The multi-pronged challenge of climate change is accelerating the need for innovation in health. We will outline the proposed responses (some tried and tested, some new) to maintain the world’s health in the face of ‘humanity’s greatest health threat’.
The obstetrician listens to the mother’s abdomen in search of movement. Hearing none, she knows this woman needs an urgent C-section. But the electricity is down and the operating room is in darkness. With little alternative, a nurse holds up the flashlight on her cell phone while she makes the first cut, hoping the battery lasts until the baby is placed safely in its mother’s arms.
This dramatic, but not exceptional, moment characterizes the risks and uncertainty that health workers and patients face when power supplies fail. For an estimated 1 billion people globally, the health services they rely on have unreliable electricity or no electricity at all. Yet it can make the difference between life and death.
Without power, cold-storage chains break down. Vaccines and blood products are spoiled. Equipment to measure a patient’s heartbeat or blood pressure cannot be used, and medical instruments remain dangerously unsterile. In short, healthcare cannot function without electrification, and the goal of universal healthcare cannot be achieved unless health services can be delivered.
A report released in June 2023 by WHO and other UN partners, outlines the scale of the challenge ahead, as well as progress already made. In the past 13 years, more than a billion people have gained access to electricity but the pace of progress has slackened since 2019. This is due to a number of factors, likely to include the effects of the COVID-19 pandemic and the rise in energy prices. In low- and lower-middle-income countries in South Asia and Africa, it is estimated that more than one in 10 healthcare facilities have no access to electricity.
“We must protect the next generation by acting now. Investing in clean and renewable solutions to support universal energy access is how we can make real change.”
WHO Director General Dr Tedros Adhanom Ghebreyesus
Power grids under strain
Climate changes present a threat and a challenge. In many areas, increasingly intense heat waves are putting power grids under strain. Even countries with extensive electricity infrastructure, such as China and the US, experience power outages during periods of high demand for air conditioning.
What’s more, the health sector alone is a major contributor to global emissions. Health facilities have been estimated to contribute 3% of greenhouse gas emissions in the UK and up to 8% in the USA (WHO). The estimated climate cost of achieving universal health coverage in low and middle-income countries is an additional 383 million tons of CO2 per year, a 16% increase on current emissions from the health sector.
Carbon dioxide emissions are the biggest polluters, while particulates from diesel generators and incinerating medical waste contribute to black carbon in the environment; nitrous oxide used for anesthetics is another potent greenhouse gas
More affordable renewables
As several analyses by WHO and others have shown, the need for electrification is urgent. People cannot afford the slow pace of connection to the power grid. Equally pressing is the need for health facilities to adapt to, and mitigate the risks from, climate change. Further, in humanitarian crises such as the Türkiye-Syria earthquake in February, where hundreds of health facilities were destroyed or damaged, an alternative to depending on the national power grid can save lives by offering alternative means of delivering energy.
WHO’s own analysis, as well as that of others, suggests that the falling cost of renewable energy technologies makes solar power much more affordable than a decade ago, and that careful planning will cut costs to the health sector in the longer term.
Rapid decrease in child deaths
WHO has been involved in a number of initiatives to electrify and strengthen the resilience of health facilities through solar power.
In Somalia, pneumonia is a leading cause of death in under 5s, yet the installation of solar powered oxygen in just one hospital was estimated to be able to save the lives of 7,000 children. One study in 38 remote healthcare facilities in nine provinces in Papua New Guinea, found that facility-wide solar power, that increased the reliability of oxygen concentrators and pulse oximeters, reduced child deaths by 40%.
WHO is calling on countries to help meet universal health targets, while refraining from causing further harm from emissions, by investing in renewable energy. It is also leading global efforts to identify investment needs, renewable energy options, and training for hospitals and other health facilities.