How to make healthcare more sustainable

13 Aspects of Sustainable Healthcare

13 critical factors to be considered for a sustainable healthcare system 

Healthcare stands as one of the most critical sectors worldwide, yet hundreds of millions of people still lack access to essential health services. Sub-Saharan Africa and Southern Asia, in particular, face significant challenges in this respect. High healthcare expenses often deter individuals from seeking help for serious and chronic diseases. Nevertheless, investing in the healthcare industry to develop human capital is crucial for sustainable economic growth.

Establishing a robust health financing system is paramount for individuals grappling with financial constraints. This effort should be coupled with enhancements in healthcare infrastructure and workforce development, including medical professionals, to ensure the delivery of essential health services accessible to all.

Health challenges persist due to unavoidable factors such as disasters, mass migration, conflicts, climate change, global pandemics, and pollution. Additionally, unhealthy lifestyles, habits, and aging populations further compound these challenges. Both public and private health organizations are addressing these issues and underscoring the importance of implementing sustainable mechanisms that facilitate real-time feedback.

Building a healthcare system founded on sustainability not only ensures access to quality healthcare but also minimizes environmental damage and contributes to overall well-being.

Sustainable healthcare encompasses a multitude of facets, spanning from prevention to the delivery of care, and involves numerous stakeholders, including patients, healthcare providers, pharmaceutical companies, and policymakers. Here, we outline thirteen critical aspects of sustainable healthcare that must be considered and improved to ensure sustainable global health:

1. Preventive Care

This is a foundational aspect of sustainable healthcare. Efforts should be directed towards preventing diseases and promoting healthy lifestyles, as this is more cost-effective and results in better health outcomes. In smaller populations, effective methods to inform and change behavior can be successfully studied, as demonstrated in Iceland.  Over two decades, a program tailored for adolescents reduced the percentage of 15-16-year-olds drinking alcohol from 42% to 5%, and smoking from 23% to 3%.

The biggest impacts on preventive health measures are well-known. Factors such as excessive consumption of unhealthy food (e.g., processed food with high sugar, fat, and salt), lack of exercise, smoking, and alcohol are the main causes of "civilization diseases" like heart attacks, strokes, diabetes, and lung cancer, which pose significant costs to society and individuals. No treatment will ever be as sustainable as prevention. Education and technology will be crucial to support the necessary behavioral changes.

The challenge is urgent. For example, the global population with diabetes is expected to rise by 51%, from 463 million people (9.3%) to 700 million (10.9%) by 2045, primarily in cities and richer countries. We need more pilot projects to improve people's health behavior and better global best practice sharing about what works and what doesn't.

2. Accessible Care

Healthcare should be universally accessible, ensuring that no one is left behind. This includes providing care to the most vulnerable populations and those living in remote or underserved areas. From a population health perspective, low-level primary care is much more important than high-end specialized treatment for improving overall life expectancy. Many diseases can be effectively treated with low-cost medications, such as those for high blood pressure. Therefore, it is crucial to have accessible primary care to detect and treat many common health problems. Technology, such as AI, sensors, and tests, will be a great help in lowering costs and making care more accessible.

3. Affordable Care

Cost is a major barrier to healthcare for many people. Sustainable healthcare should be affordable to all, irrespective of their economic condition. With scientific progress, more diseases will become treatable and even curable, leading to rising costs, no matter how well-designed the health system might be. The challenge remains to make the “biggest bang for the buck,” i.e., to implement metrics for rational decisions on where to allocate scarce resources best. New treatments are always more expensive, and sufficient funding is needed for pharmaceutical companies to invest in further research. Often, this means a trade-off between rising costs in the short run and potentially better treatments in the long run, which will become affordable after patent expiration. The way of the “blockbuster” drugs shows that they make pharma companies wealthy for a while and then lead to cheap generics that can improve healthcare for all in need. In some cases, such as new genetic treatments that might cure diseases like sickle cell, the costs may be high in the short run yet offer great promises in the long term. A combination of governmental policies and competitive elements delivers the best results, clearly showing that free trade alone cannot be successfully applied to healthcare.

4. Quality of Care

Alongside accessibility and affordability, maintaining high standards of care is essential. Quality of care encompasses effective, safe, and people-centered services. Implementing clinical practice guidelines and protocols, quality improvement initiatives, and patient safety programs is crucial. The biggest impact will come from applying principles of evidence-based medicine. To gather more "real-world evidence," data from various sources such as patient feedback, behavior, sensors, tests, and genetic information need to be used. The challenge is to determine what works best, rather than relying on biased tradition or experience. Quality has two aspects: how the treatment is perceived by the patient (patient experience) and how well it works from an evidence-based, statistical, and economic viewpoint. Both aspects must be developed further, and technology will be crucial. AI will not replace physicians, but few will work in the future without its support to make the best possible treatment decisions.

5. Healthcare Workforce

Investment in a skilled, motivated, and well-distributed healthcare workforce is crucial. This includes doctors, nurses, and other healthcare professionals. One of the key challenges is that work in healthcare is often harder and less well-paid than in other fields. There is a lack of healthcare personnel in most countries, largely due to the lower attractiveness of day-to-day work. While working in healthcare has a high reputation, employee satisfaction is often far from sustainable levels. There are many aspects to address this issue—often, what people want is a better work-life balance rather than having to make sacrifices that seem inevitable, such as working more than 50 hours per week, as 50% of US doctors do. AI, telemedicine, process improvements, and better working schemes are urgently needed to reduce the non-patient-related work, which comprises the biggest part of the daily schedule.

6. Technology and Innovation

The use of digital technologies, AI, and data analytics can improve diagnostics, disease management, patient monitoring, and supply chain management. Using Artificial Intelligence (AI) for precision medicine, Big Data for epidemiological studies, or Internet of Things (IoT) devices for remote patient monitoring are just some examples of how technology will make healthcare more efficient and, thus, more sustainable. 

7. Pharmaceuticals and Medtech

Access to essential medicines, vaccines, and medical technologies is a key aspect of sustainable healthcare. Collaboration with pharmaceutical companies and medtech industries is important in this context. Emphasizing on Research & Development (R&D) for neglected diseases, ensuring the availability of Essential Medicines as per the WHO list, and encouraging innovation through technology transfer agreements or Public-Private Partnerships (PPP) are key aspects to support sustainability from a global health perspective. The recent initiative of the German biotech company BioNTech to provide local vaccine production "BioNTainers" to Rwanda is a lighthouse example of supporting underserved areas with vaccines.

8. Healthcare Infrastructure

Infrastructure such as hospitals, clinics, and labs should be evenly distributed, well-equipped, and efficiently managed. This also includes robust telemedicine capabilities. Building Health Information Systems (HIS) or Electronic Health Record (EHR) systems, optimizing healthcare logistics through Supply Chain Management (SCM) solutions, and creating smart hospitals are essential. As hospitals are the most resource-intensive treatment options, home or local care options, cooperating in a network with specialized clinics, are the preferred pathways. Hospitals will rely on energy efficiency with better-monitored infrastructure technology, focusing especially on heating and cooling, security, and flexibility, as well as optimized information delivery and monitoring from a cockpit perspective tailored to each user role, from hospital managers and doctors to patients and technical staff.

9. Environmental Sustainability

The healthcare sector itself should reduce its environmental footprint. This includes sustainable procurement, waste management, energy use, and supply chain practices. Implementing Green Health initiatives, reducing carbon emissions in line with the UN Sustainable Development Goals (SDGs), and using Life Cycle Assessment (LCA) to evaluate the environmental impact of healthcare products and services are important. 

10. Healthcare Financing

Efficient, equitable, and sustainable financing mechanisms are needed to fund healthcare services. This could involve various strategies like public-private partnerships, insurance schemes, or innovative funding models. Instituting mechanisms such as Performance-Based Financing (PBF), or innovative funding models like Social Impact Bonds (SIBs), long-term value partnerships, or  blended finance mechanisms are important. Exploring health insurance models, such as community-based health insurance, and decentralization schemes as seen with the NHS or the Danish model, to build new “superhospitals” can be a way forward. 

11. Integrated Care

An integrated, patient-centered approach that coordinates care across different levels and providers can significantly improve outcomes and efficiency. Developing coordinated care models such as Accountable Care Organizations (ACOs) or Patient-Centered Medical Homes (PCMH) can be instrumental in implementing care pathways and transition-of-care models for chronic conditions.

12. Health Literacy

Educating individuals and communities about health and healthcare can empower them to take charge of their own health and make informed decisions. Implementing health education programs that apply principles of the Health Belief Model (HBM) or Theory of Planned Behavior (TPB) is essential. Promoting digital health literacy in the age of eHealth and mHealth can be effectively achieved by utilizing the possibilities of digital interactions and AI.

13. Policy and Governance

Good governance, robust policy frameworks, and strong regulatory systems are crucial for ensuring all other aspects of sustainable healthcare. Ensuring policy coherence through Health in All Policies (HiAP) approach, and enforcing strong regulatory systems such as Good Manufacturing Practices (GMP) in pharmaceuticals or Quality Management Systems (QMS) in healthcare organizations are essential. Key aspects of sustainable health will be driven and influenced by governmental bodies e.g. on an European level (e.g. European Green Deal), US, Chinese or Indian level, influencing smaller countries and fundamentally improving health for their citizens. 

Based on these aspects, it is evident that building and maintaining sustainable healthcare systems is necessary for addressing global health challenges effectively. From preventive care and accessible services to technological innovations and environmental sustainability, there are various challenges to face along the way.

Adapting new technologies and digital solutions in the healthcare industry will surely make our lives more efficient and reduce wasted time and resources, resulting in better healthcare systems. Efficient and equitable healthcare financing mechanisms, coupled with strong policy frameworks and governance structures, are fundamental for sustaining healthcare systems in the long term and ensuring that they remain resilient in the face of evolving health challenges.  

The path towards sustainable healthcare demands collective commitment and strategic action. By prioritizing prevention, accessibility, and innovation, we can build resilient systems that promote health equity and environmental stewardship for future generations.  

Industry experts

Please reach out to our experts for more information.
Dr. Leander Fortmann
Dr. Leander Fortmann
Global Consulting Expert Life Sciences & Healthcare
Sebastian Herrmann
Sebastian Herrmann
Global Consulting Head Life Sciences & Healthcare
Christian Neumann
Christian Neumann
Global Consulting Head Sustainability Business