Exploring the Carbon Footprint of Healthcare

Healthcare exists to protect human health, yet the same industry is also one of the most emissions-intensive sectors in the global economy. The global healthcare sector generates roughly 5% of the world's greenhouse gas emissions—that’s even more than aviation. If healthcare were a country, it would be the fifth-largest emitter on the planet. The sector is being asked to resolve a contradiction at the heart of its own mission, and regulators, procurement teams, and health systems globally are starting to force the issue. 

This guide covers where healthcare’s emissions actually sit, what the world's most advanced healthcare decarbonisation programme already requires from suppliers, and what organisations operating in or supplying to the sector need to do next.

Where healthcare emissions actually come from

The answer surprises most people who haven't looked closely at the data. Emissions from generating electricity make up around 40% of healthcare's climate footprint. Hospitals are among the most energy-intensive buildings in the economy, running continuously, at controlled temperatures, with high-dependency equipment that cannot be switched off. Most organisations already know this. What most have not yet addressed is where the rest of the footprint sits. According to the OECD's 2025 analysis, hospitals account for around 30% of health sector emissions on average across OECD countries, but the supply chain is where the real majority sits. Nearly four-fifths of all emissions associated with the health sector can be traced back to supply chains across OECD countries, pharmaceuticals, medical devices, chemicals, logistics, and facilities management. 

Healthcare is a service sector and does not manufacture goods directly, which leads many organisations to assume their footprint is modest. However, healthcare supply chains are extensive, meaning Scope 3 emissions are significant. The NHS is the most studied example in the world. In 2019, the NHS Carbon Footprint Plus totalled 25 megatonnes of CO2e, of which 62% came from the supply chain. Supply chain emissions were dominated by pharmaceuticals and chemicals, which accounted for 32% of the total, and medical equipment, which accounted for a further 19%. Direct delivery of care – the wards, theatres, and clinical operations most people associate with NHS emissions, accounted for just 24%. These figures come from a 2021 study published in the Lancet Planetary Health, the first comprehensive carbon footprint analysis of a national health system, which found that the NHS's total emissions in 2019 were dominated not by clinical activity but by what it buys.

That split matters enormously for anyone supplying healthcare. The majority of the sector's decarbonisation challenge does not sit inside hospitals. It sits in the organisations that make and deliver what hospitals use.

The NHS: The world's most advanced healthcare decarbonisation programme

In 2020, the NHS became the first national health system in the world to commit to net zero. The targets are structured around the emissions split: net zero by 2040 for the emissions the NHS controls directly, and net zero by 2045 for the emissions it influences through its supply chain.

With more than 60% of its footprint sitting in Scope 3, decarbonising procurement is the primary lever. The NHS Net Zero Supplier Roadmap is the mechanism for driving this through the supply chain, and it is already in effect. The milestones are binding:

• From April 2022, all NHS procurements include a minimum 10% net zero and social value weighting. 
• From April 2024, Carbon Reduction Plan requirements have been extended to cover all new procurements.
• From April 2027, all suppliers will be required to publicly report targets, emissions, and a Carbon Reduction Plan covering global Scope 1, 2 and 3 emissions. 
• From April 2028, new requirements will be introduced covering carbon footprinting for individual products supplied to the NHS. 
• From 2030, suppliers that cannot demonstrate progress through published reports and continued carbon emissions reporting will no longer qualify for NHS contracts.

Progress on direct emissions has been meaningful, but the harder work is driving reductions through the supply chain. NHS Supply Chain alone works with around 1,500 suppliers across its frameworks, and the wider NHS procurement base extends far beyond that. Engaging that base at scale is the challenge that defines the next decade.

The global picture: Sustainability in healthcare is accelerating

Commitment is building, but delivery lags

The NHS is the furthest along, but it is not alone. Health systems account for over 4% of total greenhouse gas emissions in OECD countries, and as populations age and demand for healthcare rises, the sector's environmental footprint is likely to grow without policies to address the issue. Following in the footsteps of the NHS, over 40 countries have set their own net zero targets for their healthcare systems, and more than 90 countries have committed to deliver low-carbon, sustainable health systems.

At COP26, 52 countries signed commitments to develop climate-resilient, low-carbon health systems. That initiative has since grown into the Alliance for Transformative Action on Climate and Health (ATACH), which now brings together over 100 countries and areas working to turn those commitments into action.

The gap between ambition and infrastructure remains wide. Many health systems have committed to targets without yet putting the procurement mechanisms, data requirements, or supplier engagement programmes in place to deliver them. That gap will close, and when it does, it will close through supply chain pressure, not just internal operational change.

How other health systems are structuring their programmes

In January 2024, Danish Regions published a national strategy for sustainable hospitals, with all Danish regions committing to a common goal: reduce hospitals' consumption-based CO2 emissions by 50% by 2035 compared to 2022, and achieve net zero before 2050. The strategy explicitly identifies procurement as a primary lever, committing to use targeted procurement activities to stimulate and encourage suppliers and markets to deliver green and sustainable products. This makes Denmark one of the first countries to embed supplier pressure directly into a national hospital sustainability strategy.

In the Netherlands, the National Green OR Network – backed by 16 scientific and professional associations, has developed the Green OR Barometer, a measurement tool designed to give hospitals insight into the environmental impact of their operating rooms, intended for rollout across all hospitals in the country. This sits alongside the Netherlands' Green Deal on Sustainable Healthcare 3.0, which has expanded to include the pharmaceutical industry, with over 200 hospitals and care institutions signed up and a target to reduce emissions by 55% by 2030 and reach net zero by 2050.

Norway has adopted both an overarching emissions mitigation target for the health sector and eight more detailed sub-objectives aimed at reducing emissions and the broader environmental footprint of the health sector while improving health outcomes. In Austria, a greenhouse gas calculator is being developed by the Competence Centre Climate and Health, enabling healthcare facilities to estimate emissions using a standardised approach that will allow consistent national reporting. Over 300 institutions have signed up for voluntary consultancy support on facility-level decarbonisation.

In Ireland, the Health Service Executive completed a full GHG emissions baseline and decarbonisation roadmap in 2025, developed in collaboration with Health Care Without Harm Europe, outlining the governance, data, and supplier engagement steps needed to transition to net zero by 2050.

What this means for healthcare suppliers

If you supply to any major healthcare system, the carbon performance of your operations and supply chain is already a commercial requirement, or is becoming one on a fixed timeline. Carbon reduction plans covering Scope 1, 2 and 3 emissions are now a condition of procurement across leading health systems. Suppliers that cannot demonstrate credible measurement and a reduction plan are being excluded from contracts today, not at some future milestone.

The direction of travel is consistent across markets: full global emissions reporting, followed by product-level carbon footprinting, followed by contract eligibility linked to demonstrated progress. Health systems that have not yet mandated these requirements are moving toward them. The procurement pressure being applied by the most advanced systems today is the model others are following.

For most suppliers, Scope 3 emissions make up the majority of their footprint, and building a credible, auditable inventory takes time. Engaging suppliers for data, establishing defensible methodology, and creating a net zero strategy is not a task that can be completed in weeks, so it's best to start on this today.

Where suppliers should start

1. Establish your emissions baseline. You cannot build a credible carbon reduction plan without knowing where your emissions sit. Start with Scope 1 and 2, then prioritise the Scope 3 categories most material to your operations, for most healthcare suppliers, that means purchased goods and services and upstream transportation.

2. Map the reporting requirements of your key customers. Leading health systems already require carbon reduction plans as a condition of procurement, with global emissions reporting and product-level footprinting following on fixed timelines. The NHS milestones are the most specific currently in force and a reliable proxy for where other systems are heading. Know your customers' timelines before they become urgent.

3. Build your supplier engagement process. Full Scope 3 reporting means data from your suppliers, not just your own operations. That takes time to collect accurately. Start outreach early, use structured templates, and treat supplier engagement as an ongoing programme rather than a one-off request. Health systems are increasingly scrutinising the credibility of supply chain data, not just whether it exists.

4. Make your carbon reduction plan future-proof. Build it to absorb increasing requirements without needing to be rebuilt from scratch. That means global emissions coverage from the start, a clear reduction trajectory, and methodology that holds up to procurement scrutiny across multiple customers and jurisdictions, not just one health system.

Building the sustainability infrastructure healthcare requires

Building a credible carbon programme for healthcare procurement is not a one-time exercise. Requirements are tightening on a fixed timeline, and the organisations best placed to meet them are the ones that have already built the infrastructure: granular Scope 3 data, structured supplier engagement, and reporting that holds up to scrutiny.

Zevero helps organisations get there. Talk to our team to find out where to start.