Government action

Toward net-zero, climate-resilient health care

Policy for climate and health

Since COP26 in Glasgow, momentum has grown among governments, international agencies, and non-state actors to align health sector development with the ambition of the Paris Agreement. In Glasgow, Health Care Without Harm helped secure commitments from 52 national health ministries to resilient, sustainable, low-carbon health systems through the COP26 Health Programme.

In 2022 the World Health Organization established the Alliance for Transformative Action for Climate and Health (ATACH) to realize the ambition set at COP26 using the collective power of WHO Member States and other stakeholders. As of May 2023, 65 countries - 22 of which are committing to net zero health systems - have joined ATACH, where Health Care Without Harm sits on the Steering Committee. 

In May 2022, G7 health ministers publicly committed “to build environmentally sustainable and climate-neutral health systems at the latest by 2050 and to support other countries in this effort.” Collectively, the overlapping commitments made by ATACH and the G7 comprise nearly half (48%) of global health care climate emissions.

Amitabh Kant, G20 Sherpa, speaking at the G20 Health Working Group side event on climate and health

In 2023, Health Care Without Harm supported the Asian Development Bank in developing a set of principles and organizing a side event at the G20 Health Working Group meeting in the state of Goa, India, on climate and health to foster climate resilient health development, low-carbon health systems, decarbonized supply chains, finance for climate and health, and One Health. The G20 Ministers of Health subsequently reflected these principles in their declaration as did the G20 Heads of State in the New Delhi Leaders’ Declaration (para 28iii). This was the first time in history that a group of heads of state has endorsed health care climate action and their commitment covered 75% of global health care climate emissions.

In 2024 Health Care Without Harm has continued to work with the Asian Development Bank to support Brazil’s G20 presidency as it prioritizes climate in the Health Working Group and prepares for COP30.

In addition to these collaborations, Health Care Without Harm works to bring the health voice to a number of international fora and negotiations related to climate and health. These include the World Health Assembly, which recently passed a resolution on climate and health, the UN Framework Convention on Climate Change (UNFCCC) where a health declaration received support from 150 health ministries during COP28, the intergovernmental negotiations towards the adoption of an International Plastics Treaty, and the initiative to negotiate and adopt a fossil fuel non-proliferation treaty.

In the photo: Amitabh Kant, G20 Sherpa, speaking at the G20 Health Working Group side event on climate and health. Photo: Health Care Without Harm.

National policies

Health Care Without Harm and its partners around the world also work with national and subnational governments and health institutions on every continent to develop policy frameworks and implementation plans for low-carbon, climate-resilient health systems. The following is a cross-section of some of our initiatives.


India: The Public Health Foundation of India (PHFI) - a Health Care Without Harm partner - serves as the Centre of Excellence for Green, Climate Resilient Health Care for the national Ministry of Health and Family Welfare. In this capacity, PHFI is supporting the development of a national plan and state level policies. Health Care Without Harm’s partner Healthy Energy Initiative is also working with several states, including Kerala, Tamil Nadu, and Chhattisgarh to develop and implement health adaptation plans. 

Indonesia: Between 2022-2023, Health Care Without Harm worked in partnership with the Ministry of Health of the Republic of Indonesia as well as the Provincial Government of Jakarta to conduct a series of training on the Climate Impact Checkup Tool with public and private health facilities in the country. Plans to scale up this initiative are underway.

Timor-Leste: With support from the WHO country office, Health Care Without Harm supported the Ministry of Health of Timor-Leste in developing its Climate-Resilient and Environmentally-Sustainable Health Care Facilities Policy and Strategy. This project has two specific objectives: assess the climate vulnerability and sustainability of select health facilities in Timor-Leste; and propose strategic policy recommendations for the implementation of climate-resilient and environmentally sustainable health care in the country.

Thailand: Through the Green and Innovative Finance Initiative for Scaling Up Southeast Asian Infrastructure Project of the Asian Development Bank, Health Care Without Harm supported the Ministry of Public Health in assessing the baseline climate vulnerability of five of its medical excellence centers. This project also aims to support the Ministry in training and building the capacity of health care professionals on climate change adaptation and disaster risk resilience in the sector.

Philippines: In partnership with the Philippine Department of Health (DOH), Health Care Without Harm led a capacity development training session on calculating GHG emissions using the Climate Impact Checkup Tool with all of its regional offices, centers for health development, and selected public health facilities. Following this, Health Care Without Harm will work with the DOH in integrating the calculator into their existing Green Viability Assessment (GVA) tool, incorporating GHG emissions reduction into the performance standards of all public health facilities in the country.

Malaysia: In collaboration with Sunway Centre for Planetary Health (SCPH) and the National University of Singapore’s Centre for Sustainable Medicine (CoSM), Health Care Without Harm is leading a series of workshops on health care decarbonization with the Ministry of Health of Malaysia. These workshops support the operationalization of MOH’s recently published blueprint for health care facilities which aims to provide safe, green, and future-proof facilities through the principles and pillars of sustainability.



Health Care Without Harm Europe is working with two additional national health authorities to develop net zero decarbonization roadmaps for their health care systems through Operation Zero. With the continued support of project partners Arup, this second phase builds on a successful collaboration with Portugal, the Netherlands, and the Lazio region in Italy in 2022. Read Portugal’s national health care decarbonization roadmap here.

Designing a net zero roadmap for healthcare sets out a step-by-step process for establishing a decarbonization roadmap for health care systems that is aligned with the principles of the Paris Agreement, including how to calculate a carbon footprint, model emissions trajectories, and develop the appropriate governance structures to support the process.

Health Care Without Harm Europe’s new partnership with Belgium and Ireland will make use of this methodology to support these health authorities in generating their own detailed climate footprint analyses and decarbonization roadmaps. This second phase will help refine the methodology and ensure it is applicable to health systems across Europe and beyond.


Latin America

Colombia: In 2022, the Ministry of Health and Social Protection and Health Care Without Harm signed a memorandum of understanding to work together to estimate the climate footprint of the Colombian national health system at the facility level.

The project had three main components: identifying a sample of hospitals and health centers in the Colombian health system, training health institutions in the sample to use the Climate Impact Checkup GHG calculator, and supporting institutions in gatherings and reporting their data to determine the size and composition of their climate footprint.

Based on the findings, Health Care Without Harm produced a series of specific recommendations to help develop a Comprehensive Sectoral Climate Change Management Plan (PIGCCS) for the Colombian health sector. 

Other countries: Health Care Without Harm has partnered with government institutions in Peru, Mexico, and Chile to conduct training for groups of public health facilities on the use of the Climate Impact Checkup tool and carbon footprint baselining.



South Africa: The National Department of Health has convened a National Climate and Health Steering Committee. The first meeting took place on the 23rd of March and Terms of Reference are being finalized with the establishment of the committee. In addition; an Air Quality Forum is also convened by the National Department of Health to address air quality in the Highveld Priority Area. Health Care Without Harm’s strategic partner in Africa, groundWork, is working closely with the Environmental Health team on both of these. The National Department of Health visited several Global Green Healthy Hospital members across South Africa to engage in their sustainability work.


North America

United States: On Earth Day 2022, the U.S. Department of Health and Human Services (HHS) launched the Health Sector Climate Pledge, a voluntary commitment to climate resilience and emissions reduction that includes cutting greenhouse gas emissions by 50% by 2030 and achieving net-zero emissions by 2050. Health Care Without Harm has been encouraging its health system partners in the United States to join this pledge, while also helping them to meet the pledge commitments.

Since the introduction of the pledge, more than 135 U.S. health care organizations representing more than 940 hospitals have signed the pledge, a large majority of which are in the Practice Greenhealth network. Additionally, more than 200 federal hospitals and health facilities in the United States are committed to decarbonizing their buildings, following an Executive Order for all federal facilities to reduce their emissions by 50% by 2030 and achieve net-zero emissions by 2050.

In August 2022, the Inflation Reduction Act (IRA) was passed, the U.S. government’s largest investment in climate action to date, comprising over $369 billion in federal programs and tax incentives to decarbonize the U.S. economy. The IRA has the potential to significantly reduce the financial barriers for health systems to procure low-carbon energy alternatives by providing substantial incentives, especially in the form of tax credits that encourage health care organizations to decarbonize and build climate resilience. 

The U.S Department of Health and Human Services Office of Climate Change and Health Equity (OCCHE) is providing a growing set of resources and information to help health systems both meet the Health Sector Climate Pledge as well as access IRA incentives.

Solutions in action & resources

G20 prioritizes climate and health action

The Group of Twenty (G20) health ministers, under the leadership of India’s G20 Presidency and with support from the Asian Development Bank (ADB), broke new ground last week, making the intersection of climate change and human health a priority issue at the highest level. Meeting in the city of Gahndinagar, India, G20 health ministers recognized that “climate change will continue to drive health emergencies,” and asserted their collective commitment to building climate-resilient, low-carbon health systems and to mobilizing resources for them.

In a new article published on Medium, Patrick Osewe, Director of Health, Human and Social Development Division, Asian Development Bank, and Josh Karliner, Director of Global Partnerships for Health Care Without Harm, analyze the global impact of the G20 health ministers’ new, groundbreaking commitment to health care resilience and decarbonization.

Analysis: Momentum is building for health care climate action

A recent commentary co-authored by Health Care Without Harm and published in The Lancet shows how the health care sector has been stepping up to the global climate challenge.

As the climate crisis progresses, the health care sector is stepping up to reduce its environmental footprint. It is not a minor task: To put it in context, if the sector were a country, it would be the fifth leading climate polluter in the world. 

In this new commentary published in The Lancet, authors from Health Care Without Harm, the Asian Development Bank, the World Health Organization (WHO), the Oswaldo Cruz Foundation, and the Public Health Foundation of India analyze how different actors work towards reducing the sector's environmental footprint.

Launch of the Alliance on Transformative Action on Climate and Health to drive the implementation of the COP26 Health Programme

This new initiative will coordinate and implement actions around the commitments on climate resilient and low carbon sustainable health systems adopted by countries during the 26th United Nations Climate Change Conference (COP26) in Glasgow.

The COP26 Health Programme was launched in November 2021 with the goal of enabling transformational change to protect the health of people and the planet. As of today, 59 countries have committed at the Ministry of Health level to this initiative, which was launched by the UK government as the Presidency of COP26, the World Health Organization (WHO), Health Care Without Harm, and the UNFCCC Climate Champions.

Over 50 countries commit to COP26 Health Programme

As one of three partners of the COP26 Health Programme, together with the COP26 Presidency and the World Health Organization, Health Care Without Harm has been working to encourage countries to develop climate-resilient and low-carbon health systems. On November 9, 2021, at the COP26, 50 countries announced their commitment. Josh Karliner, International Director of Program and Strategy of Health Care Without Harm, explains the significance of these health care climate actions and this historic moment.

Countries commit to develop climate-smart health care at COP26 UN climate conference

A group of 50 countries have committed to develop climate-resilient and low-carbon health systems at the UN Climate Change Conference in Glasgow (COP26), in response to growing evidence of the impact of climate change on people’s health.

The governments of these 50 countries, which include some of those most vulnerable to the health harms caused by climate change as well as some of the world’s biggest carbon emitters, have committed to take concrete steps towards creating climate-resilient health systems. 

COP26 Health Programme: Country commitments to build climate resilient and sustainable health systems

An overview of the COP26 Health Programme initiative's commitments for climate resilient health systems, sustainable low carbon health systems and the process for recording/tracking commitments.

Key considerations for the incorporation of a health perspective in NDCs

This policy brief identifies some of the main elements for incorporating a comprehensive health perspective in the Nationally Determined Contributions (NDCs) presented by countries as climate action commitments under the Paris Agreement. Its goal is to guide national governments in developing or updating NDCs in incorporating key considerations which would enable mobilizing the health sector to tackle the climate crisis.

Argentina becomes first country to include health care decarbonization in its global climate commitment

In 2020, Argentina became the first country to include health care sector decarbonization commitments in its Nationally Determined Contributions (NDC) to the Paris Agreement. In addition to several adaption measures, Argentina’s NDC calls for an assessment of health care sector greenhouse gas emissions and the establishment of emission reduction actions as a priority for implementing its NDCs.