Saving people and the planet

How leading health systems can be global role models in sustainability, by Gil Bashe, Health Tech World author and FINN chair global health and purpose.

The United Nations Conference of the Parties (COP) is held annually, with its Presidency rotating among five recognised UN regions.  Last year, at COP28, world leaders and climate change advocates gathered in Dubai, UAE; in a few days, they will descend upon COP29 in Baku, Azerbaijan for COP29.

Fossil fuels and renewable energy will be the topic of conversation in the COP Blue and Green Zones. At the same time, the intersection of health and environmental sustainability, while lower on the conversational agenda, has never been more critical. Two years ago, I wrote about the potential for hospitals and digital health to save people and the planet.

Gill Bashe, Health Tech World author and FINN chair global health and purpose

With climate change accelerating and health systems facing growing policy demands, this message holds even more weight today.

The health provider sector is responsible for approximately 4.4 percent of global net emissions and must address a dual challenge: delivering quality care and reducing its environmental footprint.

Hospital leaders within many of the world’s leading centers for care and social impact are embracing their responsibility to illuminate how health systems can make a difference.

Ahead of COP29, leading hospital systems in Nashville, Israel, and the United Kingdom show how the health ecosystem can play an essential role in planetary sustainability and reinforce the economic value of new digital and information technologies in patient care and climate action.

Nashville: A Global Beacon for Sustainable Health

Widely celebrated as the United States capital for country music, Nashville has also secured a global name as a leader in sustainable health.

Vanderbilt University Medical Center (VUMC) has emerged at the forefront of these efforts through a strategic energy management program launched in 2018 that has reduced energy consumption per square foot by 25 percent.

Intelligent building systems now control heating, cooling, and lighting based on occupancy and time of day, while older buildings are undergoing energy-efficient windows and insulation upgrades.

This transformation reflects the leadership of Jeffrey R. Balser, MD, PhD, VUMC president and CEO, who has remarked, “As healthcare providers, we have a responsibility not just to heal individuals but to contribute to the health of our planet.”

VUMC has committed to reducing its waste footprint in support of this vision. The institution’s recycling initiative has diverted more than 30 per cent of waste from landfills.

At the same time, reusable sharps containers prevent roughly 50 tons of plastic waste from entering the environment each year. Partnering with local organisations, VUMC donates unused medical supplies, addressing waste while supporting the well-being of neighboring communities.

Israel: Innovating for a Healthier Planet

While Israel is a relatively small nation engaged in self-preservation and noted for military innovation, its hospitals continue investing in sustainability tools.

Sheba Medical Center, Israel’s largest hospital and among the world’s top medical systems, is pioneering digital health initiatives to reduce the negative environmental impact of health delivery.

Sheba has reduced patient travel by 40 per cent through telemedicine technologies, significantly reducing associated carbon emissions.

AI-powered diagnostics in radiology optimise resources, decreasing this department’s energy use by 30 percent, while a “smart hospital” system directs resources more efficiently, reducing energy consumption and enhancing patient care.

Reflecting on the hospital’s mission, Professor Yitshak Kreiss, director general of Sheba Medical Center, states: “Our commitment to digital health is not just about improving patient care but also reducing our environmental footprint. We believe that healthcare innovation can and must go hand in hand with sustainability.”

Israeli hospitals are also leading conservation efforts in a water-scarce region. At Hadassah Medical Center in Jerusalem, a greywater recycling system has decreased water use by 25 per cent.

At the same time, the Rabin Medical Center adoption of water-efficient fixtures and rainwater adds millions of litres annually.

Although conflict continues to rage, Israel pursues collaborative exchanges around its sustainability initiatives, with many of its regional neighbors looking to incorporate environmentally friendly innovations into their evolving health systems.

United Kingdom: NHS leading change

The United Kingdom’s National Health Service (NHS) has set a bold target to become the world’s first net-zero health system by 2045, an endeavour with far-reaching implications for sustainable health worldwide.

Its initiative includes installing renewable energy sources—solar panels and wind turbines—at major hospitals across the UK, creating a green foundation for health infrastructure.

Non-emergency patient transport will rely more and more on electric vehicles, reducing emissions by an estimated 15 per cent in the first year. Meanwhile, low-carbon modular hospital buildings are helping cut construction emissions and enhance energy efficiency.

Sir James Mackey, former chief executive of NHS Improvement, a national regulator that became part of NHS England in 2019, underscores the significance of these efforts: “The climate emergency is a health emergency. By taking decisive action to reduce our carbon footprint, we’re not just protecting the environment—we’re protecting the health of current and future generations.”

The NHS has also redefined its procurement processes by embedding sustainability criteria encouraging suppliers to limit their environmental impact.

These efforts extend to a circular economy approach for medical equipment, where devices are repurposed, reducing waste and emissions. Collaboration with pharmaceutical companies to develop lower-carbon inhalers could lower emissions by as much as 800,000 tons annually.

Digital health: The key to a sustainable and healthy planet

Digital health solutions are emerging as essential tools in the drive for sustainability across these initiatives. The adoption of telemedicine, accelerated by the COVID-19 pandemic, has helped curb environmental impact by reducing patient travel and decreasing the need for physical healthcare infrastructure.

This shift cuts carbon emissions and promotes greater access to care, particularly for rural and underserved communities.

Artificial intelligence and big data analytics are also reshaping sustainable healthcare. Predictive analytics allows for more targeted disease prevention, potentially diminishing the demand for resource-intensive treatments.

Hospital operations are increasingly optimised, improving efficiency and cutting down on waste, while innovations in drug discovery now make it possible to develop more targeted, environmentally friendly treatments.

Challenges and Opportunities

While these examples demonstrate substantial progress, healthcare systems must navigate several challenges to keep advancing sustainably. Balancing immediate healthcare demands with long-term sustainability goals remains a fundamental issue.

Equitable access to digital health solutions is essential to avoid widening disparities, particularly in rural or underserved areas. Additionally, digital health technologies’ environmental impact—including energy consumption and e-waste—must be managed to ensure an overall net positive effect on the environment.

What happens if we do not rise to the challenge? The World Health Organisation estimates that between 2030 and 2050, climate change could cause approximately 250,000 additional deaths per year from malnutrition, malaria, diarrhea and heat stress.

Climate change will undoubtedly fill hospital beds with cardiovascular, infectious and respiratory disease patients – more patients means more energy consumption and one-time product use landfill.

Looking Ahead to COP29

As COP29 in Baku approaches, the health sector must also be tasked to support climate action. Nashville, Israel, and UK achievements illustrate how the health ecosystem can and must prioritise sustainability in operations, benefiting the planet and patients.

Critical areas for attention at COP29 should include setting global standards for sustainable health practices, driving investments in green infrastructure, implementing digital health solutions, and fostering knowledge-sharing to support sustainable health systems in emerging countries.

Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organisation, captures the urgency of this public health mission: “The climate crisis is a health crisis. Health systems must be part of the solution, not part of the problem. By reducing emissions and building climate-resilient health systems, we can protect health, save lives, and lead by example.”

As we navigate the twin imperatives of delivering quality healthcare and confronting climate change, embracing sustainable practices within the vast health ecosystem promises a better future for individuals and paves the way for a healthier planet.