Environmentally sustainable health care: now is the time for action

In reply: In the context of the coronavirus disease 2019 (COVID‐19) pandemic, McGain and colleagues raise the important issue of sustainable personal protective equipment (PPE) with specific reference to single‐use gowns.

Plastic waste, including from single‐use gowns, is increasingly understood as a major environmental issue for health care systems around the world.1 In recent decades, the amount of plastic waste from health care has burgeoned, partly because of infection control concerns in the context of global pandemics of human immunodeficiency virus (HIV) and hepatitis B and C, and rising levels of antimicrobial resistance. The move away from cleaning and sterilising medical supplies has also been partially driven by the relatively low cost of single‐use items produced in low and middle income countries compared with the costs of wages for cleaning and sterilising in Australia. However, as McGain and colleagues observe, this transition also increased our reliance on global supply chains, which have been greatly disrupted during the COVID‐19 pandemic.

Australian governments are currently showing policy interest in transitioning to a circular economy, including through greater reuse and recycling of materials and the valuing of waste as a resource.2 Health care leaders should embrace this policy interest as an opportunity to accelerate efforts to improve the sustainability of health care. Notably, this will require behaviour change3 across all levels of the health care system, including among those responsible for policy and guidelines. An example is the British National Health Service (NHS) sustainable procurement guidance and tools,4 which aim to drive transitions to more sustainable supply chains by harnessing the purchasing power of the health care system.

In Australia, some developments during the current pandemic are supportive of health care sustainability and should be continued. For example, the pandemic has required health care systems to rapidly embrace telehealth, which offers considerable potential to reduce the travel‐related environmental footprint of health care.

Health care workers must respond to the environmental footprint of health care in an integrated way. As the experience of the NHS has demonstrated, such measures can also improve the budget bottom line.5