Pathways to net-zero, resilient, and sustainable health systems: research, policy, and practice
1
Environment and Health Department, Istituto Superiore di Sanità, Rome, Italy
2
Evaluation Research and Policy of Healthcare Services Unit, Romagna Local Health Authority, Ravenna, Italy
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Health systems significantly contribute to global greenhouse gas emissions, while simultaneously facing increasing climate-induced demands. Global guidance and commitments to decarbonise healthcare—such as those led by Health Care Without Harm [1] and the World Health Organization (WHO) [2]— provide a high-level framework for action. However, many health systems, particularly in low- and middle-income countries, face significant challenges in translating this guidance into practice due to competing priorities, limited resources, and adaptation pressures. These challenges were explored in a prior multi-stakeholder workshop held at the Italian National Institute of Health, supported by the WHO, which used the Three Horizons framework (3H) [3] to bring together researchers, policymakers, and practitioners. That workshop produced a shared 3H narrative describing current healthcare decarbonisation efforts, emerging transition practices, and longer-term aspirations for equitable, resilient, low-carbon health systems.
METHODS:
The workshop begins with a presentation of the findings of the 3H workshop and a structured validation exercise, inviting participants to reflect on, challenge, and add to the findings from the earlier discussion. Participants then work in three facilitated groups focused on translating the findings into research, policy, and practice pathways. Each group discusses what the findings imply for their pathway and develops one concrete output for translating findings.
RESULTS:
Participants validate and refine a shared understanding of key barriers, opportunities, and tensions in healthcare decarbonisation across contexts. Group discussions produce three practical outputs: a short set of priority research questions, a policy-oriented summary of key messages, and a menu of near-term actions that health systems could adapt to their own settings.
CONCLUSIONS:
This validation workshop helps connect global guidance with what health systems can actually do in practice. It supports practical discussion on how health systems can reduce emissions while continuing to deliver essential care.
Health systems significantly contribute to global greenhouse gas emissions, while simultaneously facing increasing climate-induced demands. Global guidance and commitments to decarbonise healthcare—such as those led by Health Care Without Harm [1] and the World Health Organization (WHO) [2]— provide a high-level framework for action. However, many health systems, particularly in low- and middle-income countries, face significant challenges in translating this guidance into practice due to competing priorities, limited resources, and adaptation pressures. These challenges were explored in a prior multi-stakeholder workshop held at the Italian National Institute of Health, supported by the WHO, which used the Three Horizons framework (3H) [3] to bring together researchers, policymakers, and practitioners. That workshop produced a shared 3H narrative describing current healthcare decarbonisation efforts, emerging transition practices, and longer-term aspirations for equitable, resilient, low-carbon health systems.
METHODS:
The workshop begins with a presentation of the findings of the 3H workshop and a structured validation exercise, inviting participants to reflect on, challenge, and add to the findings from the earlier discussion. Participants then work in three facilitated groups focused on translating the findings into research, policy, and practice pathways. Each group discusses what the findings imply for their pathway and develops one concrete output for translating findings.
RESULTS:
Participants validate and refine a shared understanding of key barriers, opportunities, and tensions in healthcare decarbonisation across contexts. Group discussions produce three practical outputs: a short set of priority research questions, a policy-oriented summary of key messages, and a menu of near-term actions that health systems could adapt to their own settings.
CONCLUSIONS:
This validation workshop helps connect global guidance with what health systems can actually do in practice. It supports practical discussion on how health systems can reduce emissions while continuing to deliver essential care.
| eISSN: | 2654-1459 |
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