Certainly, associating the health sector or health systems with climate change doesn't seem to make much sense. However, as with most human activities, those related to health also have a negative impact on the environment.

Scientific and technological advances in the health sector are definitely bringing about positive changes in our quality of life.
However, this improvement does not come without a price; it comes at the expense of a higher environmental cost. Fortunately, however, science also offers us the ability to measure this cost: our ecological and carbon footprints.

The Ecological Footprint, a useful tool for measuring environmental impact
Simply put, the ecological footprint is an indicator of our planet's productive capacity. Indeed, all of our activities consume resources and generate waste. Therefore, when we exceed our waste production—that is, when we alter the Earth's capacity to absorb it—we are creating an imbalance. Thus, when this happens, it means we are doing things wrong because we are not giving the planet time to recover. A true reflection of this is that currently, according to various reports, our consumption needs exceed the planet's capacity to regenerate the resources we use by between 30 and 60%.

The carbon footprint and the impact of health sector activities
The carbon footprint is another indicator that allows us to calculate the amount of greenhouse gases emitted, both individually and as a result of a specific activity. In fact, nothing we produce or consume is possible without using energy, and this is mostly supplied by fossil fuels: gas, oil, and coal, the main sources of these gases.

Regarding the health sector, there are reports that assign it primary responsibility for climate change, which, paradoxically, constitutes the greatest threat to human health. This is because the services it provides, as well as the
products and technologies it uses are part of an intensive chain of greenhouse gas release.

Of course, the best way to demonstrate that what is claimed is what is observed in reality is through the data that reality provides. These data tell us the following:

• The ecological footprint of the healthcare sector is equivalent to 4.4% of net global emissions. This figure places the healthcare sector as one of the main drivers of climate change.
• To measure the sector's global ecological footprint, we can say that this emission is equivalent to the annual output of 514 coal-fired power plants.
• If we wanted to give the health sector a physical representation in the form of a country, this imaginary country would be the fifth largest emitter on the planet.
• More than 50% of the carbon footprint produced is attributable to energy consumption from fossil fuels.

What are the sources of emissions from the health system?
The healthcare sector contributes emissions from various sources. There are three categories, depending on their origin:

1. Those that are directly generated by healthcare facilities and account for 17% of the system's total global footprint.
2. Those of indirect origin, that is, those derived from purchased energy: electricity, steam, cooling, and heating. These represent 12% of the total.
3. Those originating from the supply chain constitute the largest percentage, 71%. These are linked to the supply chain: production, transportation, and distribution of goods and services used by the sector.

Can the sector behave in a climate-smart way?
Ciertamente, no solamente es posible lograrlo, sino que es un deber y un desafío para el sector cuidar la salud sin afectar el medio ambiente. Con ese objetivo, se proponen las siguientes acciones:

1. Adopción de medidas en los establecimientos de salud para reducir las emisiones; implementación de sistemas de energías limpias y renovables y de descarbonización de sistemas energéticos; ejecución de criterios de compras bajas en carbono o de emisiones cero.
2. Promotion, by the health sector, of the transition to clean and renewable energy.
3. Identifying paths, timelines, and frameworks for action to achieve zero emissions by 2050, involving all levels.
4. Incorporation of climate-smart healthcare principles and strategies by international lending agencies.
5. Establishment and implementation of government policies aimed at decarbonizing health systems.
6. Deepening research to better understand the interaction between health care and climate change.

Finally, it is worth highlighting that the health sector has a unique responsibility compared to other sectors of society, which is to protect and promote health and prevent harm. Therefore, investments in health and in health policies aimed at decarbonization should take priority in leading us toward a healthier and more socially equitable future.

Bibliographic references

• Gil Posse, C. (2022). Climate Footprint of the Health Sector. Available at SEE
• González, D. (2020). Do you know how much the health sector pollutes the planet? Available at SEE
• Karliner, J. et al. (2019). The Health Sector's Climate Footprint: How the Health Sector Contributes to the Global Climate Crisis: Opportunities for Action. Climate-Smart Healthcare Series. Green Paper No. 1. Available at SEE
• Miranda, D. (2020). The ecological deficit is delayed by three weeks in 2020. Available at SEE
• New Medical Economics (2022). Climate Footprint and the Health Sector. Available at SEE
• Soler, C. (2021). Health and its carbon footprint: Hospitals join the race to zero. Available in SEE
• Technological University of Pereira (2020). What is the ecological footprint? Center for Environmental Management. Available at SEE