August 3, 2023

Designing Sustainable Health Systems

Shailja Sharma

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As we look to the future and the looming triple threat posed by climate change, biodiversity loss and environmental pollution, it becomes increasingly clear that a fundamental transformation needs to take place in our economies and societies. Human well-being and equity and the welfare of our planet need to be at the heart of all policy decisions. As global citizens, sustainability must be our new mantra. The essence of Sustainable Consumption and Production (SCP) is “can we do more and better with less?” It aims to increase net welfare gains from economic activities along the whole production lifecycle by reducing waste, degradation, and pollution. Leading international agencies, including the World Health Organization, the Organisation for Economic Cooperation and Development and the World Economic Forum, have recently highlighted significant threats to the sustainability of healthcare system performance.

The World Health Organization (WHO) envisions a sustainable healthcare system as, ‘a system that improves, maintains, or restores health, while minimizing negative impacts on the environment and leveraging opportunities to restore and improve it, to the benefit of the health and well-being of current and future generations.’ The COVID-19 pandemic made medical waste more visible than ever due to the use of single use plastic and the need to dispose of PPEs after one use. Furthermore, it highlighted several weaknesses in the healthcare sector’s approach to supply chain management. From delivery delays to shortages of critical supplies during the unprecedented spike in demand for PPE, the pandemic revealed previously overlooked issues that prevent health systems from being resilient and sustainable.

Additionally, the sustainability of healthcare delivery systems is challenged by ageing populations, complex systems, increasing rates of chronic disease, increasing costs associated with new medical technologies and growing expectations by healthcare consumers. Healthcare programmes, innovations and interventions are increasingly implemented globally to increase effectiveness and efficiency; however, how sustainability is conceptualised and measured in programme evaluations has not been standardized.

We are living in an increasingly interconnected and interdependent world. When our national borders matter less, how we collaborate and learn from each other matters more. Policy-makers, politicians, industry, academia, and the wider civil society need to work together to provide the impetus for a collective global and national response to the current health sustainability crisis. Different countries will find their own routes to sustainability. However, public-private partnerships between governments and the private sectors could offer avenues to accelerate innovation and adoption of sustainable practices.

From an environmental standpoint, there is clear evidence that suggests that activities of healthcare systems can significantly impact and pressurize the environment. These include generation of hazardous and conventional waste, waste water, and greenhouse gas emissions, and the high consumption of resources such as water and energy.

Healthcare providers can also take a leading role in improving sustainability. The four ways in which healthcare providers can become more sustainable include: practicing chemical safety by making conscious purchasing decisions and recycling toxic products periodically, considering greener ways of waste disposal such as autoclaving, chemical treatment and microwaving, saving energy by reprograming their heating and cooling plants and preserving water by using water efficient alternatives and high-efficiency dishwashers.

Technological advancements in the healthcare sector have illuminated new ways of doing things that provide health and environmental benefits. Electronic e-heath interventions have improved health outcomes and access to care. They increase efficiency and decrease pollution by eliminating or reducing the need for travel and reducing healthcare costs. Various medical devices and technologies have also contributed to reduction in water usage and production of wastewater.

Additionally, our increased ability to generate data, combined with the digitalisation of healthcare systems, has created an opportunity to revolutionise healthcare through the use of ‘big data’. These technological advances are helping to facilitate global trends in how people take ownership of their health and interact with health services.

People are also beginning to become more environmentally conscious and aware of their own health and the role they can play to improve sustainability through increased access to health and environmental information via new communication technologies and media attention. Perhaps the most important shift we will see in the future is the personal responsibility that every person will assume for their own health and the health of the planet.

Article by Shailja Sharma, SBS Faculty Member and Leadership and Career Coach

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