Experts call for a greener healthcare system

Canada’s healthcare sector emits more greenhouse gases than aviation and shipping, yet remains largely unchecked. Speaking at the GLOBExCHANGE conference on Wednesday, medical experts warned that as climate change worsens, hospitals and clinics are contributing to the problem. 

They are calling for a national strategy to decarbonize healthcare, ensuring that health facilities and supply chains reduce their emissions before the sector's carbon footprint worsens the very health crises it aims to treat.

William Gagnon, director of implementation at the Centre for Sustainable Medicine, says immediate solutions exist to cut healthcare emissions. For example, replacing the anaesthetic gases, like desflurane with sevoflurane, and transitioning to increasing use of total intravenous anesthesia where possible, can reduce carbon output from medical gases while maintaining “gold standard medical care,” Gagnon told Canada’s National Observer. Also, increasing hospital sterilization capacity would limit single-use plastics, while transitioning from metered-dose inhalers to dry powder alternatives would eliminate harmful propellants that can contribute to global warming, he noted. 

Hospitals can save thousands of dollars by implementing simple, energy-efficiency measures, such as just turning off non-essential CT scanners overnight, Gagnon added.

“The challenge isn’t a lack of solutions — there are many cost-effective strategies that have a strong return on investment and can save hospitals money,” he said. “The problem right now is that we don't really take ownership of the emissions. There's a ‘hot potato’ of those emissions being transferred between Health Canada and Environment [and] Climate Change Canada.”

Gagnon suggests that a Healthcare Decarbonization Secretariat should be established to bridge the gap between the two ministries at the federal, provincial and territorial levels. The secretariat would be responsible for tracking annual emissions, identifying key sources, and developing a roadmap to net zero by implementing targeted reduction strategies over time, he added. 

Canada has among the highest per capita healthcare emissions globally, and its medical sector accounts for up to five per cent of the country’s total emissions, according to a 2022 report from medical journal The Lancet 2022. Between 2018 and 2019, its carbon output increased by 1.3 per cent, adding the equivalent of nine million cars to the road annually, the report added.

The healthcare industry itself remains a top global emitter, contributing 4.4 per cent of total carbon emissions — enough to rank as the world’s fifth-largest emitter if it were a country.

About 70 per cent of healthcare emissions come from the supply chain, including drug production, single-use plastics, and medical equipment, while 30 per cent stem from buildings, transportation, and travel, Gagnon explained.

He highlighted Singapore’s healthcare system as a model for efficient, effective climate action; a place where coordinated policies have helped hospitals reduce emissions and cut costs. A key advantage, he said, is Singapore’s clear emissions baseline, which allows hospitals to prioritize high-impact interventions. Without accurate data, healthcare facilities struggle to identify where to start with decarbonization. By tracking emissions systematically, Singapore has been able to focus resources on the most effective carbon-reduction strategies, he added.

“Right now, we’re not doing enough, but there are many opportunities to improve. We need stronger policies, better coordination, and leadership at all levels,” he said.

By 2050, climate change could lead to 14.5 million additional deaths and cause $12.5 trillion in global economic losses, according to a World Economic Forum report on the health impacts of global warming. The burden on healthcare systems is also expected to rise significantly, with climate-induced costs adding another $1.1 trillion worldwide.

Speaking at the GLOBExCHANGE conference, Sarah Lowden, who leads the climate and health portfolio at the Canadian Medical Association with a focus on net-zero and sustainable health systems, said physicians are among the most vocal advocates for climate action in healthcare. She emphasized that doctors have a duty to “do no harm,” which includes preventing the health impacts of climate change.

“We realize that we need to play our role in reducing the impact that medical practice and the healthcare system have on Canada and position ourselves as allies in the fight against climate change.”