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A diverse group of health system organisations from across Australia are sharing their knowledge and expertise of what works in reducing health care emissions, and where to focus next.
We’re already witnessing the effects of climate change on the health of Australians — increased emergency department attendances and hospitalisations due to heat and smoke, the mental health impacts of extreme events like floods and fire, and the emergence of infectious diseases like Japanese encephalitis virus in previously unaffected areas of Australia.
We also know that, as health professionals, we are contributing to these health impacts through the emissions we create in our daily work. It’s estimated that the Australian health system generates an estimated 23 522 kilotonnes of greenhouse gas annually, equivalent to about 5.4% of total Australian emissions. Approximately 19% of Australian health system emissions come from pharmaceuticals alone.
As the links between climate change and health become better understood, we’re seeing more and more governments, hospitals, health insurers, peak professional bodies and clinicians establish strategies and plans to reduce unnecessary health system emissions. One example is the Australian Government’s National Health and Climate Strategy.
But challenges remain in implementation. For example, much of the progress remains driven by local champions, and it can be difficult to maintain this momentum once they move on. Many health professionals and organisations are keen to practice more sustainably, but are uncertain about where or how to start. And those that are taking action eventually find progress is blocked or slowed by structural or administrative barriers within or beyond their organisations, such as out-dated policies, practices, regulations and funding models.
Creating a guide for the Australian health system
To help to address some of these issues, Monash University’s Sustainable Development Institute brought together leaders from fifteen health system organisations who wanted to work together, creating the Transitions to Sustainable Health Systems consortium. Members include five government departments of health, seven regional and metropolitan health providers from Victoria, the Victorian Aboriginal Community Controlled Health Organisation, BUPA, and the peak professional body, Advanced Pharmacy Australia.
Following a rapid review of global evidence of interventions for sustainable healthcare, a series of workshops were held focusing on different aspects of the challenge, involving over 130 health professionals and over 50 organisations who generously contributed their knowledge and experience of their successes and challenges in delivering high quality sustainable care, and their recommendations for improvements.
The main points from this individual and collective learning process have been distilled into ‘Accelerating Towards Net Zero: a guide for the Australian health system’ that was published on October 17 2025.
We found that ‘what’ needs to be done is quite well-established. Actions include:
- reducing pressure on high-cost high-emission hospital care by improving disease prevention and strengthening community-based care, and avoiding unnecessary or duplicative tests and treatment;
- greening our procurement processes and reducing health system waste, for example by refusing unnecessary consumables or packaging and using reusable items where possible; and
- shifting away from fossil fuel-based energy and improving the energy efficiency of our buildings and transport.
And while there is less information on ‘how’ to put these actions into practice, there are a multitude of Australian and international case studies that show that they can be done. For example:
- The Prince Charles Hospital is the first large tertiary hospital in Australia to decommission its use of reticulated nitrous oxide anaesthetic gas.
- Companies such as Medsalv remanufacture medical devices, with processes for over 50 products, including patient transfer mattresses, deep vein thrombosis prevention sleeves, blood pressure cuffs and tourniquets.
- The Grampians Health’s Health Resource Stewardship (HRS) program has trained more than 400 staff to implement resource waste reduction programs to both steward resources and enhance quality and safety of care.
- NSW Health’s Net Zero Hubs program brings together multidisciplinary teams to address carbon hotspots from clinical care.
- Advance Pharmacy Australia’s annual MedsAware deprescribing action week raises awareness around polypharmacy, with the 2025 campaign highlighting the benefits of deprescribing for people and the planet.
- Bupa’s Healthy Cities Program converts the physical activity of staff, partners and communities into funding to support environmental restoration in urban and peri-urban areas, thus engaging the community in promoting health and reducing emissions at multiple levels.
- NHS trusts in England have secured over £1 billion in funding through the Public Sector Decarbonisation Scheme, which is expected to reduce NHS energy costs by £260 million per year.
Many also often demonstrate the frequent alignment between sustainability initiatives and other health system imperatives, such as ensuring high-quality care and containing costs
Participants also underlined the importance of a supportive policy and working environment to initiate and scale these interventions. There was a strong call for policy-makers, boards and executives to provide effective climate and health governance and align funding allocations, provide practical support to the workforce to develop knowledge and skills on sustainable practice, invest in developing the data and evidence needed to inform decision-making, and engage with suppliers and service providers to increase the availability of lower carbon infrastructure, products and services.
However, it was also emphasised that creating this enabling environment is not just the role of those in positions of authority; we all have a role in shifting the system in our daily practice and conversations, particularly if we collaborate and act collectively, bringing in diverse perspectives from different parts of our organisations and sector.
Further collective action needed
While creating ‘quick wins’ is important to build confidence and demonstrate value, these preliminary efforts will not get us very far. Health professionals and organisations must also be ready to take opportunities when they arise, understand and apply emerging approaches and technologies, and work collectively towards significant change in wider system settings.
Nine priority areas for further collective action were identified. These included embedding emissions reduction as a core health system responsibility, building knowledge and capabilities at all levels of the health system, embedding low emissions and circular economy principles in health purchasing, reducing the use of single use items, and shifting our focus towards keeping people well and more integrated, high-value and health-promoting models of health care, such as embedding pharmacist-led medicines optimisation and deprescribing to cut low-value use and avoidable admissions.
It’s increasingly clear that there are greenhouse gas emissions associated with everything we do in healthcare, and that sustainability is another lever which can promote safe and high-quality care. There is a significant impetus for change underway with initiatives such as the new Healthcare Sustainability and Climate Resilience module from the Australian Commission on Safety and Quality in healthcare, new planetary health standards for medical education, and new sustainability provisions in Enterprise Agreements.
‘Accelerating Towards Net Zero: a guide for the Australian health system’, is just one part of this momentum for change. We’d encourage you to look at the guide and the whole host of initiatives described within it, find what sections are most relevant for you, and use it to motivate, inspire and challenge yourself and others to take action, however small or large.
Angie Bone FAFPHM is a public health physician and Professor of Practice in Health and Climate at Monash University in Melbourne. She is a Board member of Doctors for the Environment Australia.
Jess Fritze MEnv is Program Manager of the Transitions to Sustainable Health Systems consortium at Monash Sustainable Development Institute.
Kristin Michaels FAICD is Chief Executive of Advanced Pharmacy Australia with over two decades of leadership experience across healthcare organisations and governance in both the primary and acute care.
Kate O’Hara FANZCAP is a specialist women’s and children’s pharmacist and Deputy Service Manager-Clinical at the John Hunter Hospital, Newcastle. She is Vice-President of Advanced Pharmacy Australia and is AdPha’s national spokesperson for Residencies and pharmacy research.
The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated.
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