Addressing Climate Impact: The Healthcare Paradox

Andrew Harrison
Managing Director, Hanover Health

For the healthcare and pharmaceutical industry, the impact of climate change is twofold – responding to the increased risk of certain diseases and conditions and decarbonising their own processes and products to prevent worsening impact.

Observable effects of climate change are already being felt – for example, the Lancet’s 2019 report on the infection rates of dengue fever (expressed as vectorial capacity for transmissions) showed that nine of the ten most suitable years for transmission on record since 1950 have occurred since 2000. In 2018 there were 220 million more heatwave exposures affecting older populations increasing risks of heart and kidney stress and disease and stroke.

Yet, paradoxically, developing and delivering solutions to these challenges has a climate cost. Analysis has suggested that combined CO2 emissions from hospitals, health services and medical supply chains across the OECD group of market economies plus China and India comprise 4% of total global emissions footprint – greater than either aviation or shipping.

The NHS has been found to produce 5.4% of England’s total carbon emissions. For healthcare providers, challenges lie in areas such as transport, building efficiency and waste reduction – where high-quality waste products in operating theatres that could be recycled largely end up being labelled as infectious clinical waste and are incinerated at a high financial and environmental cost. Similarly, some procedures are particularly carbon intensive. Hospitals have been exploring solutions ranging from retrofitting heat recovery technology to dialysis machines, to switching operating room anaesthetics, which account for almost a third of the UK’s health and social care sector emissions, to less-polluting gas. Linked options include introducing technology to capture these gases and seeking alternative clinical techniques.

There is a clear role for industry to support healthcare providers through innovative product design. Boehringer Ingelheim recently introduced the first reusable, propellant-free inhaler for patients with asthma and COPD, supporting objectives of carbon and plastic waste reduction. An associated study suggested that the reusability of the inhaler reduces its carbon footprint by as much as 71% and should mean that over a million fewer inhalers are needed annually.

The challenge of producing sustainable medicines is also being explored by the Innovative Medicines Initiative. The scheme represents Europe’s largest public-private partnership in life sciences, between the European Commission and the European pharmaceutical industry. Its €26.m (£21.2m) CHEM21 project brings together six pharmaceutical companies, thirteen universities and four small and mid-sized enterprises from across Europe to develop sustainable biological and chemical alternatives to finite materials, such as precious metals, which are currently used as catalysts in the manufacture of medicines.
To minimise wider environmental impacts, efforts are being made to introduce biotechnology to the manufacturing processes for medicine production.

Nonetheless, it is critical that pharmaceutical companies retain a focus on driving decarbonisation and best practice sustainability in-house as well as in product design. In 2015 the global pharmaceutical industry produced 55% more CO2 than the automotive industry¹. The NHS Sustainable Development Unit’s 2018 National Resources Footprint² stated that pharmaceuticals are the second largest producer of both water footprint and carbon emissions (12.1%) relating to the healthcare service in England.

The shift to a far more rapid rate of decarbonisation across the pharmaceutical industry and the broader healthcare sector will require significant action. But trends have shown that focused efforts can deliver results on decarbonisation, and indeed can be delivered alongside economic growth and expansion of service. In the NHS emissions from health and social care have been cut by 18.5%³ since 2007, despite clinical activity rising by over a quarter over the same period.

Interestingly, the report on global pharmaceutical performance⁴ demonstrated that the companies leading on emissions (Amgen, Johnson & Johnson and Roche Holding) were also three of the most profitable in the sector. This is clear proof that there is economic opportunity in innovating for the future.

This article was originally published in 'Net Zero Unpacked: An Essential Guide for Business Strategy & Corporate Communications.

The report contains insights from leading companies both inside and outside of the healthcare industry including Novo Nordisk, Apple, Lucozade Ribena Suntory, Facebook, and Sky, on how businesses are acting to support Net Zero.

<sup>1 International comparison of health care carbon footprints: Peter-Paul Pichler, Ingram S Jaccard, Ulli Weisz and Helga Weisz, https://iopscience.iop.org/article/10.1088/1748-9326/ab19e1/meta#erlab19e1s3

2 https://brighterworld.mcmaster.ca/articles/big-pharma-emits-more-greenhouse-gases-than-the-automotive-industry/

3 Natural Resource Footprint 2018, https://www.sduhealth.org.uk/policy-strategy/reporting/natural-resource-footprint-2018.aspx

4 IDC FutureScape: Worldwide Datacenter 2019 Predictions, https://www.idc.com/getdoc.jsp?containerId=WC20181101</sup>