PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

97 Acting early on NCDs The Partnership for Health System Sustainability and Resilience10 Environmental sustainability Climate change and environmental degradation increasingly shape NCD burden through heat stress, air pollution, extreme weather events, and disrupted food systems, whilst healthcare delivery itself carries a significant carbon footprint. This bidirectional relationship, with health systems contributing to environmental problems whilst managing their health consequences, creates new imperatives for sustainable, resilient care models. Recent analysis provides a useful framework for understanding this challenge, as illustrated in Figure 19 (Or & Seppänen, 2024). Healthcare systems affect climate through both direct emissions (from facilities, transport, and medical gases) and indirect emissions (from energy generation and supply chains). Climate change, in turn, increases demand for NCD care through environmental health hazards. Interventions can target both supply-side changes (provider-level ’green interventions’ like renewable energy and waste reduction) and demand-side policies (system-level strategies including prevention, care reorganisation, and reducing low-value care). The most effective approaches combine both dimensions, simultaneously reducing emissions while improving care quality and health outcomes. Figure 19: Relationship between the healthcare system, climate change, and sustainability strategies and interventions Source: Adapted from Or & Seppänen, 2024. System-level mitigation strategies System-level mitigation strategies Provider-level green interventionsSupply-side policies Demand-side policies • Shifting care to less polluting settings • Minimising low value care, over-diagnosis and treatment • Regulation and incentives for greener medical products• Primary prevention • Patient education • Public information • Effective disease management • Minimising avoidable demandHealth system • Recycling, reuse and waste management • Better energy use and green care protocolsHealth outcomesClimate change direct and indirect emissions