PHSSR Policy Roadmaps for Acting Early on NCDs Synthesis Report 2025

102 Acting early on NCDs The Partnership for Health System Sustainability and ResilienceCo-benefits: emerging recognition of aligned opportunities Perhaps the most promising development is growing recognition that many interventions can simultaneously improve health outcomes and reduce environmental impact. While these co-benefits remain undervalued in formal decision-making, successful examples are multiplying and creating momentum for systematic change. Prevention demonstrates the clearest co-benefits. Avoiding progression to end-stage renal disease eliminates years of resource-intensive dialysis. Community-based care models reduce emissions from both patient travel and facility operations while often achieving better outcomes than hospital- based alternatives. These dual benefits are beginning to influence policy discussions even if not yet formally incorporated into resource allocation decisions. Digital transformation has delivered substantial if largely unintended environmental benefits. Canada’s virtual care expansion avoided 1.2 billion kilometres of travel and 330,000 tonnes of CO 2 emissions in 2021 alone, equivalent to removing 72,000 cars from roads annually (Welk et al., 2022). While implemented primarily for access and convenience rather than environmental reasons, these results demonstrate the potential for technology-enabled care models to achieve multiple objectives simultaneously. Yet such co-benefits typically remain unquantified and therefore unvalued in resource allocation decisions, perpetuating investment in high-emission care models even when lower-emission alternatives would improve both health outcomes and environmental sustainability. ENVIRONMENTAL SUSTAINABILITY: POLICY LEVERS FOR ACTING EARLY ON NCDS Healthcare system contributions to carbon emissions remain under-addressed in national policy. The absence of emissions measurement frameworks, exclusion of healthcare from climate strategies, and failure to value prevention’s environmental co-benefits perpetuate high-emission care models. Climate adaptation efforts focus on acute events while ignoring specific NCD patient vulnerabilities: medication storage during power outages, adjusted protocols during heatwaves, and disrupted care continuity. Evidence that environmental health interventions disproportionately benefit affluent areas suggests climate responses may widen rather than narrow health inequities. There must be genuine progress in addressing the environmental dimensions of healthcare. Without recognising the opportunities to improve both outcomes and environmental footprint in healthcare, health systems will increasingly struggle with the dual burden of contributing to and managing climate impacts. ■ Develop comprehensive emissions measurement systems across care pathways Health systems need standardised methodologies for calculating emissions across the entire care continuum, from pharmaceutical and medical devices life-cycle assessment through service delivery to patient travel. These should demonstrate the impact that better patient outcomes can have on reducing the environmental footprint of healthcare, and support the case for care pathway improvement and treatment to guidelines. Better measurement tools will also allow industry to benchmark its progress in reducing the environmental impact of its products at-source via innovation. ■ Build climate-resilient care models for NCD populations Healthcare systems need systematic assessment of climate vulnerabilities, particularly for NCD patients who face disproportionate risks from extreme weather. This includes developing adjusted clinical protocols for heat waves and other climate events, and ensuring medication security during power outages. Heat warning systems must also translate into modified care for chronic disease patients, for example by triggering advice to patients when extreme heat waves occur.