The climate crisis: what is it and is pharma to blame?
Stefan Woxström at AstraZeneca Europe and Canada tells
about the link between climate change and human health, as well as considering how the pharma industry has contributed to the climate crisis
Can you tell us about the link between climate change and human health, and how the connection is becoming increasingly evident?
Stefan Woxtröm (SW):
The health of the planet and people are intrinsically linked, with climate change negatively impacting population health and increasing the burden of non-communicable diseases (NCDs).
Climate change is causing a growing physical, mental and economic burden on society, as a result of extreme temperatures, weather-related events, air pollution and the growing spread of food, water and vector-borne illnesses, all of which contribute to growing rates of disease.
In turn, the care required to treat increasing disease prevalence significantly adds to greenhouse gas (GHG) emissions from the healthcare sector, with many conditions often requiring extended, costly and resource-intensive therapy.
From an economic perspective, the climate crisis is predicted to result in direct health costs exceeding $2bn annually by 2030, putting additional pressure on already stretched medical services and threatening the resilience of healthcare systems for future generations.
Ultimately, the best thing we can do for the health of the planet is to keep people healthy.
: The climate crisis is now the greatest risk to health of the 21st century – how is this specifically impacting global population health?
Over 14 million people die from environmental health risks each year, including seven million as a result of air pollution.
It is estimated that 23% of global deaths could be prevented through healthier environments and, according to the World Health Organization (WHO), the climate crisis will cause an additional 250,000 deaths every year between 2030-2050.
Nearly two-thirds of these environmental-related deaths are from potentially preventable chronic cardiovascular and respiratory diseases, leading to significant rises in hospital admissions and devastating consequences for population health.
The climate crisis is also a health equity crisis, widening existing inequalities within and among countries. The detrimental impact of climate change is disproportionately felt by the most vulnerable – older populations, displaced persons, those with existing medical conditions or in marginalised communities.
: How has the pharma industry contributed to the climate crisis?
The pharmaceutical industry, which exists to improve health, is unfortunately also contributing to the climate crisis. The research, development, manufacturing and delivery of healthcare is energy intensive – the healthcare sector as a whole accounts for approximately 5% of global GHG emissions.
71% of these GHG emissions come from the healthcare supply chain, and hospitals have the highest energy use of all publicly funded buildings, emitting two and a half times more GHGs than commercial buildings.
With ageing populations and growing rates of disease, it is predicted that the GHG footprint from the healthcare sector could as much as triple by 2050.
To realise long-term change, the industry must come together and commit to being part of the global climate solution. More sustainable choices must be made across every aspect of research and development (R&D) and the full value chain, reducing GHG emissions and finding patient care interventions that have a lower environmental impact.
: What can the pharma industry – as a whole and as individual companies – do to reduce its negative impact on the climate?
Organisations have a responsibility to take action at scale to decarbonise their own operations and partner with others beyond their immediate business to accelerate the delivery of net-zero healthcare. The sector has recognised the urgent need for change and nearly half of pharma and biotech organisations have made broad commitments to reduce resource utilisation and GHG emissions through the United Nations' (UN) Race to Zero initiative.
Some companies are already embracing ‘green chemistry’ to make drug design and discovery more sustainable, without sacrificing drug safety or effectiveness.
With labs on average consuming up to ten times the energy and four times the water of a typical office space, it is important to find greener chemicals, processes or products to maximise the efficiency of experiments, and reduce waste, conserve energy and eliminate the use of hazardous substances.
The industry is also reviewing how best to run sites and operations to reduce GHG emissions, promoting efficient, circular use of water and natural resources. Renewable energy is being embraced, with many organisations shifting to more sustainable facilities.
To achieve real change, suppliers, distributors and manufacturers will similarly need to commit to high sustainability standards. That is why we are cascading our climate ambition and target setting down the value chain. Many companies are aiming for key suppliers and partners to have science-based targets, this involves supporting suppliers on the journey to net zero. Many are also supporting Energize, a first-of-its-kind industry programme that provides resources and expertise to accelerate adoption of renewable energy throughout the value chain.
Furthermore, the Sustainable Markets Initiative (SMI) Health Systems Task Force is another example of an initiative taking scalable action to collectively address emissions across supply chains, patient care pathways, and clinical trials. The Task Force recently announced a set of common supplier standards to incentivise and simplify decarbonisation efforts across the supply chain.
The industry must also consider how to reduce the environmental impact of patient care, helping to stop people from getting sick and requiring high-cost hospital care. Investing in preventative strategies and harnessing earlier and more effective interventions can reduce GHG emissions, improve patient outcomes and lower pressures on our healthcare systems.
For example, chronic kidney disease is frequently diagnosed at an advanced stage when it may be too late to alter the course of the disease. In Europe, half a million patients rely on dialysis for survival, which is expensive, invasive and a major contributor to climate change: dialysis requires 160 billion litres of water per year and generates over 900,000 tonnes of mainly plastic waste.
Preventative strategies will provide benefit to both patients and the environment, as well as improvements to health systems, economies and society as a whole.
: What are the Sustainable Development Goals and what steps does the pharma industry need to take to adopt them?
As part of the UN 2030 Agenda for Sustainable Development, 17 Sustainable Development Goals (SDGs) were announced to address the most pressing issues we face as a global community — inequality, injustice, poverty and climate change.
The 17 SDGs should not be viewed in silos; contribution to one SDG will affect outcomes in others. Recognising the synergies between improving economic prosperity, health, education and the environment will help set society on a transformative path towards a more resilient and sustainable future.
Across the sector, organisations have pledged their support to the SDGs, incorporating new initiatives into company practices as well as into those of suppliers and partners. This spirit of collaboration and learning is the guiding principle behind the Partnership for Health System Sustainability and Resilience (PHSSR), which is now active in more than 30 countries, bringing together academic, public and private sectors to strengthen health systems through evidence-based policy change.
The industry has a critical road ahead and all those involved in the provision of care have a role to play in accelerating the delivery of net-zero, patient-centric health systems for the benefit of patients, society and our planet.
Romanello M, Di Napoli C, Green C, et al. The 2022 report of the Lancet Countdown on health and climate change: health at the mercy of fossil fuels. Lancet. 2022;400:1619-1654
Agar JW. Green dialysis: the environmental challenges ahead. Semin Dial. 2015;28(2):186–92.
is senior vice president, Europe & Canada (EUCAN) at
responsible for leading the company’s sales, marketing and commercial operations in 30 European countries and Canada. Woxström has been with AstraZeneca since 1996, when he began his professional career as a sales representative for AstraZeneca Sweden, before holding various roles including national sales manager, national sales director, marketing director cardiovascular, regional business director, Specialty Care of AstraZeneca’s former ‘Central Eastern Europe Middle East and Africa’ (CEEMEA) Office in Belgium, country president of Ukraine & the Commonwealth of Independent States (CIS), and three further leadership roles within the company. He holds a BSc and an MSc in Business Administration & Economics from Stockholm