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Column: Health Care and Climate Catastrophes

Tuesday, September 02, 2014
Last week, leading health authorities were huddled at World Health Organization headquarters in Geneva, Switzerland, discussing how to confront one of the most urgent threats to humanity. It’s not Ebola. And it’s not HIV/AIDS, malaria, cancer, obesity, heart disease or diabetes.

The problem — a changing climate — doesn’t fit the traditional definition of health hazard and yet it threatens to undermine the health of individuals and communities in nearly every nation.

In 2009, The Lancet named climate change “the biggest global-health threat of the 21st century.” Since then, the threat has increased dramatically. The warming of the planet — driven by burning fossil fuels — is already beginning to wreak havoc on our health by shifting and amplifying the burden of disease. Vector-borne diseases like malaria and dengue, transmitted by insects, are migrating to previously uninfected regions. Super storms like Sandy, Yolanda and Katrina have knocked out or destroyed entire hospitals. Seven million people die each year from air pollution, more than HIV/AIDS and malaria combined.

Even more worrisome, climate change is now causing a rise in sea levels, droughts, unprecedented forest fires and freakishly powerful storms. These have the strong potential to undermine many countries’ agricultural bases, leading to famine, conflict and mass migration. The global health sector is not prepared for this onslaught.

So what can the ministers of health, WHO officials and health organizations do about this crisis? They must quickly transform the role of health care to take on climate change threats in three fundamental ways.

First, the health care sector must lead by example and reduce its own carbon footprint. Perversely, the global health care supply chain worsens global warming. The UK’s National Health Service, for instance, contributes 25 percent of public sector emissions in that country. In the United States, hospitals contribute 8 percent of the nation’s entire greenhouse gas load.

Hospitals are learning they can save money by reducing their carbon footprint through energy efficiency, renewable energy, sustainable waste management, local food sourcing and green purchasing strategies. Thousands of hospitals and health systems have committed to do so as part of a new network called Global Green and Healthy Hospitals. Some of these leaders are aiming to become net zero energy users or even carbon neutral in their resource consumption — setting an ambitious example for others.

Second, we need to build more resilient health systems. We need to move from building gleaming towers of chronic disease to developing appropriate scale hospitals and clinics that serve community health on a daily basis and provide support during disasters. When the lights went out in most New York hospitals during Super Storm Sandy, the ones that kept functioning had energy-saving co-generation technology on site. This disaster-proof resilience, which also reduces climate impacts, should become standard practice in hospitals.

Resilience also means rural health centers in low-income countries should prioritize providing potable water for communities, as a preventative health strategy. Rural health clinics should also invest in solar panels that power them and the larger community. Resilience strategies weave sustainable economic development and health plans together. For example, a group of hospitals and universities in Cleveland, Ohio have invested in community-based solar installation and urban agriculture, and a hospital in Nepal has developed a recycling market for sterilized plastics.

Third, we all have an interest in transforming our energy systems to reduce pollution. Doing so will protect health, while saving lives and money. For instance, a World Bank study found that if India were to scale back its coal and oil production, thereby reducing particulate matter air pollution by 30 percent, it would save more than $60 billion a year in health care costs by 2030. Similarly, the U.S. Environmental Protection Agency estimated that health and welfare savings from the Clean Air Act saved Americans $2 trillion from 1990-2020.

Physicians everywhere should advocate for healthier energy policies. They should press local and national governments to take health costs and impacts into account when making energy investment and development decisions. Just as health professionals educated the public and improved public policy with regard to tobacco use, the health sector should play a similar role in advocating for reducing global use of fossil fuels. We’re already witnessing positive change: the British Medical Association became the first health organization to join a growing number of universities and foundations in voting to divest its assets from fossil fuels.

Climate change is no longer a future challenge, affecting only polar bears in the Arctic and coral reefs in the tropics. Climate change is an urgent, complex health threat that impacts everyone on the planet. The health care sector must expand its mission to slow climate change enough to protect the natural systems that support all life on Earth, including ours.

Josh Karliner is director of Global Projects. Gary Cohen is president of Health Care Without Harm, a non-profit environmental health organization.

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