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Reimagining Health Practices for a Sustainable World

The health sector has been long been at the forefront of innovation that impacts humanity. From the development of drugs and vaccines to pathbreaking research on the causation of disease and its subsequent treatment, the health sector has ensured that today we live longer and generally healthier lives. The eradication of diseases like smallpox and polio, that hitherto caused a tremendous toll on humanity, is a testament to the progress and sense of determination of this sector to ameliorate human suffering. At the same time, the health sector has also been a torchbearer of progressive public policy that has had wide ranging impact on human health. The research on lung cancer and its direct association with tobacco use helped the world understand the true impact of tobacco, one which was being obfuscated in the ‘smoke’ and mirrors of lobbyists and industry.

The Covid-19 pandemic provided an example of the sector’s ingenuity, when effective vaccines against a novel virus were formulated, produced, and then administered on an unseen scale. Notwithstanding the continuing disparities and structural inequities that exist in the availability of quality health services the world over, the overriding zeal for innovation and improving the human condition is inherent in the sector. Given the stellar role that the sector has played, the post-Covid world presents another challenge for the sector to demonstrate its inherent traits of progressivity and innovation.

Climate change and the health impact thereof, presents a clear and immediate danger to all of humanity. Pithily put, climate change will be the great (negative) health equalizer for all humanity. The impact of climate change is being felt across the world – from the developing to the developed, from the emerging to the neglected. It is, therefore, more critical than ever before for the health sector to rise to address this crisis precipitously.

The response required is multifold. The impact that the sector itself has on the climate crisis is well documented. As per estimates, the global health sector contributes to over 5% of all emissions. To put this to perspective, the global shipping sector contributes a rough equivalent. But nowhere are we seeking the type of action on decarbonization and emissions reduction in the health sector as compared to the scale in the shipping sector. Therefore, each hospital and health system needs to initiate the first exercise of conducting detailed scoping and inventory of their emissions. Calculating an organization’s emissions footprint has become necessary for succeeding interventions. A range of tools and calculators is available, free of charge, for hospitals to initiate this activity.

Along with this, the need to tabulate, or at the very minimum, estimate, value chain or Scope 3 emissions for any health organization is critical. With 75% of healthcare emissions coming from the supply chain, the need to understand the critical contributors to this inventory is a first step towards collective action. Substitution to low-carbon alternatives in non-clinical practice areas is another priority for the sector. Rapid digitalization today allows organizations to embark on reducing paper and the consumption of other polluting products like radiographic films and chemicals used in diagnostics. Such measures can help reduce the overall consumption and emissions footprint of a hospital, while also ensuring continuity and inter-operability of patient records. Also, the use of non-clinical plastics, whether for medicine dispensing or bin-liners, needs to done away with and completely replaced with biodegradable and compostable options or non-plastic options.

Apart from this, unlike before, the need for introducing an energy conservation program is not only imperative but also less capital intensive. Moving to efficient LED lighting, building management systems, efficient HVAC, air handling units and chiller systems, automatic lighting, low embodied carbon building materials, insulation, and so on are available options that healthcare organizations need to adopt going forward. Phasing out of fossil fuel consumption, whether as fuel or in the fleet, is becoming possible with the concerted drive towards low-carbon fuels like natural gas and fleet electrification. Recycling of water, on-site treatment of waste, transition to renewables both through on-site solar panels, enhanced energy storage or sourcing from a renewables provider need to become central to a hospital’s energy transition strategy. These initiatives were immensely capital intensive earlier, but with advancements in technology and growing parity in demand-supply, the cost of the energy transition is marginal or equivalent to traditional options.  

In spite of this, challenges on meaningfully getting to a net-zero target for the sector remain. Take for example anesthetic gases. These vital compounds are essential for the sector yet are incredibly depletive for the environment. Till such time as alternatives to these gases emerge, the only option for the sector is to move to low-carbon versions. This highlights the need for cross-industry collaborations. The health sector needs to actively reach out to researchers, technology companies, start-ups, and sectors like power generation (where previously there was minimal contact) to innovate and create alternatives.  The needs of the sector – both on clinical technologies and non-clinical ones – need to be communicated to a wider set of stakeholders for innovations to make their way to the sector.

Along with this, the sector needs governmental support and a conducive policy environment. Preferential and subsidized renewable energy and capital goods need to be made available to the sector given its inherent challenges to fully transition to become net zero. But more than this, the need for healthcare leaders to now evaluate each decision that they make through a carbon lens will be important. As will be an organization’s move towards formal governance structures to track how progress is being made on decarbonization and sustainable practices. The good to do, has now become the ‘cannot do without.’ The health sector needs to step up to this new challenge and continue its record of innovation, ideation, and adoption for the benefit of humanity and the planet.

By Dr. Karan Thakur

Vice President – Sustainability & Public Affairs

Apollo Hospitals Group | India