Environmentally Sustainable and Climate Neutral Health and Care Systems

This topic aims at supporting activities that are enabling or contributing to one or several expected impacts of destination 4 “Ensuring access to innovative, sustainable and high-quality health care”. To that end, proposals under this topic should aim for delivering results that are directed, tailored towards and contributing to all of the following expected outcomes:

• Policy and decision makers, providers of health and care, health and care workers and citizens have increased knowledge on how today’s health and care systems^[1] are not environmentally sustainable, what the possible costs of that are (today and future) and where improvements are possible with maintained or improved quality of care (optimal patient safety not being jeopardised) and possible investments needed.
• Policy and decision makers and providers of health and care services have access to innovative solutions, organisational models (including financing models), and guidelines and recommendations that reduce the pollution and carbon emissions stemming from health and care systems, so that health and care provision can become more sustainable and cost-effective while maintaining or improving quality of care thanks to the reduction of energy and materials use, decreased carbon emissions, reduced waste and discharges, and efficient resource management.
• Monitoring and reporting of carbon emissions and pollution is mainstreamed through a life-cycle approach and with standard methods in the health and care systems.

The health care sector is responsible for 4-5% of global total carbon emissions^[2], and generates significant demands for energy and materials, as well as dangerous waste streams that may cause air, soil and water pollution. At the same time, health and care provision generally experiences less pressure to decarbonise and improve its circularity than other sectors of the economy. With the European Green Deal, the EU commits to reducing net greenhouse gas emission by at least 55% by 2030, and to reach no net emissions by 2050, and the health and care systems are not exempt. Research and innovation can support by ensuring a smooth transformation while maintaining or improving quality of health and care services.

Health and care systems are undergoing structural changes, for example by strengthening primary care and community-based care, strengthening digitalisation and making sure patients are treated or cared for at the most efficient level. This offers the possibility to connect structural changes with an environmental transformation.

During COP26, 18 countries (including two EU Member States) have committed to cutting all carbon emissions from their health systems over the next 10 to 30 years and during the same period in total fifty countries (including six EU Member States) have committed to creating climate resilient, low carbon, sustainable health systems.

In February 2022, the WHO published a report on the waste that had been generated as a result of the COVID-19 pandemic, even more emphasising the need to improve waste management systems of the health and care systems^[3]. The report states that 30% of healthcare facilities word-wide, and 60% in the least developed countries, are not fit to handle the waste generated even when not taking the extra waste generated by the pandemic into account. Not only does this pose environmental risks such as water and air pollution, but it also poses a risk to health workers’ safety by increasing the risk of being exposed to stick injuries, burns and pathogenic microorganisms.

Research and innovation activities under this topic should be specific to health and care sectors. They should include cost studies when relevant (environmental impacts and benefits to be quantified through the life cycle thinking approach (e.g. LCA/SLCA), to be effectively implemented in line with the European Green Deal and the Zero Pollution Action Plan) and piloting research results onsite in hospitals or other care settings while generating accessible knowledge could be included. Apart from that, successful proposals should address several of the following:

• Research and innovative solutions for decarbonisation of hospitals and other care providers: improvements in new and existing building stock, decarbonisation of energy supply to premises, reduction in energy demand of hospital sites and other care facilities (for example heating and cooling, hot water, laundry, cooking, transport systems).
• Research and innovative solutions for increased circularity of hospitals or other care providers that integrate the zero-pollution ambition: such as solutions to reduce waste, improved waste management practices (with a possible focus on water effluents and Antimicrobial Resistance (AMR)), increased circularity (for example sustainable use of linen).
• Research and innovative solutions for decarbonisation and greening of supply chains and material inflows: reduction of single-use plastics, substitution of anaesthetic gases and inhalers with high global warming potentials (GWPs), substitution of conventional pharmaceuticals with green(er) alternatives, low-carbon supply chains of food, waste reduction, management models on for example prescription of pharmaceuticals.
• Development of a framework to measure and benchmark the environmental footprint of the health and care sectors or improving infrastructures for relevant collecting, sharing, accessing and processing of data.

Projects with interdisciplinary teams representing the health and care sectors, and the environmental sector or other relevant sectors are welcome.

This topic requires the effective contribution of social sciences and humanities (SSH) disciplines and the involvement of SSH experts, institutions as well as the inclusion of relevant SSH expertise, in order to produce meaningful and significant effects enhancing the societal impact of the related research activities.

All projects funded under this topic are strongly encouraged to participate in networking and joint activities, as appropriate. Therefore, proposals should include a budget for the attendance to regular joint meetings and may consider covering the costs of any other potential joint activities without the prerequisite to detail concrete joint activities at this stage. The details of these joint activities will be defined during the grant agreement preparation phase.

Applicants are encouraged to consider how their proposals can contribute in the context of the European Green Deal^[4], and to take into account the principles of the Circular Economy Action Plan^[5], the Zero Pollution Action Plan^[6] as well as the Technical guidance on the climate proofing of infrastructure in the period 2021-2027.

Applicants envisaging to include clinical studies should provide details of their clinical studies in the dedicated annex using the template provided in the submission system. See definition of clinical studies in the introduction to this work programme part.

[1] “Health and care systems” implies a broader notion than “health systems” or “healthcare systems” notably encompassing all parts of health systems and health related parts of social care systems.

[2] https://www.thelancet.com/action/showPdf?pii=S2542-5196%2820%2930271-0

[3] https://www.who.int/news/item/01-02-2022-tonnes-of-covid-19-health-care-waste-expose-urgent-need-to-improve-waste-management-systems

[4] https://ec.europa.eu/info/strategy/priorities-2019-2024/european-green-deal_en

[5] https://ec.europa.eu/environment/strategy/circular-economy-action-plan_en

[6] https://ec.europa.eu/environment/strategy/zero-pollution-action-plan_en