Health systems and environmental sustainability: updating frameworks for a new era

Healthcare systems around the world have a responsibility to “do no harm” but are responsible for substantial negative health effects through the production of greenhouse gases, particulate matter, pharmaceutical waste, and other environmental pollutants.1 Recent studies estimate that the healthcare sector accounts for 4.6% of global greenhouse gases, and over 8% of these emissions in some countries.23 Although high income countries produce most health system pollution, low and middle income countries also contribute through poor hazardous waste disposal practices and other carbon intensive healthcare activities.45Growing numbers of health systems have recognised the importance of their environmental impact and are acting to reduce it. To date, 82 countries, nearly half of which are classified as low or lower middle income by the World Bank, have signed an international pledge to develop climate resilient and low carbon health systems.6 In early 2023, over 100 health systems in the US signed a health…
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