Do health systems promote climate change?

Can you imagine a world where a medical consultation, a diagnostic test, or the monitoring of chronic diseases could be done from the comfort of your home? Technology applied to health can help us achieve this. our Health systems also contribute to a global problem that affects everyone? Some countries, like the United Kingdom and Canada, are already measuring the environmental impact of health systems, an issue still pending in our country.

Tools such as My Health, electronic prescriptions, and test and data storage are very useful and necessary. Before the COVID-19 pandemic, technological tools applied to health already existed, but their use was limited and often raised questions. Did they guarantee people's anonymity? What if having too much information led to false hope? The need to reduce in-person visits and continue caring for sick people made what seemed unfeasible more than five years ago suddenly possible during the pandemic. Access to the My Health platform increased exponentially, and mobile applications that allowed for organizing mass vaccinations became widespread very quickly. These were months in which the digital transformation of the healthcare system accelerated significantly. Now, five years later, it would be good and advisable to advance this digital transformation in a more measured and analytical manner.

Technology applied to healthcare appears to bring many benefits, such as the more than likely improvement in the quality of care and the efficiency of the system. These are undoubtedly key aspects, but others are equally important and have not been sufficiently considered until now. The climate change we are experiencing and suffering is primarily driven by greenhouse gas emissions. According to a study published in The LancetThe healthcare sector is responsible for an average of 4.4% of global greenhouse gas emissions. In other words, if the global healthcare system were a country, it would be the fifth largest greenhouse gas emitter, behind China, the United States, India, and the United States. The data we have is global and often approximate. We need much more data to be able to analyze more accurately, for example, whether the carbon footprint of a trip is greater or less than that of an e-consultation.

The impact of climate change on health is now well known. The World Health Organization estimates that between 2030 and 2050, climate change will be responsible for more than 250,000 additional deaths worldwide. The healthcare sector, which aims to ensure the health of all people, also bears some responsibility for climate change. We could say that what heals you can also harm you. Consider virtual consultations, for example. They reduce travel and emissions associated with transportation, but what is behind these video calls? Each interaction depends on large servers that consume huge amounts of energy and water: a single virtual consultation with an artificial intelligence system can consume ten times more electricity than a Google search. This impact is compounded by the environmental cost of manufacturing and managing the devices. The extraction of minerals for electronic components damages ecosystems, while the lifespan of these devices generates hazardous waste. The digital transition in healthcare, therefore, requires balancing innovation with environmental sustainability.

We are still far from knowing how to conduct a careful analysis and make decisions about whether a technological tool does more than harm in terms of health. However, it seems clear that the healthcare sector, like all other sectors of society, has a responsibility to reduce greenhouse gas emissions as much as possible. Given its mission to protect and promote health, the sector also has a responsibility to uphold the Hippocratic Oath—"First, do no harm"—in relation to its climate footprint, and to influence other sectors to do the same. In a world where health and the environment are inextricably linked, the healthcare sector must lead the way toward a sustainable future.