Thu | Dec 7, 2023

Healthcare a major contributor to climate change crisis – MAJ president

Published:Friday | September 29, 2023 | 12:09 AMAsha Wilks/Gleaner Writer
Plastic pollution, as depicted in this file photo of Kingston harbour, endangers the ecosystem through the emission of greenhouse gases from its decomposition, which impacts climate change.
Plastic pollution, as depicted in this file photo of Kingston harbour, endangers the ecosystem through the emission of greenhouse gases from its decomposition, which impacts climate change.
Dr Brian James, president, Medical Association of Jamaica.
Dr Brian James, president, Medical Association of Jamaica.

DR BRIAN James, president of the Medical Association of Jamaica (MAJ), has raised concern about how the global health care industry’s operations contribute significantly to the climate change crisis.

James, who was speaking at the recent ‘Science for Today’ public lecture series hosted by The University of the West Indies’ Faculty of Science and Technology, stated that based on studies conducted, “healthcare activities is a major contributor to [the] climate crisis and our mission is to first do no harm and to heal the sick. However, we are a big contributor, and this is quickly evolving into a huge health emergency.”

The lecture series focused on the continuous effects that climate change has on the environment and various industries.

Discussing matters surrounding the ‘Effect of climate change on the delivery of healthcare and the carbon footprint of healthcare delivery’, James, an anaesthesiologist, explained that from extensive studies conducted, the healthcare industry had a climate footprint of 2.0 gigatonnes of equivalent carbon dioxide in 2014, which is equivalent to 4.4 per cent of global net emissions.

Recent studies have shown that the global healthcare systems’ climate footprint has increased to approximately 4.6 per cent of total greenhouse gas (GHG) emissions.

“If healthcare was treated as a country – [because] what they’ve done is to rank the countries in terms of their greenhouse gas emissions, and if you take all of the healthcare emissions and put it on that ranking, we’d be ranked number five,” he said.

“Only China, the United States, India and Russia would emit more greenhouse gases than the healthcare system, think about that. The amount of greenhouse gases that we emit would be equivalent to the greenhouse gases emitted by 514 coal-power plants, just think about that,” he said.


James added that while functioning to provide healthcare to individuals, each healthcare facility generated these greenhouse gases either directly or indirectly.

The greenhouse gas protocol, 2022 specifies three categories of the carbon footprint of healthcare delivery. Scope one looks at the direct emissions associated with the use of energy, excluding that of purchased electricity. This accounts for 17 per cent of the industry’s global footprint.

“Energy use for various activities is the main reason for all of our greenhouse gas emissions and that comes also from transport [and] from manufacturing of the products that we use in healthcare,” he said.

Scope two addresses indirect emissions related to purchased electricity and the use of the electricity that has been produced elsewhere. This makes up 12 per cent of the sector’s global footprint.

Scope three looks at the rest of the indirect emissions of an organisation, that is, the production not controlled by the organisation. This accounts for 71 per cent of the sector’s global footprint.

“Most of it comes from the healthcare supply chain, from the production of the things that we use whether it is pharmaceuticals, whether it is from the chemicals that we use, whether it is transportation, whether it is [the] disposal of the waste material and then some of it will come from food and agricultural products,” James said.

James continued that the use of anaesthetic gases, 0.6 per cent of all emissions worldwide; and metered dose inhalers – 0.3 per cent of all emissions worldwide, contribute to the healthcare industry’s global climate footprint, which is roughly four million metric tonnes of emissions. That is nearly one per cent of all the emissions on Earth.

He explained that metered dose inhalers which are typically used for the treatment of asthma and other respiratory conditions use hydrofluorocarbons as propellants, and that these gases are highly potent greenhouse gases with warming potentials between approximately 1,500 and 3,000 times the warming potential of carbon dioxide.

“In Jamaica, we do not have the data, we do not know ... how many metered dose inhalers we use per annum or per month or per day,” he said.

As such, James noted that it could not be tracked how much hydrofluorocarbons are being added to the atmosphere and therefore contributing to the problem. He appealed to the Faculty of Science and Technology at UWI to partner with healthcare organisations to gather that data.


“This is what is going to help us to make decisions about how we’re going to mitigate climate change,” he said, arguing that since these inhalers were essential medications medical professionals could not simply stop prescribing them.

So he advocated alternative delivery systems for inhalers that are currently available such as dry powder-based inhalers, and making them widely available.

For gases used for anaesthesia, James noted that they were potent greenhouse gases.

He highlighted that the global warming potential of the commonly used anaesthetics which include nitrous oxide, fluorinated gases, sevoflurane, isoflurane and desflurane, ranged between 130 and 2,540 times the global warming potential of carbon dioxide.

James expressed that the health sector has the responsibility to align its actions and development trajectory with the Paris Agreement to stave off the worst impacts of climate change. For the sector he said that serious climate action will require facilities, systems, and ministries, together with manufacturers and suppliers, to organise ways to achieve net zero emissions by 2050 or before.

“Climate change threatens to disrupt the health system’s ability to deliver high-quality care and to undermine all of the gains that we’ve made in public health in the past 50 years and this is as a result of the heatwaves that we’ve heard about, the extremes weather that we’ve heard about and emerging infectious diseases ... It seems to me that we have a responsibility, a vital role to play in the climate change mitigation efforts and we need, with the help of the scientists, to plan and implement substantial reductions in our emissions,” James said.