Nature-based Solutions 7

Reducing Adverse Ecological Impacts on Global Healthcare Delivery Systems (GHCDSs).

Reimagining GHCDSs That Heal Without Harming the Planet.

Modern healthcare has produced remarkable breakthroughs (e.g., informatics, cell-gene therapy, systems medicine)—but not without environmental cost. From hospital-generated greenhouse gas (GHG) emissions to pharmaceutical and biomedical waste, the global healthcare sector is, paradoxically, contributing to the very ecological disruptions that threaten the health, safety, and planetary well-being of the natural world.

As a physician and an advocate for environmental stewardship and sustainability, I believe we must confront an essential truth: Global Healthcare Delivery Systems (GHCDSs), although created to promote health, can unintentionally—and at times even knowingly—inflict harm on the natural environment. In doing so, they compromise their own long-term resilience, effectiveness, and capacity to safeguard the global commons.

Nature-based Solutions (NbS) offer a compelling and actionable way forward. They enable us to re-envision GHCDSs as systems that restore rather than exhaust the ecosystems and ecological services upon which the health and well-being of all living beings ultimately depend.

The Ecological Footprint of GHCDSs.

Global healthcare delivery systems (GHCDSs) are responsible for an estimated 4 to 5 % of global carbon emissions—if healthcare were a country, it would be the fifth-largest emitter in the world.

Beyond carbon, the sector contributes to:

• Air, soil, and water pollution from medical waste and pharmaceutical runoff.

• Habitat loss due to expanding infrastructure.

• High consumption of energy, water, and single-use plastics.

• Heat emissions from healthcare campuses in urban heat islands.

These ecological impacts exacerbate the same climate-related threats—extreme heat, poor air quality, and biodiversity loss—that drive chronic disease, mental health strain, and infectious disease outbreaks.

Nature-Based Solutions: Healing Systems from the Ground Up.

Nature-based Solutions (NbS) restore and protect natural ecosystems to address human challenges— including those rooted within GHCDSs. When thoughtfully designed and implemented, NbS can reduce the environmental footprint of the healthcare sector while simultaneously strengthening its resilience and capacity to respond to future risks.

Here’s how:

✅ Greening Health Infrastructure.

Incorporating green roofs, walls, and landscapes around hospitals reduces energy demand, filters pollutants, and provides cooling—shrinking the facility’s carbon footprint and improving the healing environment.

✅ Natural Wastewater Treatment.

Constructed wetlands and eco-filtration systems can treat medical wastewater sustainably, reducing pharmaceutical contamination of rivers, lakes, and groundwater.

✅ Decentralized Climate Resilience.

Implementing NbS in the areas surrounding healthcare facilities helps reduce environmental and ecosystems’ impacts and strengthens the resilience of both the healthcare delivery system and the community.

✅ Biodiversity-Sensitive Design.

Preserving native species and ecosystems during healthcare facility expansion supports pollination, carbon sequestration, and local food systems while minimizing land degradation.

Healthier Ecosystems, Healthier Patients.

The connection is clear: when ecosystems thrive, so do people.

Nature-Based Solutions (NbS) help reduce the ecological degradation that leads to:

• Respiratory illness from poor air quality.

• Waterborne and vector-borne diseases from polluted or stagnant water.

• Mental health challenges linked to environmental stress.

• Food insecurity from degraded soil and disrupted pollination.

By confronting the environmental conditions that drive illness, NbS deliver a systems-level pathway for alleviating the ecological pressures imposed by GHCDSs.

A Systems’ Paradigm Shift for a Healthier Future.

For GHCDSs to thrive, leaders must embrace planetary health as a core pillar of what it means to care for patients.

This includes:

• Embedding environmental sustainability into infrastructure design, service delivery, and all operations.

• Partnering with environmental, business, and urban planning sectors.

• Investing in proactive health strategies that protect human, animal, plant, and ecosystem health.

• Advocating for healthy public policies that prioritize NbS in health infrastructure funding.

The Bottom Line.

Nature-based Solutions (NbS) are far more than aesthetic greening—they represent a vital shift toward GHCDSs grounded in resilience, sustainability, and social justice.

To meet the environmental challenges that lie ahead, we must broaden our vision of care to honor and safeguard the ecosystems’ services that sustain all life and protect the global commons.

Together, we can build GHCDSs that heal without harming—systems that support people, their communities, and the planet.