Managing change towards environmentally sustainable health systems (ESHS)


Promoting and managing a systemic change is necessary to advance the environmental sustainability of health systems (ESHS). This was the conclusion of experts and representatives of the WHO Member States at a meeting held in Bonn, Germany, on 24-25 October 2016. They noted the urgency of complementing the current pool of provider-driven sustainability activities with planned change management. This will require a top-down, governance-driven approach that nurtures bottom-up initiative via a mandate and regulatory or institutional frameworks, stakeholder buy-in and Incentives for change, strategic planning and progress metrics.

Benefits and opportunities of ESHS

Health systems are major energy consumers and producers of waste and emissions that affect health. Participants acknowledged the evidence supporting action towards greater environmental sustainability of health systems, both in terms of the need to reduce the environmental impacts of health systems and also on the opportunities and benefits for patients, practitioners, health systems functions and the environment.  Specific areas of sustainability action with proven health and environmental benefits include the minimization and adequate management of healthcare waste and hazardous chemicals, the reduction of greenhouse gas emissions, and the promotion of intersectoral action for health and the environment, among others.

Moving the agenda forward

The meeting participants highlighted the importance of taking stock of existing governance-driven initiatives on ESHS that can serve as models for action and a basis to build upon, as well as the need to take into account broad regional trends to target action in policy promotion efforts. Capacity building of the health workforce and public awareness were also emphasized as key enabling factors for a widespread uptake of this topic. The experts and member state participants stressed the relevance that a firm commitment at the upcoming Ministerial Conference on Environment and Health would have in terms of providing support to already existing initiatives, as well as kick starting action in other areas. The meeting also served as a technical platform for the discussion of proposals on the outcome of the declaration for the conference.

The outcomes of this meeting will inform discussions in the upcoming meeting of the European Environment and Health Task Force (EHTF). The results of both events, along with a recently concluded web-based consultation, will be incorporated into the working documents outlining a strategic approach towards environmentally sustainable health systems in the lead up to the Sixth Ministerial Conference on Environment and Health, where ESHS will be a priority theme.