Is healthcare sustainability the missing piece of the climate puzzle? Although the focus in recent years has been on greening the corporate sector, have we all missed the opportunities that arise as the global healthcare community grapples with the scale of its carbon footprint? ?

The healthcare industry is responsible for 4.4% of global net emissions, or more than 2 gigatonnes of carbon dioxide (CO2). The need to address this issue is so pressing that the World Health Organization (WHO) recently released a comprehensive set of climate guidelines for healthcare facilities around the world. These guidelines emphasized that the health sector needs to be more aware not only of the risks to human health inherent in climate change, but also of the direct contributions of the sector’s use of resources such as water and energy, and its releases of hazardous materials. It will be a huge challenge, but there is a compelling case to be made so that healthcare start-ups and investors can take advantage of this urgent transition.

In the UK, the National Health Service is a pioneer of these adaptive strategies. It has adopted two major targets – a net zero carbon footprint by 2040 and, for emissions that the NHS can influence (its so-called NHS Carbon Footprint Plus), a target of net zero by 2045. This transformation product as I write: metered-dose inhalers account for 25% of the carbon footprint of primary care, and there is now widespread advice for switching to dry powder inhalers. Meanwhile, the NHS has announced the world’s first zero-emission ambulance capable of traveling up to 300 miles before recharging. Electronic prescriptions replace paper prescriptions. Patients receive text messages, not letters. In my practice, we are discovering the potential of social prescribing – a health intervention focused on lifestyle changes, rather than even more packaged drugs. And in hospitals, the changes can be just as dramatic: in just two years, staff at Bristol University Hospitals have reduced the use of the carbon-intensive anesthetic desflurane, saving the equivalent of 30,000 kg of CO2 per month.

In the United States, health care is responsible for approximately 8.5% of national greenhouse gas emissions. In response, the National Academy of Medicine (NAM) is launching collaborative action on decarbonizing the US healthcare sector with the stated goal of identifying opportunities to link sustainability performance to value-based payments. and reimbursement of training for health professionals on climate change. .

Healthcare companies are also seizing the urgency and opportunity inherent in our climate crisis. In 2021, Kaiser Permanente became the first healthcare system in the United States to achieve carbon neutral status, thanks to both energy efficiency (such as the installation of solar power on site) and the carbon offset. Like the NHS, Kaiser is also working to reduce emissions which it can influence, for example by reducing business travel. The company, which serves 12 million Americans, reduced its greenhouse gas emissions by 29% while increasing its membership by 20%. They are not the only ones saving money while preserving the environment. By installing a system that adjusts air exchange based on operating room usage and only exchanging the amount of air needed, Cleveland Clinic has reduced energy costs by $2 million per year . Partners HealthCare is facilitating the construction of a large new wind farm in New Hampshire, a venture that is expected to reduce costs and emissions. But there are still many opportunities for innovation and startups will have a key role to play.

Of course, all of these challenges and opportunities are present not just in the UK and the US, but all over the world. What happens anywhere on the planet can potentially affect everyone on the planet. As I write, here in London, a cloud of dust from the Sahara Desert has descended, giving the sky a tint of yellow. We used to say no man is an island, now it seems no island is even an island. What we need are global targets for reducing healthcare-related climate emissions.

Health systems around the world, public and private, should actively collaborate to share best practices so that the global health sector can be part of the solution to the climate emergency. Take sustainable waste management. If it had been more of a priority before the pandemic, the flood of plastic waste generated by the need for personal protective equipment (PPE) could have been better managed. Over the past two and a half years, more than 8 million tons of plastic waste associated with the pandemic has been produced globally, of which more than 25,000 tons has entered the global ocean. As the WHO recently stated, “Covid-19 has shown that the world is unprepared to deal with an increase in medical waste – but that through innovation and collaboration we can solve a issue that has huge implications for mitigating climate change, fighting pollution, and creating resilient healthcare systems Companies in the healthcare sector are also feeling the urgency: Pfizer and Novartis have become members of RE100, an initiative event on renewable energies that brings together companies committed to becoming 100% renewable, even as the Covid-19 pandemic explodes.

For startup founders who want to be part of the solution, funding is available through venture capital and government grants. In the US, venture capital funds such as San Francisco-based Obvious Ventures raised $271.8 million in 2020 to invest in sustainable businesses, including health-focused startups, while in the UK UK, the National Institute for Health Research (NIHR) has announced £20 million in research funding to support the delivery of a net zero health and social care system. The NHS is investing in early-stage companies that create innovative products or clinical pathways that deliver benefits to patients, while reducing carbon emissions through a new £1million net zero SBRI Healthcare competition. Dozens of startup accelerators are now prioritizing sustainability, from Y Combinator and Plug and Play, to Techstars to Google for Startups.

Climate change is a human health care crisis as well as a crisis caused, in part, by health care. The WHO estimates that the direct health cost of climate change will reach $2-4 billion per year by 2030. Expect an increase in preventable diseases: from dehydration and malnutrition to skin cancers . We have a compelling opportunity to avert millions of deaths: Nature, one of the world’s leading scientific journals, has published an estimate that 74 million deaths could be averted by optimizing climate policy over the next 80 years.

Investors and startups have a key role to play. Investors can do more to help founders build sustainable startups. Climate and sustainability should be part of the due diligence process in the decision to invest in a healthcare business. Startups need mentorship and communities to help them build sustainable businesses and they need to embrace measuring and reporting their own carbon footprint. In the same way that we may soon be available to make informed decisions about the carbon footprint of what we buy at the supermarket, investors should now consider the emissions that sustainability-focused startups are saving: startups like YewMaker, who designed an evidence-based tool to support low-carbon decision-making in drug purchasing and prescription. If healthcare is the missing piece of the climate puzzle, then startups like YewMaker, savvy investors factoring in emissions reductions, and global collaboration on healthcare best practices are at the forefront of this piece.