The current climate crisis presents a dual challenge to global public health. According to the World Health Organization, climate change will cause an additional 250,000 deaths per year between 2030 and 2050 and will increase healthcare costs globally. On the other hand, the healthcare sector is responsible for almost 5% of global greenhouse gas (GHG) emissions, mostly due to its high energy consumption and the burning of fossil fuels in its long supply chain. If it were a country, the sector would be the fifth-largest emitter, ahead of nations such as Brazil and Japan.

Although the impact of climate crisis is already being felt across the planet, different regions are affected according to their levels of vulnerability and adaptability. The Pan American Health Organization registered that more than half of the 18,000 hospitals in Latin America are in risky areas for natural disasters, such as floods, earthquakes, or hurricanes. However, less than 1% of these hospitals calculated their carbon footprint and made reduction commitments by the year 2020. Brazil, the country most prone to floods on the continent, only had its first carbon-neutral health institution through carbon credit purchase 3 years ago. 

These numbers must be understood in the context of how the climate change has been more acutely felt by the Brazilian population in the last decade, which includes worsened air quality in metropolitan areas, increased power costs, and catastrophic floods and landslides in coastal regions. Climate change has also negatively affected local biodiversity, food security, and water availability, impacting national agriculture and economy. The poorest and least accessible populations in the country, including indigenous and riverside peoples, are also the most vulnerable to these effects.

In that context, the Brazilian healthcare sector, like its counterparts in other countries, has contributed to the current climate crisis and should take responsibility for reducing its GHG emissions. Although the Brazil’s private healthcare network has increasingly adopted ESG (Environmental, Social, and Corporate Governance) practices, incorporating them into their vocabulary and investment plans; sustainability strategies are still in their infancy in the context of public unified national health system (SUS), where resources are structurally limited. 

In the green economy era, Brazil has the potential to lead new socio-environmental policies related to decarbonization and sustainable management of natural resources. To build more sustainable healthcare ecosystems with optimized workflows, efficient waste management, and minimal energy waste, investments in renewable energy sources and digital technologies and solutions are crucial, and principles of the circular economy and sustainable design may be disseminated. Brazilian public and private institutions and multiple other agents, including investment funds and banks, must be aligned in promoting a common agenda based on shared experiences and cooperation.

Leading by example, Brazil can show to the world how the Hippocratic aphorism "Primum non nocere" (or "First, do no harm") only makes sense when applied to the entire planet.

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Article written in partnership with José Araújo Filho, MD, PhD, a cardiothoracic radiologist with post-doctoral fellowship at Memorial Sloan-Kettering Cancer Center (New York),  currently member of the Young Leaders Program of National Academy of Medicine (Brazil), and of the Global Outreach Committee of the Society of Thoracic Radiology (USA). 

Publicado na coluna de junho de 2023 na The Yuan.