Meeting the Climate Challenge: A leadership pledge by hospitals, health centers and health systems from across the globe

Please read the text below. If you would like to sign the pledge, you can use the form at the bottom.

Climate change, as The Lancet Commission put it in 2009, is “the biggest public health threat of the 21stCentury.”[1]  Since then, the climate crisis has only deepened, and the science has become increasingly irrefutable, heightening the urgency for action.

We know that climate change is already causing or exacerbating a wide range of health problems the world over. As the earth warms, infectious diseases like malaria and dengue are spreading to new locations, threatening to reverse hard won health gains in many parts of the planet. Heat waves are growing in intensity and number, killing tens of thousands outright and aggravating asthma, heart disease and heat stroke. Increasingly severe storms, droughts, fires and floods, harm human health and put oft-overstretched and ill-prepared health systems at risk.[2]

If greenhouse gas emissions remain unchecked, climate change will, within a matter of decades, have severe, pervasive and irreversible effects, undermining the food and water supply in many parts of the world, setting off mass migrations, and thereby triggering potentially unmanageable public health crises. [3] While everyone will experience the scourge of climate change, the most vulnerable populations–the urban and rural poor, those who are least responsible for the problem—will suffer the greatest impacts.

Fossil fuel combustion—particularly burning coal–is the single greatest contributor to greenhouse gas emissions.[4] Fossil fuels are also the source of significant local health problems. For instance, fossil fuels are a primary driver of outdoor air pollution, which, according to the World Health Organization, kills more than four million people every year[5]

In October 2018 the Intergovernmental Panel on Climate Change (IPCC) issued an alarming report which found that staving off the worst impacts of climate change by limiting global warming to 1.5°C, the ambition of the Paris Agreement, would “require rapid, far-reaching and unprecedented changes in all aspects of society.”  Such thorough going change, will need to include transitions in land, energy, industry, buildings, transport, and cities, that reduce global net human-caused emissions of carbon dioxide (CO2) “by about 45 percent from 2010 levels by 2030, reaching ‘net zero’ around 2050” [6]

In order to protect local and global health from climate change and its sources, the world needs to heed this warning and rapidly move toward a zero-emissions economy based on clean, renewable, healthy energy, sustainable transportation and sustainable agriculture.  Such a transition to a zero-emissions economy will benefit both the climate and public health. Health care, whose climate footprint is equivalent to 4.4% of global net emissions [7]  , must do its part to reverse the climate crisis by practicing primary prevention and aligning  its own operations and supply chains with the ambition of the Paris agreement.  

As health care providers—hospitals, health systems and government health institutions—we must reduce our climate footprint and move toward zero emissions.  We must simultaneously prepare our workforce and infrastructure, and in collaboration with the communities in which we are anchored,  we must respond, adapt and build resilience as the climate crisis unfolds.   We must also play a leadership role in our broader societies, advocating for a transition to a healthy, zero-emissions, equitable economy, as we continue to strive to meet global health goals.

We pledge to do our part to meet the challenge posed by climate change —a test perhaps as great as human civilization has ever known—by taking the following steps:

  1. Prevention: Mitigating Our Own Climate Footprint: Our collective vision is to reduce our health care systems’ emissions, moving toward low carbon, and ultimately, zero emissions health care. Many hospitals in most parts of the world are major energy consumers and can make large reductions in greenhouse gas emissions. Many other hospitals and health systems are energy-starved, and can deploy renewable energy and other climate-smart strategies to foster greater access to health care and better health outcomes. 

We pledge to lead the way toward zero emissions health care by setting greenhouse gas reduction and renewable energy targets and to increase our ambition thereafter.  We will work to implement energy efficiency measures and, when feasible, deploy clean renewable energy to power our buildings. We will measure and report on our progress, including financial savings related to these actions. We will also seek to identify our institutions’ other climate impacts, including transportation systems, use of anesthetic gases, purchasing policies, waste generation and disposal.  We will develop and implement plans to reduce these impacts as well.  

The most ambitious among us also commit to join the United Nations Framework Convention on Climate Change’s Race to Zero as part of our participation in the Health Care Climate Challenge.   This means we are committing to achieving a 50% reduction in our measurable greenhouse gas emissions by 2030 at the latest for high emitters or a fair contribution in line with the requirements of a 1.5C world, and net zero emissions 2050 or earlier.  


  1. Preparedness:  Building Resilience to Withstand and Respond to the Climate Crisis: In order to serve our communities, hospitals and health centers need to remain operational during and after extreme weather events. We need to understand, anticipate and be equipped to respond to the health needs of our immediate community and prepare for shifting disease patterns. We pledge to prepare for the impacts of climate change by becoming more resilient to climate impacts and supporting our communities to do the same. We will work to implement a series of measures to assure that our physical infrastructure, staff, and communities are prepared for the immediate impact of extreme weather events, and the longer-term impacts of changing patterns of disease, as well as other climate impacts, combining these efforts with low-carbon solutions whenever possible.


  1. Leadership: Forging the Way for a Healthy Climate: As health care providers respected by local communities, government and business, we commit to provide leadership in our societies for a healthy climate. We pledge to do so by educating health care professionals and hospital staff, as well as working with the communities in which we are located, on the challenges and solutions related to climate and health. We also pledge to encourage public policy, economic development and investment strategies that move our societies away from fossil fuel dependency and foster instead a healthy energy future, thereby protecting local and global health from fossil fuel combustion and climate change.

By moving toward low carbon or zero emissions health systems, health care can mitigate its own climate impact, save money and lead by example. By becoming more resilient, health care can help prepare for the growing impacts of climate change. And by providing societal leadership we can help forge a vision of a future with healthy hospitals and healthy people living on a healthy planet.

At this crucial juncture, the time to act to protect public health from climate change is now.