HEALTH AND SUSTAINABILITY

Hermes Wisdom.

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4.1. Healthcare and sustainability: a strategic link for the future

REPORTS & RESEARCH PAPERS
Edited by Victoria Giannetti

In recent decades, the concept of sustainability has progressively consolidated as a key paradigm for guiding political, economic, and social decisions. It can no longer be interpreted as simple environmental concern, but as a systemic and transformative process, in which value creation must integrate social responsibility, protection of natural resources, and intergenerational equity. The healthcare sector is in a particularly delicate position with respect to sustainability. While its primary mission is to guarantee a universal and fundamental right such as health, it is also responsible for significant environmental, economic, and social impacts. According to recent estimates, the sector contributes approximately 5% of global greenhouse gas emissions, a figure greater than that produced by civil aviation as a whole. Added to this are the high intensity of energy consumption, the production of hazardous and medical waste, and the complexity of supply chains, with direct impacts on management costs and community safety. The challenge is therefore twofold: on the one hand, reducing the negative impacts of a sector that by its very nature requires high resources; on the other, transforming the healthcare system into a driver of sustainable innovation.

On the environmental front, in addition to climate-altering emissions, it should be considered that 80% of the healthcare carbon footprint is linked to Scope 3, i.e., the production and supply chain of pharmaceuticals, medical devices, and services. This means that healthcare sustainability depends largely on the ability to rethink procurement and supply chain processes, encouraging suppliers to reduce their impact and rewarding the most innovative and environmentally friendly solutions. On the social front, growing critical issues are emerging related to staff well-being, burnout, equitable access, and inclusion. These aspects, if not addressed in a structured manner, risk undermining not only the quality of service but also the overall resilience of the system. Finally, governance appears crucial: healthcare organizations' leadership and management models must evolve towards ethical, transparent, and forward-looking approaches capable of integrating sustainability objectives into daily decision-making processes. This is not simply a reporting exercise, but a true cultural transformation that must permeate the entire organization.
The international landscape already offers significant examples. The British National Health Service has introduced stringent sustainability criteria in procurement, requiring suppliers to report and progressively reduce their emissions as a prerequisite for market access. This approach has transformed sustainability into a competitive factor, destined to become standard in other countries as well. In Italy, however, monitoring of healthcare companies' sustainability performance remains fragmented.

Recent studies highlight how only a minority of facilities transparently disclose their environmental data: just 7% report environmental initiatives, 8% publish energy consumption data, and 5,4% report emissions information. Even on the social and governance front, disclosure remains predominantly descriptive and geared toward regulatory compliance, lacking a real strategic framework. In this context, there is an urgent need for shared tools for sustainability planning, measurement, and reporting, leveraging specialized skills capable of translating ESG principles into consistent and measurable operational practices. ERMESSrl's commitment fits in with this direction. Through a structured program of support and guidance for Local Health Authorities, it fosters the dissemination of an organizational culture oriented toward ESG values ​​and provides concrete tools for monitoring, evaluating, and transparently communicating healthcare facilities' commitment to the community and their stakeholders. The proposed project is structured into clearly defined phases: from staff training to the analysis of existing policies and practices, and the evaluation of hospitals and healthcare districts through a customized KPI system. The outcome of this process is the production of an ESG positioning report and the development of operational guidelines, enabling local health authorities to integrate concrete actions—from energy efficiency to hazardous waste management, from strengthening internal welfare to inclusive leadership, from digitalization to sustainable supply chain management—into their long-term strategy.

This methodology has already been successfully tested in several healthcare systems in Campania: the local health authorities of Salerno, Caserta, and Napoli 3 Sud, with the support of ERMESSRL, have embarked on an innovative process of integrating ESG principles into their organizational and management processes, laying the foundation for a more sustainable, resilient healthcare system capable of generating shared value. This process went beyond mere analysis, producing concrete governance and guidance tools. Thanks to the preparation of a detailed ESG report, the healthcare organizations involved were able to access a true sustainability dashboard: a clear snapshot of their current status, highlighting strengths and critical areas, accompanied by operational guidelines. The recommendations aren't just on paper, but are translated into practical actions: energy and water consumption monitoring systems, protocols for sustainable healthcare waste management, structured organizational well-being and women's empowerment programs, One Health community-focused awareness initiatives, process digitalization, and the introduction of ESG criteria in purchasing and supplier accreditation. Each area has been accompanied by measurable KPIs and objectives.
Concrete, so as to make progress visible and verifiable over time. In this way, sustainability becomes not only a cultural value, but a management lever capable of guiding daily decisions and stimulating continuous improvement. The adoption of ESG criteria is not merely a formal requirement, but a strategic lever capable of reducing costs, improving the quality of services, strengthening relationships with communities and stakeholders, and positioning the public healthcare system as an example of innovation and sustainability.
Responsibility. Within this framework, ERMESSrl accompanies healthcare organizations on a transformative journey, fostering the transition from an abstract vision of sustainability to a structured, measurable integration capable of generating shared value. This approach not only addresses current challenges, but also prepares the sector to resiliently address those of the future.