Greener Hospitals, Healthier Futures: Why Sustainability Must Become a Healthcare Priority

Healthcare is a carbon-intensive industry, with energy-intensive operations, substantial waste generation and extensive supply chains. Globally the sector is responsible for about 5% of global emissions. In other words, if the sector was a country, it would be the 6th largest emitter in the world.

For a sector dedicated to protecting life, this raises an important question: how do we deliver the care people need while reducing the environmental harm associated with providing it?

For Kenya’s healthcare industry, the growing integration of sustainability into boardroom discussions and business strategy is a welcome development. This reflects its recognised contribution to financial performance, quality of care and operational resilience. The opportunity now is to build on this momentum, delivering high-quality care while using resources more efficiently and reducing environmental impact.

The urgency is clear: climate change is already harming the people, and the risks are intensifying. Extreme heat increases heat-related illness, floods heighten the risk of waterborne diseases, and drought undermines food security, increasing the threat of malnutrition. These same shocks can damage health facilities and interrupt access to treatment, creating a double burden.

For healthcare providers, sustainability can no longer be a distant ambition. Investing in cleaner energy, conserving water and reducing resource wastage must be part of a broader effort to cut emissions, strengthen resilience and protect the continued delivery of care. The cost of inaction is measured not only in environmental damage but in lives and livelihoods.

A practical starting point is to examine the everyday decisions that determine a hospital’s environmental footprint: how it generates heat, sources and uses electricity, conserves water, handles waste and manages clinical supplies. These practices may attract less attention than new medical equipment, but they deserve serious consideration in how healthcare institutions plan and invest.

Consider hospital heating. Steam and hot water support essential services, including sterilisation, laundry and cooking. Where these needs are met using diesel, they come with a fuel bill, an environmental cost and dependency on volatile supply chains. The industry’s opportunity is to rethink how these services are powered without compromising their reliability or safety.

At Aga Khan University Hospital, Nairobi, a biomass boiler commissioned in 2023 replaced diesel-powered heating with a system using locally sourced wood waste and biomass briquettes. Our system displaces approximately 950,000 litres of diesel and avoids more than 2,000 tonnes of carbon dioxide emissions annually. These emissions, on a monthly basis, are equivalent to driving back and forth between Nairobi and Mombasa over 700 times in an average sized car.

Electricity presents another opportunity. Suitable hospital roof space could become an energy-producing asset for solar power, which could meet part of a hospital’s daytime demand.

At our hospital, the solar project meets approximately six per cent of our electricity needs over the course of the year. It is designed to offset daytime consumption across operations such as cooling, diagnostic equipment and lighting. The contribution demonstrates how hospitals can begin reducing their reliance on purchased electricity without waiting for a solution that meets every need.

“How about the huge investments associated with some of these initiatives?” one may ask.

For hospital boards, the assessment should extend beyond the purchase price to the savings an investment can generate over time while helping conserve the environment. Solar power, for example, requires spending on equipment, installation and ongoing maintenance, but uses freely available sunlight to reduce reliance on purchased electricity or fuel. These savings can help recover the initial investment and continue to lower operating costs. Assessing how long it takes for the savings to cover the initial cost, known as the payback period, helps boards make informed investment decisions. The opportunity is to identify initiatives that deliver environmental benefits alongside lasting financial value, potentially freeing up resources for patient care.

Secondly, meaningful progress does not always require major new installations. Everyday improvements can offer lower-cost opportunities to reduce resource use. Better waste segregation, for example, can reduce the volume unnecessarily sent for costly incineration, while careful management of anaesthetic and refrigerant gases can help limit avoidable emissions.

Energy efficiency offers further opportunities. Energy audits can identify where electricity is being wasted and help prioritise improvements, from equipment maintenance to adjusting lighting and cooling schedules in offices and meeting rooms to match their use.

Water efficiency is another important part of good practice. Targeted investment can complement the above measures, including efforts to conserve water in a growing city such as Nairobi. Our hospital has installed rainwater-harvesting tanks with a combined storage capacity of 18,000 litres. The collected water is used for selected cleaning and maintenance tasks previously undertaken using mains water, reducing demand on government supplies and putting rainwater to productive use. The wider principle is to match water sources to appropriate uses, with the necessary quality and safety controls.

Clinical practice also deserves attention. Reviewing how nitrous oxide was managed at our hospital revealed opportunities to reduce wastage and unnecessary releases. Through improved controls around its storage, delivery and use across clinical services, the hospital reported a nearly two-thirds reduction in nitrous oxide emissions since implementation of the comprehensive practice changes.

Sustainability is a hospital-wide responsibility. Clinical teams improve practice; finance assesses costs and long-term savings; procurement prioritises efficient equipment; and housekeeping strengthens waste segregation and conserves water and energy. In the end, we conserve the environment as a team while patient safety remains non-negotiable.

These efforts form part of the Aga Khan Development Network’s journey to net-zero emissions in operations. The commitment covers direct operational emissions and emissions from purchased energy, alongside a separate drive to reduce supply-chain emissions. Its guiding principles include environmental stewardship, protecting vulnerable communities and sharing experience to encourage wider change.

For the healthcare industry, this last principle is particularly important. Sustainability should not become a competition in which a few institutions accumulate accolades while practical knowledge remains behind their gates. Providers should share what works, what it costs, what requires specialist expertise and what has not delivered the expected results. The aim should be to help more facilities make informed decisions, not suggest that every hospital needs the same equipment.

Credible measurement must underpin this exchange. The World Health Organization emphasises that measuring emissions enables institutions to identify their largest sources, set meaningful targets and track progress. Hospitals should apply the same discipline to sustainability that they apply to other aspects of performance: establish a baseline, assign responsibility, budget for action and report results. Targets should guide investment, while measured outcomes should demonstrate whether that investment is delivering.

The industry’s ambition should be bigger than efficient equipment and facilities. It should be a healthcare system that uses resources responsibly, creates opportunities for local suppliers and frees up money that can support patient care. Each successful initiative should strengthen the case for others to act.

Hospitals exist to protect health. Reducing the environmental cost of that mission is not a distraction from care. It is part of doing it well.