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Measuring greenhouse gasemissions in health systems Measuring greenhouse gas emissions in health systems ISBN978-92-4-011842-3(electronic version)ISBN 978-92-4-011843-0 (print version) © World Health Organization2025 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0IGO licence (CCBY-NC-SA3.0IGO;https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercialpurposes, providedthe work is appropriately cited, as indicated below. In any use of this work, there shouldbe no suggestion that WHO endorses any specific organization, products or services. The use of the WHOlogo is not permitted. If you adapt the work, then you must license your work under the same or equivalentCreative Commons licence. If you create a translation of this work, you should add the following disclaimer Any mediation relating to disputes arising under the licence shall be conducted in accordance with themediation rules of the World Intellectual Property Organization (http://www.wipo.int/amc/en/mediation/rules/). Suggested citation. Measuring greenhouse gas emissions in health systems. Geneva: World HealthOrganization;2025. Licence:CCBY-NC-SA3.0IGO. Cataloguing-in-Publication (CIP) data.CIP data are available athttps://iris.who.int/. Sales, rights and licensing.To purchase WHO publications, seehttps://www.who.int/publications/book-orders. To submit requests for commercial use and queries on rights and licensing, seehttps://www.who.int/copyright. Third-party materials.If you wish to reuse material from this work that is attributed to a third party, suchas tables, figures or images, it is your responsibility to determine whether permission is needed for thatreuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of General disclaimers.The designations employed and the presentation of the material in this publicationdo not imply the expression of any opinion whatsoever on the part of WHO concerning the legal statusof any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or The mention of specific companies or of certain manufacturers’ products does not imply that they areendorsed or recommended by WHO in preference to others of a similar nature that are not mentioned.Errors and omissions excepted, the names of proprietary products are distinguished by initial capital All reasonable precautions have been taken by WHO to verify the information contained in this publication.However, the published material is being distributed without warranty of any kind, either expressed orimplied. The responsibility for the interpretation and use of the material lies with the reader. In no event Contents Glossaryvii Guiding principles for health system emissions measurement23 Summary and next steps37 References51 Annex 1. Checklist: key milestones for high-emitting and high-ambitionhealth systems Acknowledgements This report was co-led by the Centre for Sustainable Medicine at the National Universityof Singapore (Singapore), Greener NHS, NHS England (United Kingdom of Great Britainand Northern Ireland) and the World Health Organization (WHO) Environment, Climate The co-leads were Nick Watts (Centre for Sustainable Medicine); Christopher Gormley(Greener NHS, NHS England); and Diarmid Campbell-Lendrum and Elena VillalobosPrats (WHO Environment, Climate Change and Health Department). This document was written by Thomas Andrew (Centre for Sustainable Medicine), HitenPatel (Greener NHS), Amy Savage (WHO Environment, Climate Change and HealthDepartment), Jit Sohal (Centre for Sustainable Medicine), Sammy Bishop (Greener NHS),Olena Zotova (WHO Environment, Climate Change and Health Department), Elizabeth The concepts behind the report were presented for discussion at several internationalworkshops, with participation of WHO country offices, representatives from ministries Gratitude is expressed to the following WHO and PAHO staff for their valuable input:Daniel Buss (PAHO Department of Social and Environmental Determinants of HealthEquity), Sally Edwards (WHO Asia-Pacific Centre for Environment and Health, WPRO),Mohamed Eissa (WHO Egypt Country Office), Ahammadul Kabir (WHO Bangladesh The co-leading organizations thank the following representatives who participated inthe Alliance for Transformative Action on Climate and Health (ATACH) task team onMeasuring greenhouse gas (GHG) emissions of national health systems and other Erlend T. Aasheim (Directorate of Health, Norway), Maria Sol Aliano (Health CareWithout Harm, Argentina), Nermeen Ashour (Egypt Health Authority, Egypt), Martijn vanBodegraven (National Institute for Public Health and the Environment (RIVM), Centre forSustainability, Environment and Health, the Netherlands), Tinia de Bruycker (NationalInstitute for Public Health and the