Clinical Leadership and Integration of Triple Bottom Line for Planetary Health
Authors: Alamgir Wasim , Shan Hina 
Published: August 2023

The accelerating global concern of climate change and its link with human health requires sustainability to be a crucial part of healthcare quality. The protection of planetary health in the context of ecological and social determinants of health require the integration of all aspects of health services including the professionals, management, and administration. Clinical health professionals particularly hold a critical position in this scenario, as they are mandated to protect individuals and communities from diseases caused or accelerated by environmental factors. Therefore, to combat the negative impacts of climate change on human health, the trusted voice of clinicians needs to be raised for communicating climate risks and solutions to patients, the public, and policymakers.

Medical colleges’ curricula and continuing education programs require an alignment of climate and health education.  This will equip future and current health professionals with skills for planetary health, regardless of their area of health focus. Clinical teaching and training with an updated medical education curriculum focusing on prevention; self-care; patient empowerment; lean service delivery such as community-based interventions; minimizing waste of medications and consumables, and low carbon emission alternatives is imperative to health service’s contribution in enhancing the quality of ecological sustainability.

It has been documented that if the healthcare sector is ranked as a country, it would be the 5th largest CO2 emitter in the world with 4.4% global net emissions of greenhouse gases.1 The WHO has recently reported that 60% of healthcare facilities in the global south are ill equipped to handle existing waste loads. The healthcare community, clinicians, and hospital management are well-placed to play a vital role as change agents with Health in All Policies approach by protecting health during the current climate crises. An eco-friendly, equitable, interprofessional, and transdisciplinary approach is required to create a resilient healthcare sector that works harmoniously with nature while coping with increasing disease burdens and challenges to healthcare infrastructure.

The triple bottom line is a holistic framework that helps organizations consider the environmental, social, and economic costs of their actions.2 In a healthcare setting, triple bottom line incorporates environmental and social impacts with patient-based outcomes and financial costs to measure the sustainability of healthcare interventions and services.2 It is an approach to reduce the adverse effects of healthcare delivery on the environment by incorporating improved sustainable quality and resource stewardship. The overall sustainable value is measured when the patient-based outcomes comprising utilization of a system, service, or process in healthcare are weighed against the “planet, people, and profit”.

In conclusion, embedding sustainability principles, core knowledge, and practice in health professional expertise; the voice of clinicians in advocacy and policy to minimize healthcare sector greenhouse gases and ecologic footprint; and cross-sectoral solutions to the climate crisis are the only way forward for sustainable healthcare and the planet.

Editor-in-Chief