to embrace bold and innovative strategies to combat this public health crisis.

Ironically, the healthcare industry is one of the biggest contributors to climate change, contrary to our healing mission. The US healthcare industry is responsible for 8.5% of our national GHG emissions. And yet, our patients are experiencing the adverse health effects of a changing climate every day, along with injuries, illness, and mental health impacts related to extreme weather events. These climate-fuelled weather events can also disrupt healthcare access, delivery, and supply chains. Those of us committed to healthcare must also be committed to preventing illness. We must be part of the solution.

Our health network is taking deliberate steps to reduce its environmental footprint. We are partnering with state utility companies through the Hospital Efficiency Program to create more energy efficient campuses, which has resulted in an investment of over $115 million. Energy-efficient cooling and heating systems, air handling units, lighting and other major equipment have replaced antiquated systems, reducing energy consumption by 30% on average in the past decade. By operating more efficiently the savings go directly to our bottom line and enable us to continue to invest in the health of our patients and the community.

We have advocated at both the state and federal levels, urging public-private partnerships to address the climate crisis. This summer, we were one of the first signatories of the Department of Health and Human Services (HHS) health care climate pledge, committing to lower our GHG emissions and build more climate resilient infrastructure. The House Ways & Means Committee deemed Hackensack Meridian Health a "climate innovator" based on the network's work with the Committee to better understand how climate events impact the health sector, as well as ways we are taking to address our role in mitigating the climate crisis. And, in New Jersey, we signed the Business Leaders Green Workforce Development Pledge, recognizing the economic and health benefits that stem from supporting local opportunities to grow the green economy.

The network has aligned its food strategy with its population health strategy, reducing its meat consumption by more than 21% at hospitals throughout the system. Plant-based diets are better for patients and the environment. Hackensack Meridian is the largest health system in the nation to join the Cool Food Pledge, founded by the World Resources Institute to help organizations reduce their climate impact by promoting more plant-based foods. We have reduced our total food-related emissions by over 40%, making our network a leader in terms of overall reductions.

Incorporating a smaller carbon footprint must be part of a robust and comprehensive strategy to improve public health. Fighting climate change is an important pillar of our increased focus on prevention and getting to the root cause of illness. We have seen how a more holistic approach to healthcare leads to improved outcomes, especially in the management of chronic, debilitating, and costly diseases like diabetes, asthma, and cardiovascular disease.

The healthcare industry must lead the way to a sustainable, low-carbon and resilient economy – both by reducing our own emissions and by serving as models for sustainability within our communities.

Shobana Kamineni, Executive Vice-Chairperson, Apollo Hospitals Enterprise Limited

As India’s largest private integrated healthcare provider, Apollo Hospitals recognizes our dual responsibility to mitigate the impact of climate change on patients, while simultaneously making our operations climate resilient. We endeavour to ensure that healthcare delivery is seamless and aligned to pre-empt risks resulting from adverse climate changes. To ensure our hospitals continue to be safe during disasters, and provide patient care services with minimal interruption, we regularly review our ‘Hazard Vulnerability Analysis’ (HUA) and align our resources to efficiently mitigate the impact.

In cases of a surge in unseasonal vector-borne diseases, dengue or malaria, an example of changing weather patterns, or an uptick in air pollution, we immediately amplify our community outreach through advisories across social and traditional media platforms alerting people and simultaneously strengthen our capacity to provide care given foreseeable rise in diseases.

Our steps towards a net-zero healthcare system are yielding results, through our focus on areas of energy, water and waste management, as well as green design in construction. For instance, to ensure that our 71 hospitalsspread across the country are compliant with sustainable energy practices, we implement a stepwise approach – quantification of wasteful energy consumption, and assessment of viable solutions, followed by ensuring commitment across stakeholders in engineering and management.

We identified twenty of our hospitals that collectively accounted for over 90% of the overall energy consumption and started developing solutions to deliver 10-20% reductions in energy consumption through our partnership with a leading energy solutions provider. Deploying advanced IoT tech for automatic controls and continuous, data-based optimization, our hospitals have been able to deliver efficient patient care, while our partner helped deliver improvements in energy management. We now envisage energy savings of 300 million kWh, carbon emissions reduction of 290,000 tonnes, and energy cost savings of $27 million over 10 years beginning September 2021.

For disposal of e-waste, solid waste and hazardous waste, we are actively contributing to “take-back” programmes for the safe disposal of unused medicines, along with imparting compliance training to our personnel. The sustainability initiative includes moving our packaging to more environmentally friendly variants and biodegradable material, along with incorporating more “green design” norms in construction.

That climate change is the greatest threat to humanity,
has strengthened Apollo Hospitals’ resolve to ensure that healthcare delivery is aligned to pre-empt the impact of climate change and accordingly we have been deepening our effort towards sustainability.

H.E. Majid I. Al Fayyadh, Chief Executive Officer, King Faisal Specialist Hospital & Research Centre

The surging pollution levels mainly caused by industrial emissions have been exacerbating severe diseases, shortening life spans, and aiding extreme climate events and threats to public health, i.e. the patient community.

As one of the top tertiary and quaternary healthcare providers in the Middle East, we, at the King Faisal Specialist Hospital and Research Centre (KFSH&RC) have undertaken the responsibility to align ourselves to the highest standards of care for our patients, the broader community and the environment. This commitment also underpins our support for Saudi Arabia’s Vision 2030 and the Kingdom’s net-zero carbon emissions target by 2060.

We place great importance on researching the impact of climate change on public health. At KFSH&RC, we develop studies to provide the necessary data for public health departments, healthcare providers, and policymakers to promote public health awareness and implement more appropriate measures to treat climate-sensitive diseases.

We recognize that the healthcare sector has a vital role to play in climate change mitigation efforts. Therefore we also have been working on tackling our environmental footprint by incorporating CSR and ESG initiatives to advance healthcare equity for all.

Our efforts include: transitioning to electronic health services such as virtual care and the elimination of paper transactions; introducing recycling programmes, food composting programsme, waste management systems and conservation of water and energy resources; and, more recently, integrating the use of renewable energy across our facility expansion plans to reduce building emissions according to LEED certification standards. Additionally, we are transforming our supply chain and procurement operations to reduce our supply chain’s GHG gas emissions footprint.

In essence, advancing diversity, equity and inclusion, from conducting scientific research to incorporating sustainability initiatives in our everyday operations, are core commitments of KFSH&RC, underscoring our goal to be the region’s leader in sustainability in healthcare. We are determined in our response and efforts to tackle climate change and recognize that we, as a healthcare community, still have a long way to go before we see and reap the benefits of our collective initiatives to guarantee a healthier future.

Cheryl Moore, Director, Research Programmes, Wellcome Trust

It’s no longer news that the world’s climate is changing, and that we can no longer stop that from happening. What’s less well-known is the impact this will have on our health.

The United Nations Secretary-General, António Guterres warned that the window to take urgent climate action is closing rapidly, and unless countries dramatically scale up their efforts to counter the climate crisis, the world faces a global catastrophe. According to the World Health Organization (WHO), climate change is the single greatest threat facing humanity with the effects on human health already being felt.

Many of the greatest impacts are being felt in the poorest countries around the world – from spikes in water-borne disease during the floods in South Sudan, to high temperatures causing premature births in Australia, or the bread crisis faced by families in Syria after another year of conflict and failing crops.

Evidence from The Lancet Countdown found that heat-related deaths in the most vulnerable populations – babies and the elderly – increased by 68% over the past four years compared with 2000-2004. UNICEF warn that 559 million children are currently exposed to high heatwave frequency, and this will rise to 2.02 billion children globally by 2050.

A recent study published in the Lancet Planetary Health estimates that up to 8.4 billion people could be at risk from malaria and dengue if emissions keep rising at current levels. The urgency of this health threat is why Wellcome has made Climate & Health one of the key health challenges we focus on. We aim to transform the world’s understanding of the health impacts of climate change, and to generate well-evidenced policy options and interventions to respond to this threat.

Core to our approach is ensuring that evidence is turned into action. The production of evidence alone is important, but it simply isn’t enough. With this in mind, we are funding research differently, to ensure that emerging evidence is put into practice by community, national and global policy makers. As one example, our recent research call on mitigation policy solutions in G7 countries specifically funds collaborations between researchers and policy actors.

We also know that real change requires commitment from the entire global community, from researchers to policy makers to health practitioners. The field of climate and health is also significantly under-resourced. One approach we’re excited about it our partnership with the Climate Leadership Initiative to develop concrete action plans designed to inspire others to support and finance action on this shared global challenge.

The challenge is immense. But we believe that climate catastrophe can be averted in a way that allows human health to flourish – if we, together, put health at the heart of climate action.