Executive summary
Primary health care (PHC) is essential for delivering equitable, accessible and continuous health services — particularly in times of crisis.
Robust infrastructure systems are foundational to enabling PHC and ensuring health systems can function effectively during health emergencies. Yet, these same infrastructure systems are increasingly vulnerable to climate shocks, and the health care sector contributes to accelerating climate change, making up 4.4% of total global emissions.1
Health facilities generate environmental waste and pollution, including greenhouse gases and other harmful substances that may be infectious or toxic, posing risks to healthcare workers (HCW) and communities. Although most emissions generated in the health care sector (~70%) are attributed to supply chain goods and services, there has been increasing focus on carbon hotspots in secondary and tertiary facilities.2
Accordingly, initiatives to reduce the health care carbon footprint are mainly focused on hospitals and larger health facilities in high-income countries that contribute the largest share of emissions and do not consider PHC facilities in resource-constrained settings. The sheer number of PHC facilities (>2M globally) underscores the need to prioritize PHC systems for targeted improvements to lower emissions. PHC systems in resource-constrained settings offer a unique opportunity for climate-smart innovation with smaller footprints and locally appropriate designs, that need to be supported and scaled.3
As climate change is increasing the frequency and intensity of climate-related shocks, there has been growing attention on climate adaptation and mitigation to reduce damage to critical health infrastructure.
The World Health Organization (WHO) recently published a comprehensive overview of resources for HCW safety, health facility resilience, and sustainability. WHO found that while there are numerous resources on climate-resilient4 and environmentally sustainable health care facilities, and separately on PHC and infection prevention and control (IPC), the guidance is siloed and divergent. Thus, there is an urgent need for integrated solutions to address these overlapping and competing priorities at the PHC level.
To address this challenge, Jacobs and RTSL are partnering in a new public-private partnership to develop a model for epidemic-ready, climate-resilient, and sustainable PHC infrastructure.
Building on RTSL’s expertise in PHC and IPC, and Jacobs’ expertise in climate-resilient tertiary care construction and engineering, we are focused on collating evidence-based recommendations and practical actions that will lay the foundation for climate-epidemic health, to develop a model for climate epidemic-ready PHC infrastructure.
Everyone has a role to play in building forward better.
We urge national governments to embed resilience into health and infrastructure planning. We call on donors to support integrated, scalable investments and help countries learn from what works. And we encourage facility leaders and communities to codesign and implement local solutions. Only through integrated action can we build PHC systems that are prepared, equitable and truly resilient.