Greening health systems meeting held

On 27-28 August 2013, WHO/Europe held a technical meeting on greening health systems at which:

  • technical requirements for environmentally friendly health systems were discussed;
  • steps were taken to develop a roadmap covering the strategic direction on how this topic could be further developed across WHO European Member States; and
  • lessons learnt from a variety of European local and regional initiatives were shared.

The meeting was attended by external advisors from a wide range of backgrounds, from national ministries, academics, health professionals and health administration, public health specialists, UN agencies, the private and civil society sectors, as well as WHO experts.

During the meeting it was agreed that actions within health systems to improve the environmental sustainability of their operations also provide immediate health benefits, significant financial and resilience benefits and important social benefits, as well as contribute to innovative models of care and workforce development. Sustainability was discussed as a core component of quality health care, requiring strong governance and a coordinated and strategic approach.  Improvements to health infrastructure and service delivery were highlighted as key to improving health system resilience to environmental threats and changes.

Background documents to be developed

As a basis for the discussion, two background documents were presented. The development of the draft strategic and technical documents represents a first major step towards greening the health sector, under the suggested title of “Towards environmentally sustainable health systems”. This series will consist of two complementary documents: the first will be a strategic document that will outline the process and establish the vision, objectives and context on which to build. The second will be a detailed technical document covering separate topic areas, such as procurement, waste, energy, built environment, water, travel and transport, food, chemicals, service delivery, information, health workforce, models of care, investment and financing. New areas for consideration, such as education and training, legislation, leadership and management were also introduced for further discussion.

The draft strategic document is due to be produced in time for the Mid-Term Review (MTR) of the implementation of the Parma commitments, to be held in mid-2014. The draft technical document is expected to be developed by 2015. The strategic document and final technical document should be completed in time for the 6th Ministerial Conference on Environment and Health in 2016.  This process will occur concurrently with the development of the IIATTS-WHO Guidelines on Sustainable Procurement, which will contribute to the development of the technical document.

Common criteria for green health system

While a green health system or environmentally sustainable health system has not been defined, common criteria were discussed. They included the ethical principle of “first, do no harm”, the health system contribution of a reduction of the environmental burden of disease, social equity, capacity for inevitable growth with minimal impact on the environment, whilst striving to achieve universal health coverage.


The “Commitment to act”, endorsed at the 5th European Ministerial Conference on Environment and Health in Parma, Italy, 2010, recommends collaborating to increase the health sector’s contribution to reducing greenhouse gas emissions and strengthen its leadership on efficient management of energy and other resources. Furthermore, the need to create supportive environments is a core component of Health 2020.