Domain 7: Environmental sustainability and resilience Sustainability •Saudi Arabia has set binding greenhouse gas emissions (GHGE) reduction targets for key sectors, including health, and has pledged to reduce carbon emissions to net zero by 2060. Initiatives and indicators have been implemented in multiple sectors to build environmental sustainability and resilience, and achieve GHGE targets that are compatible with international standards. •Efforts to mitigate the environmental impacts of the health system, such as atmospheric carbon emissions, waste production and natural resource consumption, are an important component of broader initiatives to reduce pollution, waste and emissions. •Achieving environmental sustainability and resilience requires increased coordination at the national level, regular monitoring, transparent and accountable targets for reducing the ecological footprint, a commitment to behavioural change, and established guidelines for health service providers. •The National Centre for Waste Management regulates and supervises waste management activities (recycling, resource retrieval and safe disposal) to achieve better environmental and economic results. In 2022, the government allocated $50 billion to municipal services, including health facility waste management. Key stakeholders in the waste management sector collaborate to ensure the proper disposal of health facility waste, contributing to the overall goal of an environmentally sustainable health system. •Developing sustainable built infrastructure is another critical aspect of environmental sustainability. The Saudi Mostadam (sustainable) rating system for existing and new buildings was recently introduced. However, as it does not include international standards for sustainable hospitals and green healthcare, a new domestic rating system for healthcare facilities needs to be developed in Saudi Arabia. Resilience •In addition to environmental impacts, climate change is linked to adverse health impacts, such as heat-related injuries and deaths, and increased mortality from natural disasters and vector-borne diseases. •Air quality is a key environmental factor and critical to the health sector’s focus on wellbeing. Average NO 2 concentration in Saudi Arabia is much higher than recommended by WHO. Major cities record high PM2.5 levels, and O 3 concentrations surpass standard levels. However, due to decreases in the sulphur content of diesel, SO 2 rates in have fallen to within acceptable limits.The Ministry of Environment, Water, and Agriculture has warned that data on air quality are incomplete and unreliable, due to the lack of source emission monitoring and inventory. 14 Sustainability and Resilience in the Saudi Arabian Health System The Partnership for Health System Sustainability and Resilience

PHSSR Saudi Arabia 2025