Diagnosing the future of sustainability in healthcareDiagnosing the future of sustainability in healthcare

As the world convened for the COP28 climate change event in the UAE last year, a critical lens is being cast upon every sector’s contribution toward a sustainable future. The pharmaceutical and healthcare industries, the heart of global well-being, are no exception as they represent both significant economic weight and a direct lifeline to billions. These sectors possess an exceptional capacity — and responsibility — to lead in sustainable transformation.

Historically, industries related to healthcare have had a complex relationship with sustainability. While they have delivered remarkable innovations that have helped prolong and improve the quality of human life, their extensive supply chains, energy-intensive processes, and waste production have raised environmental concerns.

According to a recent report by the World Economic Forum, healthcare is responsible for 4.4 per cent of global emissions, significantly more per dollar of revenue than the automotive sector. To combat the adverse health consequences of the climate emergency, pharmaceutical companies need to expand access to healthcare globally and reduce their greenhouse gas emissions through net-zero strategies.

The impact of climate change both on and because of the healthcare industry is two-pronged. On one hand, climate plays havoc with the very tools that underpin the industry, i.e., raw materials production and supply chain due to adverse and destructive weather directly impacting access. Extreme weather systems, sky-high temperatures, extreme cold snaps, floods, or otherwise, the pharmaceutical supply chain requires shipments to reach their intended destination in optimal condition to avoid delays that may impact the product. On the other hand, the emissions and carbon footprint due to drug manufacturing and the very same supply chain cause ill effects on climate as well.

Related: Refining precision medicine to protect people and planet

During COP27, research indicated only 4 per cent of biotechnology and pharmaceutical firms were aligned with the Paris 2030 climate objectives, despite being a sector that ranks as one of the top carbon-dioxide contributors globally. In particular, a 2019 publication revealed that for every US$1 million in pharmaceutical revenue, it emitted 48.55 tonnes of carbon dioxide equivalent (CO2e).

It is important to note that recent years have seen a shift. Faced with mounting evidence of the impact of climate change on human health — ranging from the spread of vector-borne diseases due to changing ecosystems to the repercussions of extreme weather events on vulnerable populations — there is an increased urgency for these industries to address their ecological footprint. We are already seeing decisions being made to curtail these concerns. Consumers are leading this shift with their voices. In 2021 a GlobalData survey revealed 43 per cent of participants identified environmental concerns as the primary area for the pharmaceutical sector to tackle. Within that survey, 52 per cent of respondents cited climate change as their most urgent concern.

A study cited by EuroNews found that if the global healthcare sector were a country, it would be the fifth-largest greenhouse gas emitter. This has profound implications for how stakeholders view the industry’s responsibility towards climate action.

Companies have begun re-evaluating their packaging strategies, adopting biodegradable materials and minimising excesses, potentially reducing thousands of metric tonnes of waste annually. Healthcare facilities, traditionally high consumers of energy, have also increasingly adopted energy-efficient infrastructures and renewable energy sources, leading to significant reductions in CO2 emissions. Recognising the environmental impact of raw material extraction, industries have been moving toward sustainably sourced ingredients and materials. Green chemistry is increasingly being vetted and integrated into current processes by the pharmaceutical sector, focused on designing products via processes that minimise environmental impacts and toxic waste.

While these strides are commendable, it is still just the beginning. Following government ministers, healthcare professionals, company decision-makers, and members of the media’s discussion of our shared future at COP28, it is imperative to highlight the role of sustainability in shaping an industry that does not just heal people, but also the planet, our only home.

So, what does the future of sustainability in healthcare hold?

Manufacturing, transport, mobility, and logistics technology are evolving faster than ever, and most are taking environmental feedback and climate-related innovations seriously as part of that process. What is now a vision will fast become a reality, and here we want to consider what that reality will look like.

Related: Hospitals spearhead sustainable healthcare initiatives

Sustainable healthcare becomes a consumer norm

The production of medical devices, drugs, and related items will be done in a manner that is environmentally responsible at its heart, socially equitable as part of its mandate, and economically viable as part of its business decisions. This will involve everything from greener production processes to sustainable raw materials sourcing.

Potential investment indicators

Eco-friendly packaging

With the production of single-use plastics being more and more demonised and a reduction in use by consumers aware of their environmental impact, there will be a significant push towards sustainable packaging alternatives, including biodegradable or recyclable materials. In the past, medical packaging was designed for the open-use-dispose dynamic in healthcare. Safety remains the primary packaging goal. Current estimates by TRVST approximate that about 25 per cent of hospital waste is plastic. 1 With eco-friendly packaging becoming the norm, roughly a quarter of waste in hospitals will be reduced worldwide.

Green chemistry

This involves designing products and processes that reduce or eliminate the use and generation of hazardous substances. In pharmaceuticals, green chemistry could lead to less waste and safer products. The EU Green Chemistry Subsidy programme was launched for this purpose, offering various subsidies and funding programmes under the EGD, to support transitioning into a green economy. In February this year, the European Commission presented its Green Deal Industrial Plan (GDIP) for the net-zero age with an initial investment of US$270 billion, further providing a benchmark to other countries and regions to follow.

Energy-efficient facilities

Manufacturing facilities are being retrofitted or designed from the ground up to minimise energy consumption. An example of this future in the present can be seen with Teva Pharmaceuticals, a key global generic pharmaceutical giant, which recently partnered with Honeywell to optimise energy efficiency. Teva reported a 24 per cent reduction in absolute scope 1 and 2 greenhouse gas emissions compared to 2019, which puts them ahead of schedule to meet their 2025 target of a 25 per cent reduction. Their absolute Scope 3 GHG emissions also reduced by 12 per cent over 2020. In August 2023, AstraZeneca struck a deal with Stratkraft, Europe’s largest renewable energy producer. The deal will see AstraZeneca purchase 200 gigawatt-hours per year for 10 years, corresponding to approximately 80 per cent of the company’s total electricity needs at its research facility in Gothenburg and its manufacturing plant in Södertälje, Sweden.

Sustainable sourcing

Companies are already ensuring raw materials are sustainably sourced, particularly for medications derived from natural resources. The future is already taking shape, with industry leaders like GSK leading the charge. The company is currently evaluating its supply chain to develop a mitigation plan as a participant in a pilot of science-based targets for nature being managed by the Science Based Targets Network (SBTN). As part of the pilot, GSK has developed sustainable sourcing standards for materials such as lactose, gelatin, palm oil, paper and sugar, used in the company’s drugs and inhalers, or as “adjuvants” in vaccines to help create a stronger immune response in people receiving the vaccine. Many others are used for packaging or in drug testing.

The future of sustainable healthcare is promising. Consumers are increasingly aware and there is a significant demand for sustainable healthcare products, making it not only an environmental imperative but a competitive one, something companies need to bear in mind if they want to be a part of the sustainable lifestyle in the future these consumers are preparing themselves for.

Wastewater management

The growing concerns surrounding waste management in healthcare, especially in the GCC with its increasing drug manufacturing facilities, take center stage. Medical waste, from used needles to expired medicines, when mishandled, can introduce serious health risks. Non-infectious waste piles up in significant quantities, potentially polluting soil and water. Incorrect disposal of medicines can introduce them into water systems, posing threats to aquatic life, humans, and the broader ecosystem for extended periods. Hospitals and clinics consume enormous amounts of water for sanitation and patient care, straining local water sources. This is particularly troubling in regions like the GCC where fresh water is scarce, and reliance on desalinated water is high. Between 30 per cent to 90 per cent of specific orally taken drugs end up in our rivers and soils, as reported by Euronews. The call for action at COP28 was clear: to adopt sustainable practices to protect both our environment and public health.

Companies can address wastewater management sustainably by integrating innovative technologies, best practices, and proactive strategies. One approach is source reduction, refining manufacturing processes to minimise waste generation and embracing green chemistry principles. Advanced treatment technologies have also emerged as effective solutions. Membrane Bioreactors (MBRs), which merge conventional activated sludge treatment with membrane liquid-solid separation, ensure pollutants are effectively removed. Another reliable method is the use of activated carbon absorption, known for effectively eliminating organic compounds from wastewater. Investing in on-site wastewater treatment plants gives companies more control over the water’s quality and ensures adherence to regulatory benchmarks. Ultimately, adopting a continuous improvement ethos and staying current with the latest technologies and practices will position companies at the vanguard of sustainable wastewater management.

Conclusion

Following COP28 we have much to consider in the healthcare industry. Steps are being taken, but are they fast enough? Strong enough? Impactful enough? Or are concerted efforts toward sustainable healthcare simply superficial due to pushback from economic, financial and regulatory stakeholders? Is innovation too slow, or too fast thereby limiting this slow-moving industry’s attempts to ramp up climate-friendly initiatives?

The goal of Health Day at COP28 was to build consensus on priority policy and investment in health systems and to get commitments from health and climate funders for a first tranche of money for implementation. The industry is at the precipice of a sustainable future, and we look forward to powerful, impactful decisions from this event and beyond, for patients, healthcare workers, pharmaceutical manufacturers, and more