Interview

EUKI interview: Reversing the negative health impacts of the healthcare sector

by Luciana Lerho and Anselm Bareis, GIZ/EUKI

We have spoken to Health Care Without Harm (HCWH) Europe’s Climate officer Mireia Figueras Alsius from EUKI project “Low-carbon Healthcare in the Mediterranean Region”. Her project aims to reduce the environmental footprint of the European healthcare sector and to facilitate the transition towards low-carbon healthcare. Even though the healthcare sector is one of the biggest global net emitters, it often goes unnoticed when it comes to setting binding national climate plans. Still, Mireia is optimistic that the healthcare sector will be on track to achieve net zero emissions within a timeframe that is compatible with the Paris Agreement.

Mireia Figueras Alsius (c) private

Mireia, your EUKI project aims to reduce the climate footprint of the healthcare sector. Why is this important?

The healthcare sector’s mission is to protect and promote health – its carbon-intense activities, however, paradoxically undermine this unique healing mission. The global climate footprint of healthcare is equivalent to 4.4% of global net emissions – if the healthcare sector was a country, it would be the fifth largest emitting nation on the planet.

Climate change is the largest public health threat of the 21st century (The Lancet), globally rising temperatures increase the incidence of extreme weather events and vector-borne diseases that both undermine community health and test the healthcare sector’s resilience and capacity to provide care during such emergencies. The health sector must play a leading role in addressing carbon emissions.

If the healthcare sector was a country, it would be the fifth largest emitting nation on the planet.

Mireia Figueras Alsius HCWH

What are the main challenges for the transition of the European healthcare sector towards climate neutrality?

Currently there is no mandate for hospital boards to take action on climate change and integrate this into their healthcare planning activities. There are no top-down, legally binding national plans for carbon reduction and climate action within the healthcare sector. National healthcare systems across Europe are diverse, each with their own structures and priorities employing different models and policy frameworks – creating a harmonised European plan for healthcare decarbonisation is therefore challenging.

Another challenge when looking at a bottom-up approach is the lack of data to support goal setting and benchmarking. There is no existing basis for setting climate targets within the healthcare sector, no common baselining methodology or reporting framework for healthcare emissions across Europe – if you can’t measure it, you can’t change it!

Another (immediate) challenge is time. Climate action is needed urgently and evidence suggests that the next 10 years are critical.

Which concrete measures do you take to tackle these challenges (within the scope of your project) and which outcomes do you intend to trigger?

Health Care Without Harm Europe is supporting five hospitals in the Mediterranean region to develop carbon management plans. We are helping them to first quantify the problem by developing baseline carbon footprints and then supporting them to change it through reduction targets, laying out the business case, and specifying activities that will support their journey. This project takes a bottom-up approach and supports participating hospitals to set carbon reduction goals and create plans for achieving them.

The project will also feature an element of scaling up and replication across the region through a low-carbon healthcare toolkit that can be used by other hospitals. This will help develop the Mediterranean as a best-practice region for low-carbon healthcare in Europe.

Another output of the Low-carbon project is to develop policy recommendations that will help to identify the legislative changes necessary to accelerate the transition to low-carbon healthcare in the region. It is important to develop top-down policy advocacy initiatives with a climate and health narrative to ensure that the healthcare sector is incorporated in national and European climate and energy plans.

It is important to develop top-down policy advocacy initiatives with a climate and health narrative to ensure that the healthcare sector is incorporated in national and European climate and energy plans.

Mireia Figueras Alsius HCWH

You mainly collaborate with hospitals in the Mediterranean Region. Why did you choose Southern Europe as your focus area?

At HCWH we collaborate with hospitals, healthcare providers and healthcare systems covering the 53 countries of the World Health Organisation’s Europe region. For this specific project we chose to work with Southern Europe, and the Mediterranean region in particular, because the region shares specific challenges, opportunities, and threats in moving towards low-carbon healthcare. The region typically experiences hot, dry summers and mild winters meaning that they are reliant on air conditioning and cooling systems, leading to spikes in increased energy demands across the year.

There is also a significant untapped potential for renewable energy generation (particularly solar and wind) to meet their energy demands, boost local economies, significantly reduce greenhouse gas emissions, and accelerate the transition to a low-carbon economy.
The warm Mediterranean region also faces greater threats from extreme weather events, particularly heat waves, which we have already seen within the last decade across Europe, testing health systems’ resilience. The project aims to identify and address these opportunities and challenges and facilitate the transition to low-carbon healthcare in the region.

To what extent does the current corona crisis affect your work with hospitals and other healthcare actors?

The current COVID-19 pandemic has quite rightly taken priority for the healthcare sector and our project partners – it has not just affected our work, but all of our daily lives as well. Hospitals are on the front lines of this crisis, caring for the most vulnerable in our communities – we have re-shaped a number of our planned activities and move them online, to allow hospitals and healthcare actors to focus on their courageous work tackling this crisis.

The ongoing pandemic has further reinforced the parallels drawn between COVID-19 and the climate crisis, and has put the healthcare sector at the centre of attention. During the last months, we have seen a stronger and renewed interest from health providers in Europe in working to reduce the environmental footprint of the healthcare sector. The COVID-19 pandemic means that decisive leadership at all levels is now more important than ever in creating a more sustainable, resilient, and equitable healthcare sector in Europe.

[By 2030,] we should see a sector committed, and on track to achieve net zero emission within a timeframe that is compatible with the Paris Agreement.

Mireia Figueras Alsius HCWH

Final question (taking a glaze into a crystal ball): Compared to more prominently targeted sectors as Energy or Mobility, where will the healthcare sector stand in 2030 concerning greenhouse gas emissions?

We are seeing the health sector become more and more engaged – we are working to educate and influence healthcare leaders and decision makers on the importance of the links between climate and health. We work together with sustainability professionals, senior leaders, doctors, nurses, and what we see is that there is a growing awakening of the role of the sector in addressing climate change. By 2030 we should see a firm understanding of the climate and health connection, supported by action plans and matching policies. In other words, we should see a sector committed, and on track to achieve net zero emission within a timeframe that is compatible with the Paris Agreement. We have recently seen an inspiring example from England’s National Health Service (NHS) – the first health system in the world to commit to net zero-emissions by 2040!