Healthcare systems contribute to global greenhouse gas emissions, raising urgent clinical, operational, and ethical questions about how to reduce environmental impact without compromising care quality.

At a recent webinar, Valérie-Anne Chantrain, a healthcare analyst and a visiting lecturer at the Catholic University of Louvain, Faculty of Physiotherapy and Rehabilitation, Louvain-la-Neuve, Belgium, outlined how clinicians and institutions can reduce the environmental impact of healthcare while maintaining care quality, and how clinicians and institutions can reduce the environmental impact of care delivery while maintaining high standards.

Carbon Burden

"The carbon footprint of the healthcare system is far from negligible," Chantrain said. In 2019, the sector accounted for an average of 4.4% of global greenhouse gas emissions, approaching the levels observed in civil aviation. In the US, healthcare contributed 7.8% of the national emissions, compared with about 5% in Belgium.

Despite the essential role of healthcare services, Chantrain emphasized that decarbonization is both feasible and necessary in this sector. "Studies have shown significant heterogeneity in energy consumption between national healthcare systems of comparable quality. Therefore, it is possible to maintain this quality while emitting fewer greenhouse gases," she said.

Climate Imperative

The sector requires urgent and sustainable transformation. “In the coming years, the risks to infrastructure and energy supply will worsen. Healthcare must learn to become more resilient,” she said. This is ethically imperative. “Healthcare professionals are becoming aware that their sector generates emissions and pollution that drive the climate and environmental crisis, affect population health, and, in turn, their patients. This should push us to transform.” 

Chantrain also emphasized the importance of social responsibility. “Large-scale surveys show that healthcare professionals are among the few professions that retain public trust. On climate change, their voice can therefore be decisive in shaping societal change.”

Shared Responsibility

An international survey of more than 4000 healthcare professionals reflected this shared responsibility. Chantrain said, “No fewer than 86% believe it is their responsibility to inform patients about health effects linked to global warming”; however, a significant number of them still hesitate to communicate on this topic. “There is a gap between willingness to inform and limited knowledge. Therefore, there is a need for training in this area. Time constraints during consultations are also a limiting factor." 

Global Models

Countries are advancing decarbonization efforts with mixed results. “The Netherlands is an excellent example,” Chantrain said. “They adopted a bottom-up approach. The healthcare sector started multiple actions that were later supported by the government with €42 million through a 3-year Green Deal.” The program aims to reduce the consumption of raw materials by 55% by 2030, maximize the circular economy, and lower the environmental impact of medications by revising prescription practices. It has engaged 90% of hospitals, along with general practitioners, medical centers, insurers, pharmacies, and nursing homes in the country.

In contrast, the UK highlights the challenges of implementation. “Between 2019 and 2025, the National Health Service (NHS) reduced the carbon emissions it directly controls by 14%. However, increased demand during the COVID crisis, along with overall growth in NHS activity, offset these gains,” she said.

Belgium Landscape

However, progress in Belgium has still been fragmented. The country’s institutional structure complicates the coordinated national policy, Chantrain said. At COP26, Belgium is committed to making its healthcare system sustainable and resilient by 2050. “In practice, federal, regional, and community entities are advancing in a fragmented manner. A federal strategic roadmap was presented in 2025 within a working group of the Environment and Health Unit.”

Regional efforts differ from one another. In Flanders, almost 240 organizations joined a Green Deal that was launched in 2023. “At the Brussels-Capital Region level, the situation is more complex. The initiatives were led by the Common Community Commission, a bilingual public authority in Belgium's Brussels-Capital Region. However, it appears to be no longer dedicated subsidies tied to reducing the sector’s carbon and environmental footprint.” 

The Health in Transition Alliance was recently launched in Wallonia. Chantrain noted that its aim was to mobilize hospitals and nursing and care homes with other sector stakeholders to support a sustainable transition, particularly through communities of practice and meeting groups.

Changes in the country are still underway. The expert referred to the tipping point theory, which suggests that coordinated action by healthcare professionals, associations, institutions, and policymakers can drive lasting shifts in both the health sector and society as a whole.

This story was translated from MediQuality, part of the Medscape Professional Network.