Decarbonising healthcare in low and middle income countries: potential pathways to net zero emissions

Rasheed, F.N.; Baddley, Jerome; Prabhakaran, Poornima; Barros, Enrique; Reddy, K. Srinath; Vianna, Nelzair; Marten, Robert

doi:10.1136/bmj.n1284

Cited by 33 publications

(28 citation statements)

References 33 publications

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“…If the health care sector were a country, it would be the fifth-largest emitter worldwide [15]. Trend analyses show that health care GHG emissions have increased by nearly a third over the last two decades [5], both in low and high income countries [17]. Notably, several reports indicate that this carbon footprint is largely avoidable and could be reduced without compromising quality [5,15,18,19].…”

Section: The Carbon Footprint Of Gi Endoscopymentioning

confidence: 99%

Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement

Dinis‐Ribeiro²,

et al. 2022

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Climate change and the destruction of ecosystems by human activities are among the greatest challenges of the 21st century and require urgent action. Health care activities significantly contribute to the emission of greenhouse gases and waste production, with gastrointestinal (GI) endoscopy being one of the largest contributors. This Position Statement aims to raise awareness of the ecological footprint of GI endoscopy and provides guidance to reduce its environmental impact. The European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) outline suggestions and recommendations for health care providers, patients, governments, and industry. Main statements 1 GI endoscopy is a resource-intensive activity with a significant yet poorly assessed environmental impact. 2 ESGE-ESGENA recommend adopting immediate actions to reduce the environmental impact of GI endoscopy. 3 ESGE-ESGENA recommend adherence to guidelines and implementation of audit strategies on the appropriateness of GI endoscopy to avoid the environmental impact of unnecessary procedures. 4 ESGE-ESGENA recommend the embedding of reduce, reuse, and recycle programs in the GI endoscopy unit. 5 ESGE-ESGENA suggest that there is an urgent need to reassess and reduce the environmental and economic impact of single-use GI endoscopic devices. 6 ESGE-ESGENA suggest against routine use of single-use GI endoscopes. However, their use could be considered in highly selected patients on a case-by-case basis. 7 ESGE-ESGENA recommend inclusion of sustainability in the training curricula of GI endoscopy and as a quality domain. 8 ESGE-ESGENA recommend conducting high quality research to quantify and minimize the environmental impact of GI endoscopy. 9 ESGE-ESGENA recommend that GI endoscopy companies assess, disclose, and audit the environmental impact of their value chain. 10 ESGE-ESGENA recommend that GI endoscopy should become a net-zero greenhouse gas emissions practice by 2050.

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Section: The Carbon Footprint Of Gi Endoscopymentioning

confidence: 99%

Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement

Dinis‐Ribeiro²,

et al. 2022

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“…The move to a sustainable economy can start in the health sector, which contributes nearly 5% of global emissions 3. Decarbonisation of healthcare systems would catalyse action in other sectors, while also strengthening health system resilience 1314. The health response is not only about what we do, but how we do it.…”

Section: Effective Actionmentioning

confidence: 99%

An unequivocal call to climate action for the health sector

Beyeler¹,

Salas

2022

BMJ

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“…The LMIC governments can reduce CO2 emissions by investing in favorable geographical sourcing, logistics, and eco-conscious suppliers thus limiting travel distance and reducing unnecessary packaging of goods. [11].…”

Section: Review Reducementioning

confidence: 99%

The Role and Duty of Global Surgery in Increasing Sustainability and Improving Patient Care in Low and Middle-Income Countries

Banhidy¹,

Banhidy²

2022

Cureus

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Global health is one of the most pressing issues facing the 21st century. Surgery is a resource and energyintensive healthcare activity which produces overwhelming quantities of waste. Using the 5Rs (Reduce, Reuse, Recycle, Rethink, and Research) provides the global surgical community with the pillars of sustainability to develop strategies that are scalable and transferable in both low and middle-income countries and their high-income counterparts.Reducing energy consumption is necessary to achieving net zero emissions in the provision of essential healthcare. Simple, easily transferrable, high-income country (HIC) technologies can greatly reduce energy demands in low-income countries. Reusing appropriately sterilized equipment and reprocessing surgical devices leads to a reduction of costs and a significant reduction of unnecessary potentially hazardous waste. Recycling through official government-facilitated means reduces 'informal recycling' schemes, and the spread of communicable diseases whilst expectantly reducing the release of carcinogens and atmospheric greenhouse gases. Rethinking local surgical innovation and providing an ecosystem that is both ethical and sustainable, is not only beneficial from a medical perspective but allows local financial investment and feeds back into local economies. Finally, research output from low-income countries is minimal compared to the global academic output. Research from low and middle-income countries must equal research from highincome countries, thereby producing fruitful partnerships. With adequate international collaboration and awareness of the lack of necessary surgical interventions in low and middle-income countries (LMICs), global surgery has the potential to reduce the impact of surgical practice on the environment, without compromising patient safety or quality of care.

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Decarbonising healthcare in low and middle income countries: potential pathways to net zero emissions

Cited by 33 publications

References 33 publications

Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement

Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement

An unequivocal call to climate action for the health sector

The Role and Duty of Global Surgery in Increasing Sustainability and Improving Patient Care in Low and Middle-Income Countries

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