Intended for healthcare professionals

Editor's Choice

What’s your carbon reduction strategy?

BMJ 2009; 338 doi: (Published 26 March 2009) Cite this as: BMJ 2009;338:b1272
  1. Fiona Godlee, editor, BMJ
  1. fgodlee{at}

    Back in 2006 I wrote an Editor’s Choice called “What did you do about climate change Mum?” (BMJ 2006;332:10 June, doi:10.1136/bmj.332.7554.0-f). It suggested that doctors might start measuring their carbon footprint. The most interesting thing about this short piece was the response it received on ( What was this stuff doing in a medical journal? What was I doing uncritically accepting the propaganda of the global warming lobby?

    Things have changed since then. WHO’s director general Margaret Chan has called climate change the biggest public health challenge of the 21st century. And last week the UN and Red Cross warned that a humanitarian crisis caused by droughts, floods, storms, and heatwaves could overwhelm relief agencies (doi:10.1136/bmj.b1229). Most chilling for me was a comment at a meeting at the Royal College of Physicians last year. When asked what people should do about climate change, Tom Burke of Rio Tinto said “Don’t be under 40.”

    So although some will question the need for action, most are likely to say we’re not doing nearly enough. This was the response from many to the new NHS carbon reduction strategy. But as Andrew Cole reports, its targets—to cut emissions by 10% by 2015 and 80% by 2050—are ambitious (doi:10.1136/bmj.b933). A big chunk will have to come from NHS procurement, especially from drugs and equipment, using the NHS’s purchasing power to get suppliers to adopt greener technology and getting us all to use less of everything. As David Hutchins and Stuart White explain (doi:10.1136/bmj.b609), health services can reduce, reuse, and recycle just like everyone else. For its part, the BMJ is embarking on its own carbon reduction programme. As a small part of this, the journal is now printed on 100% recycled paper.

    Meanwhile, there’s a new guide to sustainable development from the Faculty of Public Health, NHS Kidney Care is funding the first ever “green nephrology fellowship” (doi:10.1136/bmj.b1214), and the people at have identified “carbon dependency syndrome.” As well as advice on sourcing food (“Seasonal and local (unless living next door to an intensive beef farm)”) they give some startling facts. If everyone in the UK stopped eating meat on one day a week this would equate to taking five million cars off the road. And according to WHO, the 150 000 deaths so far attributed to climate change each year have been in “non-addicts”—children in the developing world.

    Action by individuals and organisations is important. It will help to reduce carbon use and change our culture. But real progress will need action by governments. This doesn’t mean we can sit back and do nothing. Governments need permission to take unpopular decisions, especially during an economic downturn. In December in Copenhagen the world’s leaders will update their carbon commitments. The Climate and Health Council ( wants to ensure that the health effects of climate change are fully acknowledged in these discussions. Nearly 2000 doctors and senior managers have already signed the council’s pledge. We would like 10 000 signatures. If you do one thing today, go to the council website and sign the pledge.


    Cite this as: BMJ 2009;338:b1272