National Incentives to Promote Health Care Climate Action

The first principle of health care is to “do no harm.” However, emissions from health care services are contributing to climate change and having an impact on human health. An estimated 4.7 percent of global emissions come from health care services; without action this could triple by 2050. In response, some governments and health care organizations have launched initiatives to reduce emissions. The World Health Organization launched the COP26 Health Programme in 2021, which has resulted in more than 60 countries committing to resilient, sustainable, low-carbon health systems. In 2022, the G7 health ministers set an intention to build environmentally sustainable and climate-neutral health systems by 2050 and to support other countries in their efforts. In 2023, the Health Working Group meetings of the G20 nations have been discussing climate change and its impact on health.

These international commitments demonstrate the growing momentum and support for action to decarbonize health care. They are being supported by individual countries that aim to facilitate change within their health systems. This post describes actions governments can take to support and incentivize health systems to reduce their emissions.

National Mechanisms to Reduce Emissions

National leadership and commitment are critical and can take different forms, depending on the structure of the country’s health system. For many, the first step is signing on to international programs like the COP26. Some countries also have set national targets for reduced emissions. Having a clear national commitment or target gives health systems a goal and a starting point for conversation and action.

In addition, national bodies can use the following tools to incentivize action. (Examples are provided in the table.)

1. Legal or regulatory requirements that call for health care providers and their suppliers to take action to reduce emissions or meet reduced emissions targets is one of the most direct ways to drive change. Requirements may include having emission reduction plans, ensuring board-level accountability, or public reporting of emissions.
2. Voluntary commitments and pledges to reduce emissions provide a mechanism for health systems to demonstrate support for national goals where formal regulation has not yet been introduced. However, there is a risk that these commitments are adopted by those already highly engaged and do not reach the whole health care system.
3. National plans or roadmaps that set out how commitments will be met provide clear actions for health care organizations and their partners. This can be helpful for systems that do not yet have their own plan.
4. National teams focused on climate change and health can help advance policy and practice. Having a defined national team within government demonstrates a commitment to progress. It also can provide central capacity, capability, and tools.
5. Government investment can be used in a wide range of areas including creating local teams to support delivery of decarbonization plans; upgrading buildings, facilities, energy, and transport infrastructure with low-carbon alternatives; and funding research and innovation.
6. Data and reporting requirements can incentivize health systems to understand their baseline and reduce emissions.
7. Training and development help staff understand their roles in protecting the public from the impacts of climate change and reducing emissions. Some medical schools are starting to include climate change in undergraduate teaching. Ongoing professional development courses also can serve to educate staff.
8. Networks and communities can provide a less formal way to address climate change and health by sharing best practices, knowledge, and tools.

Next Steps

The United States, like many other nations, has made a commitment to reduce emissions from health care. As policymakers consider how they can help the health system reduce emissions by 50 percent by 2030, they may look to international examples and consider how to introduce similar incentives to drive change. Supporting initiatives to collect data and share best practices will be important to encourage action. However, investment in change will be needed for all health systems to reduce their emissions. The Inflation Reduction Act is a broader incentive that U.S. health care organizations can draw on. But more targeted support and investment and support will be needed to reach net zero.