Toward Climate-Smart Hospitals: Reducing Health Care’s Environmental Footprint

In the face of escalating climate threats, health systems are increasingly exposed not only as responders to climate-related health crises but also as contributors to the problem. Authored by Nicole Mauer, Béatrice Durvy, and Dimitra Panteli for the European Observatory on Health Systems and Policies, outlines a strategic vision for transforming health care facilities into engines of environmental sustainability. The brief draws from collaborative work supported by the EU’s Technical Support Instrument and implemented by Expertise France, with key contributions from national agencies such as Austria’s Gesundheit Österreich, Belgium’s Federal Public Service Health, and Slovenia’s Ministry of Health. With health care systems accounting for around 5% of global greenhouse gas emissions, and 17% of that arising directly from facility operations, the urgency to decarbonize is undeniable. Yet this transformation is also rich with opportunity: aligning sustainability with better care delivery, cost-efficiency, and public trust.

Procurement Power: Driving Green Markets from Within

One of the most potent tools in a hospital’s sustainability arsenal is procurement. From pharmaceuticals to catering and building materials, hospitals purchase vast volumes of goods and services, making them powerful market influencers. The brief underscores how strategic procurement can drastically cut emissions and waste. Norway’s Hospital Procurement Trust has been a pioneer, integrating environmental criteria into tenders for antibiotics and chemotherapy, creating ripple effects throughout the Nordic market. In England, the NHS has taken a more aggressive stance by requiring its 80,000 suppliers to adhere to net-zero commitments or risk losing contracts. Hospitals can also opt for eco-friendlier alternatives, such as powder inhalers or reusable surgical supplies, but doing so requires not just policy change, but also buy-in from clinicians and patients. Ireland offers a creative example with HaPPE Earth, which developed compostable PPE aprons that break down in five weeks, versus 50 years for standard plastic, and even turn into biofertilizer.

Greener Buildings, Smarter Energy

Health care infrastructure is a carbon giant. Globally, energy use in health facilities accounts for over half of the sector’s emissions. Retrofitting old buildings and ensuring that new ones meet green building standards can yield dramatic benefits. Austria is one of the leading lights in this area, having supported over 450 facilities through its national Competence Centre for Climate and Health. Some Austrian hospitals, like KAGes and Tirol Kliniken, have embarked on ambitious projects involving geothermal systems, wood–hybrid construction, and solar panels. While such initiatives can be capital-intensive, the EU offers support through funds like the LIFE programme and the Recovery and Resilience Facility. However, as the Austrian experience shows, navigating these funds is not simple; projects must be meticulously planned, meet technical specifications, and align with tightly regulated application windows. Still, the long-term returns, both economic and ecological, make these efforts worthwhile. Certification systems like BREEAM and LEED offer further guidance and accountability on sustainable hospital design.

Waste Not: Circular Thinking in Health Facilities

The health care sector generates millions of tonnes of waste annually, much of it non-hazardous and recyclable. Yet few facilities fully embrace the circular economy. The brief advocates adopting the 6Rs approach: Reduce, Reuse, Recycle, Refuse, Rethink, and Repair. Catalonia’s MútuaTerrassa is held up as a model, having implemented reusable surgical textiles that save 160 tonnes of waste per year and drastically reduced food waste through flexible portioning and patient engagement. Composting, better segregation of hazardous and non-hazardous waste, and eliminating unnecessary single-use items are additional measures that can be implemented with relatively low investment. International guidance is available from WHO and the Global Green and Healthy Hospitals network, offering facilities step-by-step support to overhaul their waste systems. However, regulatory hurdles, costs, and institutional inertia remain significant barriers. Overcoming them requires leadership and a cultural shift within organizations.

Workforce as Champions of Change

Beyond technology and infrastructure, the heart of the transformation lies in people. Health workers are not only service providers but also trusted community leaders who can model and promote sustainability. Yet they often lack the training and institutional support to do so. The brief emphasizes the need to build “green skills” among health professionals, from understanding carbon footprints to engaging in sustainable procurement. Initiatives like WHO’s Climate Change and Health courses, the Geneva Sustainability Centre’s tools, and the EU-funded BeWell project offer promising solutions. BeWell, for instance, has developed an EU-wide digital training platform and is crafting a European strategy for a climate-smart health workforce. New professional roles, such as climate managers, are emerging in countries like Austria, where hospitals receive specialized support to embed sustainability in daily operations. These developments signal a shift in the identity of health professionals, from caregivers to environmental stewards.

Health care’s transformation is not just about mitigating climate change but about safeguarding the sector’s ability to deliver high-quality, resilient care in a warming world. Financial investment, political will, and workforce empowerment must go hand in hand. Institutions like the World Health Organization, through its ATACH platform and operational frameworks, are fostering collaboration across borders. The EU’s evolving support ecosystem, though complex, holds enormous potential if properly leveraged. Case studies from Ireland, Austria, and Catalonia prove that sustainable health care is both achievable and beneficial. The future of health systems depends not only on curing illness but on healing their own environmental impact. And the time to act, as the brief makes unmistakably clear, is now.