CLIMATE CHANGE AND THE HEALTH SECTOR
The phrase “climate change” refers to a significant or abnormal difference in the long- term weather patterns of a region or of the planet as a whole. This is caused by the concentration of greenhouse gases that trap heat in the atmosphere, slowly raising the global temperature and consequently melting ice caps, raising sea levels, changing rainfall patterns and creating extreme weather events. The advent of COVID- 19 has thrown a glaring light on the interconnectedness of health and environment, bringing into stark relief the urgency needed for stringent climate action. While climate change does impact everyone, the impacts will not be borne equally or fairly. The most vulnerable, including low- income communities, women, indigenous peoples, the elderly and children, will bear the brunt of climate impacts (UN, 2019). It is a little- known paradox that the health sector, whose primary role is to protect and improve human health, emits a significant amount of greenhouse gases and other pollutants, thus contributing to the global burden of disease. If the global health sector were a country, it would be the fifth- largest emitter on the planet (HCWH and Arup, 2019). Healthcare’s most oft- repeated tenet, “first, do no harm” was originally intended to apply to patients but has a poignant significance in the context of climate change, emphasising the additional responsibility that should be taken by the health sector in ensuring that its operations do not harm the planet, and by extension, humankind. The sector’s considerable emissions come from the vast energy use, water consumption, waste generation and disposal, transportation and carbon- intensive supply chains of healthcare facilities and hospitals that function ceaselessly all day every day to deliver care and cater to the health needs of the population. In recent times, the climate- induced changes in disease patterns in places like India have become more palpable, with an increase in the number of patients with respiratory diseases, cardiovascular disease, non- communicable diseases, heat stress and disaster- related injuries, as well as the continuously rising climate change- related death toll (Watts et al., 2020). Health facilities, especially those with weak infrastructure in developing countries, will be unable to shoulder this growing burden of daily care indefinitely, much less remain a stronghold for the community in times of natural disaster. It is becoming increasingly clear that the climate crisis is also a health crisis. Hence, it is imperative to strengthen the health sector against the impact of climate change with a two- pronged approach: firstly, practicing primary prevention and mitigating climate change by reducing the sector’s greenhouse gas emissions in its daily operations, and secondly, fortifying itself in order to remain resilient and operational for the community during extreme weather events. In 2015, the international community produced three landmark global agendas to work towards for a sustainable future: the Paris Agreement, the Sustainable Development Goals (the 2030 Sustainable Development Agenda) and the Sendai Framework for Disaster Risk Reduction, setting course for a transition to low- carbon, climate- resilient societies and economies (UN, 2017). Each of these has targets relevant to health and climate change. The Paris Agreement is the centrepiece of global climate policy, bringing together the nations of the world under the common cause of mitigating climate change. Its aim is to hold the global temperature increase to well below 2°C above pre- industrial levels and to pursue efforts to limit it to 1.5°C. Under the Paris Agreement, all signatory countries undertake Nationally Determined Contributions (NDCs) with a view to achieving this aim. They simultaneously also develop National Adaptation Plans (NAPs) to reduce their vulnerabilities to the adverse effects of climate change in the medium and long term. The Sendai Framework brings in resilience- building as the core target to be reached by 2030. The 2030 Sustainable Development Agenda lays out 17 Sustainable Development Goals in total, with SDG 13 in particular tracking progress for urgent action on climate change. The need for integration between adaptation, sustainable development and disaster risk reduction represented by each of the above three instruments is paramount when it comes to the health sector. In 2017, a study estimated that the healthcare sector generated 2.6 billion out of the 52 billion metric tons of CO2e globally emitted in 2011, or 5% of global emissions (World Bank, 2017); it was calculated at 4.4% in 2014 (HCWH and Arup, 2019). The 2019 report established the first- ever detailed estimate of healthcare’s global footprint with detailed information from 43 countries throwing light on the sources of these emissions. It measured emissions across three scopes: scope 1 category of emissions emanating directly from health care facilities (17%), scope 2 category of indirect emissions from purchased electricity, steam, cooling and heating (12%) and scope 3 category of emissions derived from the healthcare supply chain such as the production, transport, use, and disposal of goods and services that the sector consumes (71%) (HCWH and Arup, 2019). These numbers indicate that health facilities will need to work together with manufacturers and suppliers of healthcare goods and services, as well as with governments and ministries, in order to achieve climate action that aligns with the goals of the Paris Agreement, while working in tandem to achieve the SGDs and the Sendai Framework goals. Ensuring rapid decarbonisation between now and 2030 needs to be the healthcare sector’s immediate focus of attention to contribute to the 1.5°C target (HCWH and Arup, 2021).
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