Intended for healthcare professionals

Editor's Choice

Covid-19 and net zero for health

BMJ 2020; 371 doi: (Published 15 October 2020) Cite this as: BMJ 2020;371:m3970
  1. Fiona Godlee, editor in chief
  1. The BMJ
  1. fgodlee{at}
    Follow Fiona on Twitter @fgodlee

Nine months ago the world stopped for covid-19. Amid the loss of life, health, and livelihoods there were welcome blue skies and birdsong. People did less flying and driving, more Zooming, walking, and cycling. Consultations between patients and healthcare staff moved online as telemedicine became routine.1 But for the past few months countries have been stumbling back to a semblance of normality, which means that air pollution and traffic noise are back. Rates of new coronavirus infection and long covid are rising alarmingly,2 along with anger about misuse and denial of science and continued government failings,3 and amid increasingly heated debate about the effectiveness of lockdown restrictions and levels of population immunity.456 But in all of this we must not forget that the climate emergency remains by far the biggest threat to human survival.

What can we do as healthcare professionals? Since the start of the pandemic we have already moved a year closer to the 2030 deadline for global carbon dioxide emissions to halve and to the 2050 deadline for them to reach net zero. And healthcare itself is a substantial and growing part of the carbon challenge, responsible for about 5% of global emissions. As a sector it also lags behind others.

The good news, as Renee Salas and colleagues explain,7 is that this presents us with a big opportunity. Net zero is technically feasible across much of the world’s economy, they say. They outline broad transformative steps that the world’s health systems can take that, as well as helping to limit climate change, will improve health and wellbeing. These include disease prevention to reduce demand for healthcare, clean energy use, low carbon supply chains, and reduced travel through telemedicine. They detail wide but reducible variation in carbon footprint between different specialties and interventions. Healthcare, they say, must lead from the front.

And that’s what the NHS intends to do, announcing this month its ambition to become the world’s first net zero national health service by 2040.8 The path will not be easy, as Neil Jennings and Mala Rao make clear.9 Achieving this bold plan will require change in every sector of the service. But the commitment is itself a crucial step. As a member of the expert panel advising on this initiative, I add my congratulations to the NHS leadership and its Sustainable Development Unit, whose detailed data and analysis have made such a commitment possible.

We have to do things differently. Each of us can make changes in our professional and personal lives that will make a difference. If covid-19 has taught us anything it is that the world can stop if the need is urgent enough.


  • Competing interests: I am a member of the expert panel advising on NHS Net Zero.

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