Tackling this challenge requires understanding the various sources of emissions, or “scopes”, which fall broadly into three categories. Scope 1 emissions encompass those caused directly by healthcare facilities and equipment—fuelling ambulances with petrol, burning kerosene to keep the power humming at rural hospitals and so on. Scope 2 emissions emerge through the consumption of electricity, gas for heating and other indirect forms of energy. Finally, scope 3 emissions represent everything else: carbon dioxide produced from the various activities that surround the sector, from manufacture of medical supplies to disposal of drugs and supplies.
This huge diversity of emissions sources makes it hard for healthcare decision-makers to know where to begin. Even agreement on unified standards to report and publish emissions data remains elusive. Some progress is occurring in the region—corporate greenhouse gas reporting platform CDP says that Asia comprises nearly 30% of its set of global responses —and regulators are considering forcing some sectors to disclose their carbon footprint . Still, experts agree more needs to be done, especially in healthcare.
“You can’t manage what you don’t measure,” says Dr Renard Siew, Climate Reality Leader for the Climate Reality Project, and Climate Change Adviser at the Centre for Governance and Political Studies. “Asia Pacific healthcare sector leaders really [need to] step up to the plate to improve maturity of carbon reporting.”
Health Care Without Harm, a group pushing for healthcare decarbonisation, has laid out a roadmap for the sector, starting with transitioning to renewables like wind and solar to power operations . This may be more difficult than it seems: healthcare organisations are relatively constrained when it comes to where they get their energy from, typically needing to plug into local grids like everyone else.
Where they can affect change, however, is at the policy level: Dr Renzo Guinto, chief planetary health specialist at Sunway Centre for Planetary Health, Malaysia and director of the Planetary and Global Health Program at St. Luke’s Medical Centre in the Philippines, says that the weight of the sector in political circles gives them leverage over questions of energy investment and the shift to greener forms of generation across the broader economy. “The healthcare system does not have full control over the electric grid, but it certainly does have power,” he says.
A thorough accounting of greenhouse gases may uncover emissions from unexpected corners of the healthcare landscape. Dr Guinto notes that executives in hospitals around the world are examining how to reduce the impact of gases that anaesthetise patients during surgery, which, when vented into the atmosphere, can cause significant warming. With Asian healthcare systems poised to boost their use of such gases more rapidly than elsewhere, according to forecasts [7,8], this slice of the market may come under greater scrutiny.
Dr Siew says that more mundane tweaks like renovating facilities to meet stricter energy efficiency standards can make a big difference. Health officials are taking note: in 2021 the US Green Building Council awarded Malaysia’s Ministry of Health a Leadership Award for the green retrofit of a major hospital .
But Dr Siew notes these kinds of upgrades are not mandatory in most places and that more must be done. “This is an area we have to push for, because I think it would result in huge emissions reductions directly from hospitals,” he says.