Healthy tomorrow, sustainable healthcare today

In the existing VUCA world fraught with challenges, “Sustainability" has caught the attention of different industries globally, be it automobile, agriculture, chemical, construction, etc. Healthcare is one such industry that requires our immediate attention. There are a couple of reasons for it. Firstly, healthcare and medical sciences are not well-discussed in the context of sustainable initiatives for a better tomorrow. This is probably because this sector gets a slight exemption from following all the sustainable guidelines or operating methods, as human life consideration is paramount. This could have been a valid excuse 50 or 60 years earlier, but doesn’t seem to hold much ground now. Much of the day-to-day operations at a hospital do not think much about the damage they do to human life, to the environment, and ultimately to the larger section of society. This seems ironic; on one side, you are saving lives and on the other, pushing the lives of a greater count into unforeseeable dangers. Now, let’s delve deeper into the sustainability of the healthcare sector.

What is healthcare sustainability?

Sustainability in healthcare involves integrating environmentally responsible, socially equitable, and economically viable practices. This encompasses adopting green infrastructure and energy-efficient technologies, implementing sustainable procurement and supply chain management, promoting patient education on sustainable living, leveraging technology like digital health records, engaging with communities to address healthcare disparities, prioritizing workforce training, supporting research for green practices, and overall, striving to balance social, environmental, and economic considerations.

Therefore, incorporating sustainability provides a clear value-adding proposition through which the industry can minimize its environmental impact, promote public health, and contribute to a more equitable and resilient healthcare system. While the sustainability discussion in healthcare typically revolves around business operations, supply chains, energy-efficient technologies, digitization of health records, and educational initiatives, managing waste generated during treatment and its disposal remains a less discussed yet critical component.

The different areas of concern for sustainability in healthcare can be broadly categorized as environmental, social, and economic dimensions. An abstract from "Measure of Sustainability in Healthcare" puts it quite precisely.¹

1. Environmental

• Practices in Circular Economy: The idea of keeping resources in use for as long as feasible by recovering and reusing them in accordance
• Design of Facilities: It relates to the architectural design of a hospital, including its technology and equipment, as well as the impact on patient safety. Creating a truly therapeutic environment that includes nature, daylight, and fresh air is necessary.
• Management and Reduction of Waste: Waste reduction aims to decrease trash destined for eventual disposal to the maximum extent possible through reuse, recycling, and other activities.
• Procurement for Sustainability: When making purchase decisions, it is important to consider social and environmental aspects and financial considerations. It entails making decisions based on life-cycle costs and the associated environmental and social risks and rewards.

2. Economic

• Green Development: Green hospitals, for example, incorporate environmentally friendly techniques into healthcare delivery, promoting low carbon emissions and enhanced productivity.
• Research and Development: Innovation and research are key variables in bringing about radical change because they can contribute to fundamental shifts toward sustainability. AI in healthcare can be utilized for cost reduction, efficient clinical practices, and reduction in overall processing time.
• Cost savings and increased profits: Reducing the overall cost of care delivery is critical for healthcare providers worldwide because it is the sole way to enhance their bottom line. This economic aspect includes measures that promote cost savings, earnings, and R&D.
• Indigenous Manufacturing: India’s medical technology business is heavily reliant on imports; only 30% of the country’s medical device requirements are covered by local production, and even that is of low quality. However, with the recent advancement, the scenario is progressive.

3. Social

• Patient Contentment: It measures how satisfied patients are with their healthcare. It is a measure of care quality that provides physicians with information on numerous elements of medicine, such as their care’s effectiveness and level of empathy.
• Employee Contentment: This aspect shows employee satisfaction in the healthcare sector, portraying the industrial retention rate.
• Affordability: This determines the reach of the healthcare institutions in the sense of whether the institution is available to all at a feasible rate, 24 hours a day, and within the user’s reach.
• Sustainable health: It is the practice of following a healthy lifestyle through yoga, exercise, meditation, etc., with the primary objective of disease prevention

As big companies and global institutions are all about making healthcare more sustainable, we’ve got to tackle the waste issue head-on if we want a healthcare system that’s truly strong and eco-friendly. The trash we produce in healthcare, especially the dangerous stuff, can mess up both people and the planet because of how it’s made. Check this out: around 16 million shots are given worldwide, but not everyone’s doing the right thing with the needles and syringes after. Burning healthcare waste can let out nasty toxins like dioxins, furans, and other bad particles. The amount of waste we’re making has shot up since COVID-19 hit. WHO says there are different types of trash – infectious, pathological, sharps, chemicals, pharmaceuticals, cytotoxic, radioactive, and non-dangerous kind. And guess who’s contributing the most? Hospitals, labs, research places, morgues, places that deal with animals, blood banks, nursing homes – they’re all in on it. WHO’s got the stats, too. Rich countries make about 0.5 kg of dangerous waste for every hospital bed every day, while poorer ones make around 0.2 kg. That’s the deal.²

Biomedical waste before, after, and during COVID-19 in India:

The investigation examined by Wasim Ayub Bagwan, the daily fluctuations in BMW (biomedical waste) generation between 2020 and 2021 on a national scale.³ The results revealed a notable decrease of –50.35 % in daily BMW generation. In the specific case of Maharashtra state, a change detection analysis for pre-COVID-19 and post-COVID-19 pandemic periods indicated an initial increase of approximately 32%. However, in 2021, there was a reversal in the trend, demonstrating a -2.23% reduction in daily BMW generation compared to 2020. These findings suggest that the COVID-19 pandemic has had a discernible impact on biomedical waste generation.⁴

Although the various characteristics have varying effects on the healthcare sector, there is some correlation between them. For example, the economic dimension impacts the social and environmental dimensions, and vice versa. As a result, we must address each dimension separately and concurrently. As a result, it’s time for us to start making the correct choices, i.e., our decisions should align with practices that promote sustainability across several dimensions, ultimately leading to a "healthy tomorrow."

¹ Mehra, R., & Sharma, M. K. (2021, January 1). Measures of Sustainability in Healthcare. Sustainability Analytics and Modeling. https://doi.org/10.1016/j.samod.2021.100001

² Mol, M. P. G., Zolnikov, T. R., Neves, A. C., Santos, G. R. D., Tolentino, J. L. L., De Vasconcelos Barros, R. T., & Heller, L. (2022, April 1). Healthcare waste generation in hospitals per continent: a systematic review. Environmental Science and Pollution Research. https://doi.org/10.1007/s11356-022-19995-1

³ Bagwan, W. A. (2023, April 28). An investigation of the bio-medical waste produced in India during the COVID-19 pandemic and Maharashtra state (pre-COVID-19 and post-COVID-19) analysis: a GIS-based approach. Research in Health Services & Regions. https://doi.org/10.1007/s43999-023-00023-9

⁴ Health-care waste. (2018, February 8). https://www.who.int/news-room/fact-sheets/detail/health-care-waste