If global healthcare were a country, it would be the fifth-largest greenhouse gas emitter in the world. This was the alarming conclusion international NGO Healthcare Without Harm reached last year in the most comprehensive report ever released on the impact of health systems on climate change. Galvanized by these findings, this month the National Health Service (NHS) of England became the first in the world to commit to a net-zero national healthcare system, by 2040.
Although NHS Chief Executive Simon Stevens recognizes that the COVID-19 pandemic is the most significant health challenge of 2020, he nonetheless states that climate change is the “most profound long-term threat to the health of the nation.”
Canadian healthcare providers must similarly commit to reducing carbon emissions within our healthcare system to uphold our oath of doing no harm – to our patients, to ourselves and the planet.
Climate change is a risk amplifier when it comes to health. The heat waves, air pollution, wildfires, floods, droughts and infections that global heating drives directly affect the physical and mental health of the people we serve as well as virtually all the social determinants of health: income, food security, housing. When healthcare systems that are already pushed to the limit by crises like COVID-19 and the opioid epidemic collide with climate change, we risk losing decades worth of gains that we have made in public health. In fact, the World Health Organization (WHO) estimates that climate change will be responsible for 250,000 excess deaths per year by 2030.
The irony of the fact that our pollution from healthcare is damaging human wellbeing is not lost on decision-makers. Dr. Tedros Adhanom, Director-General of the WHO, decried the contribution of healthcare facilities to carbon-dioxide emissions last year, saying, “Places of healing should be leading the way, not contributing to the burden of diseases.”
How does Canada’s healthcare system compare to its counterparts in leading the way on climate change? Healthcare is responsible for 4.4 per cent of carbon emissions globally, equivalent to 514 coal-fired power plants. Though the United States, China and European Union make up more than 50 per cent of the world’s healthcare climate footprint, Canada ranks in the top 10 of emitters and holds the dubious distinction of being the world’s third-highest polluter per capita.
To tackle this problem, we must take inspiration from colleagues distant and near. Like the NHS, we must formally commit to measuring our carbon footprint and take targeted measures to reduce it. This has already led to an 18.5-per-cent reduction in NHS emissions between 2007 and 2017. As the NHS lays out in its roadmap, we must also electrify our ambulance fleet, make our buildings more energy efficient and shift to plant-rich hospital food – which will also give rise to the co-benefits of cleaner air and healthier bodies.
On this side of the ocean, we need to embrace the examples of climate leaders like surgeon Dr. Andrea MacNeill of Vancouver, who is leading ground-breaking work on reducing the carbon footprint of anaesthetic gases, or Dr. Jean Zigby of Montreal, whose not-for-profit business Synergie Santé Environnement has been helping Quebec healthcare institutions save costs while reducing their environmental impacts for years. These home-grown initiatives must be systematized, legislated and championed by medical professionals and leaders as we push for a green transition in our federal and provincial governments’ economic recovery plans.
COVID-19 has reminded us of the collective importance we place on health and the difficult choices we are prepared to make to protect it. We must go beyond a reactive approach to treating the asthma, strokes and heart attacks caused by climate change and air pollution; like the NHS, we must take bold steps to reduce greenhouse gas emissions that affirm our commitment to preventative medicine. Let us become role models for the rest of Canada by healing ourselves and our healthcare system.