Many countries are not meeting their green healthcare obligations, research says

Countries around the world are falling short in meeting their international obligations to improve the sustainability of their health care systems, according to a new study co-led by Yale’s Jodi Sherman.

Shortcomings range from an inability to effectively assess and monitor greenhouse gas emissions to a lack of planning to make healthcare systems, procedures and supervision more robust and sustainable. These shortcomings seriously hinder the likelihood of achieving significant sustainability gains in what is one of the most carbon-intensive sectors, the study authors say.

“The healthcare sector is responsible for almost 5% of global greenhouse gas emissions and results in 4 million disability-adjusted life years [a measure of years lost due to ill health, disability, or early death] lost annually,” said Jodi Sherman, associate professor of anesthesiology at the Yale School of Medicine and epidemiology in environmental health sciences at the Yale School of Public Health, and co-senior author of the new study.

“At the same time, people need more healthcare to treat climate- and pollution-related diseases, and healthcare systems must increase their resilience to severe weather-related events,” Sherman said.

The study is published in The Lancet Planetary Health.

For the study, an international team of researchers analyzed the progress, or lack of progress, made by the more than 80 countries that agreed to key initiatives of the COP26 Health Program – which emerged from the 26th United Nations Climate Change Conference (COP26) in 2021, in Glasgow. The COP26 health program promoted a tiered system of national commitments to achieve climate-resilient, low-carbon healthcare systems.

But according to the study, only 30% of pledging countries reported that they had conducted key vulnerability and adaptation assessments of their healthcare systems.

Although 85 countries and territories agreed to commit to implementing low-emission healthcare systems or net-zero policies, these countries are only responsible for 26% of global healthcare emissions. Furthermore, only 11% of those countries have even assessed their healthcare emissions. The study also notes that less than half of countries have integrated healthcare into their national climate strategies.

The study identifies critical gaps in monitoring sustainable health progress against existing or proposed World Health Organization indicators. The authors said such indicators do not adequately reflect progress on sustainability and in fact raise concerns about ‘greenwashing’ – the idea of ​​reporting data that gives a false sense of progress on sustainability without meaningful results to reach.

“The lack of independent monitoring and the absence of robust, results-oriented indicators for sustainable healthcare are very worrying,” said Iris Martine Blom, first author of the study, physician and Ph.D. candidate at the London School of Hygiene & Tropical Medicine.

“Without meaningful tracking, we risk creating the illusion of progress while the real work of transforming our healthcare systems remains unfinished,” she said.

The study authors say countries need to develop and integrate more robust outcome indicators for healthcare systems. Such monitoring, they said, is essential to ensure that international obligations result in real progress.