New WHO policy paper reviews opportunities to promote environmental sustainability in health systems


Health systems have a substantial impact on the environment and are major consumers of energy and resources, according to evidence compiled in the new WHO policy paper “Towards environmentally sustainable health systems in Europe”.

The paper explains, however, that although health systems use up natural resources, contribute to greenhouse gas emissions and produce large quantities of waste, including hazardous material, they can also have a positive impact on the environment – particularly in the areas of health promotion and environmental health protection activities.

Dr Srdan Matic, Coordinator for Environment and Health at WHO/Europe, presented findings from the policy paper at the CleanMed Europe 2016 conference, held in Copenhagen on 19–21 October 2016. The paper draws on evidence from government reports, case studies, grey literature and 172 articles published in journals. “As professionals in the health sector,” said Dr Matic, “we have a responsibility to mitigate the environmental impacts of our activities. This is much more than a question of doing less harm – it is about doingmore good.”

Examples of measures beneficial to both health and environment

The review of evidence in the policy paper includes several examples of measures that have proven beneficial in both health and environmental sectors.

  • Regulatory measures on air quality have reduced acidification of soil and freshwater reserves in most regions of Europe and North America since the 1990s.
  • A 2012 analysis in the United States of America by Kaplan et al. estimated that, if implemented nationwide, a package of interventions designed to lessen the negative environmental impact of hospitals could generate financial savings exceeding US$ 5.4 billion over 5 years and US$ 15 billion over 10 years.
  • A 2009 modelling exercise in the United Kingdom by Haines et al. suggested that the promotion of active transport combined with a low-meat diet could help reduce the burden of cardiovascular diseases and contribute to climate change mitigation.
  • Research from Canada, Germany, Sweden, the United Kingdom and elsewhere found that telehealth/telemedicine can both reduce the need for patient travel and improve access to care in, for example, rural areas. A 2009 study by Bond et al. demonstrated that using mobile breast screening clinics reduced greenhouse gas emissions while improving patient experience.
  • A 2015 evaluation by the Global Action Plan found that changes to lighting use in inpatient wards improved patient sleep patterns and saved US$ 650 000 over 2 years across 6 hospital sites in the United Kingdom.

Focusing on win-win strategies and actions

“We are not advocating for the adoption of environmental sustainability at the expense of core goals or functions of health systems,” commented Dr Hans Kluge, Director of the Division of Health Systems and Public Health at WHO/Europe. “While there will undoubtedly be trade-offs involved, we think the focus should be on strategies and actions that will generate benefits for health systems as well as for the environment.”

Findings from “Towards environmentally sustainable health systems in Europe” will feed into the Sixth Ministerial Conference on Environment and Health, to be held in June 2017 in Czechia. At the Conference, Member States are expected to adopt a ministerial declaration and an implementation plan which aims to make progress on eliminating the most significant environmental threats to human health.